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How to Prevent Frozen Shoulder (Adhesive Capsulitis)

One of the most common and preventable physical health challenges that I have treated over the years is called frozen shoulder, also known as adhesive capsulitis. Even if you don't currently have a problem with your shoulders, I highly recommend that you read this article in its entirety, as the guidelines provided below can help you maintain healthy shoulders and prevent a wide variety of physical ailments of the shoulder and upper back regions.

Frozen shoulder is characterized by a gradual stiffening of the shoulder region. Women first tend to notice that they have difficulty fastening a bra and brushing their hair. Men first tend to notice that it is painful to put their hands in their back pockets or to comb their hair.

Although frozen shoulder is sometimes classified as being idiopathic in nature i.e. without a known cause, my experience has been that there are three major causes of the progressive capsular tightening that characterizes this condition:

Lack of Use of Your Shoulder Complex

Your main shoulder joint (glenohumeral joint) is surrounded by several ligaments and tendons that are meant to provide the joint with enough stability that it doesn't easily dislocate, but also with enough flexibility that you can use your arms for a wide variety of activities.

If you don't put shoulder complex through a wide range of motion on a regular basis through everyday activities and exercise, the ligaments and tendons in this area won't receive an optimal supply of blood for nourishment and removal of waste products. Over time, lack of optimal blood circulation to these ligaments and tendons can cause them to tighten up.

Poor Biomechanics of the Shoulder Complex

Your shoulder complex includes your main shoulder joint, your clavicle (collar bone), breast bone (sternum), shoulder blade (scapula), and upper back (thoracic and cervical spinal regions). All of these areas need to function properly for fluid arm movement.

For example, hunching over in front of the computer for several hours a day can create an alteration in the alignment of your shoulder blade and upper arm bone, which can put significant stress on the ligaments and tendons that surround your shoulder complex. Over time, this stress can cause a mild to severe degree of inflammation in the region, which can lead to scar tissue formation and shoulder stiffening.

Autoimmune Response

Emotional stress, a diet that includes plenty of highly processed foods, a weak digestive system, and a genetic predisposition for autoimmune activity can cause your body to eventually damage your own tissues, including those that surround your shoulder complex. Repeated injury of any kind to your tissues will invariably lead to scar tissue formation, which can contribute to capsular tightening in your shoulder.

Here are some simple steps that you can incorporate into your daily life to dramatically reduce your chances of developing frozen shoulder as you age:

Stretch Your Shoulders

To stretch the entire shoulder region, take a towel in your right hand and hold it behind your head as though you are holding a long back scratcher.

Wrap your left arm around your left lower back so that the bony side of your left hand is against your left lower back, just as a lady would begin to reach around to fasten her bra. In this position, your left hand should be able to easily hold onto the bottom of the towel.

Once both hands are firmly holding onto both ends of the towel, use your right hand to slowly pull up on the towel until you feel a good stretch in your left shoulder. Hold this stretch for about 30 seconds and make sure that you don't stop breathing. Then, slowly pull down on the towel with your left hand until you feel a good stretch in your right shoulder. Hold again for 30 seconds and maintain steady breathing.

Repeat the same routine on the other side, with your left hand holding the top of the towel and your right hand holding the bottom.

Strengthen the Tendons Around Your Shoulders

There are many ways to strengthen the tendons that surround your shoulders, but the single best method that I know of is to hang on a bar. This may sound easy, but hanging on a bar for more than about 30 seconds is harder than most people imagine. Hanging on a bar for even 5-10 seconds a day can dramatically improve the strength of the tendons that surround your shoulders.

If you can't support your body weight on a bar, find one that is at a height that allows your feet to be on the ground so that you can use your legs to give you some help.

For optimal results, flex your elbows ever so slightly to increase the amount of tension on your shoulder tendons.

The position of your hands can vary from day to day. Having your palms face forward will strengthen mainly the tendons that are at the front of your shoulder complex. Having your palms face backward will strengthen mainly the tendons that are at the back of your shoulder complex. And having your palms face each other (if you can find monkey bars or rings that allow you to do this) will strengthen the entire region equally.

Stretch Your Spine

In order for the main joint of your shoulder complex to move properly, it is essential to have a healthy upper back region, one that isn't slouched forward.

To combat the natural tendency to hunch forward at a desk, at least once per day, perform a stretch that allows your spine to be pushed forward. The best such stretch that I know of is to take a pillow and put it length-wise on the ground or on your bed, lie back on the pillow so that your bum hangs off the bottom of the pillow, your head hangs off the top and your arms are allowed to fall off the sides of the pillow to rest on the ground. If you don't feel that your mid and upper back are being stretched forward while you're in this position, add another pillow to increase the height of your arch. Rest in this position for as long as is comfortable, up to 15 minutes each evening.

For more guidance on this stretch, view:

How to Stretch the Mid and Upper Regions of Your Spine

Include Vitamin D and Friendly Bacteria in Your Diet

Whether you have a genetic predisposition to developing autoimmune activity in your body or not, including reliable sources of vitamin D and friendly bacteria in your diet can significantly strengthen your immune system and decrease your risk of developing conditions that have an autoimmune component, frozen shoulder included.

Eat Mainly Minimally Processed Foods and Adopt Healthy Eating Habits

In the event that you do have a genetic predisposition to developing autoimmune activity in your body, it is critical for you to adopt a minimially processed, plant-centered diet and eating habits that promote a healthy digestive system.

Genetic predispositions do not have to be expressed and can actually stay dormant for your entire life if you consistently eat healthy foods in a healthy way.

The real key to adopting any new lifestyle habits is to have enough motivation to do so.

Having pain and stiffness in your shoulders to a point where you can't perform activities of daily living is not something that you want to add to your list of life experiences.

Whether to address an existing case of frozen shoulder or to prevent frozen shoulder from developing, I hope that the suggestions provided in this post prove to be useful.

 
 

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Great Insight

12.75

Very informative article that most definitely caught my eye. I've been suffering from pain in my right shoulder for six years now, and just finally went to a doctor. My diagnosis was: bursitis. I must look into physical therapy as I do not like the notion of cortisone shots.

I plan to apply these simple steps to also help prevent any other conditions as I age. Thanks yet again for such a helpful article.

- Sarah in Arizona

shoulder

I was frozen for 4-6 months, and then started swimming.
At first I was was weaker on one side, but the pain and stiffness disappeared in about 2 weeks. Swimming 1/2 mile 4x/week in a lake.

Frozen Shoulder Mystery Solved

12.75

Dear Dr Kim,

Thank you so much for this article. I now believe that I have 'frozen shoulder', something two chiropractors have been unable to clear up for me and have been found a bit mystifying. My problem lies in having a frozen shoulder blade making it nearly impossible for me to reach over my shoulder or behind my back with my right hand. I am a full-time fine artist and felt that many years of standing all day at my easel with paint brush in hand was the cause of this. I also have psoriatic arthritis (autoimmune) but have kept it in remission with proper eating (as you've suggested). After reading this article I do believe that you've solved the mystery for me. Thanks, again, I will certainly try these exercises.

to prevent a frozen shoulder

12.75

dear doctor Kim,
i like your messages very much and very often i send them through to my clients (i have a practice on physical activity and health)
as you said, you are always too late: the frozen shoulder will appear suddenly, unexpected. so prevention is not done. only people who are training regularly don't have a hogh risk to get a frozen shoulder except by accident.
when it is clear diagnosed you could visit a bowen therapist (i have seen amazing results after only 2 or 3 treatments) and apply some times a day pepperbalm, capsaicin. in my experience that is the best solution.
thanks for your attention and i hope you will tell it your audience.
kind regards
nico cok
culemborg
the netherlands

Don't forget that

Don't forget that therapeutic massage care by a well-trained, licensed and Nationally Certified Massage Therapist (for US clients) is also an excellent form of prevention and treatment of adhesive capsulitis!

Frozen shoulder article

12.75

Thank you so much for this article! I can speak from personal expeience that this is one of the most painful conditions I've ever encountered. I first "woke up" with a frozen left shoulder in April of 2008. Besides having limited mobility (could not raise my arm above my chest, the pain was excruciating. I sought help in both traditional and alternative therapies. The traditional advised intense physical therapy, 3x/week for 6-8 weeks. The physical therapist insisted that additional stretching every day was also critical to my recovery. Made sense, but the only problem was...it was very painful to do the sretches, so consequently, I didn't do them as often or as intensely as was recommended. But I did go into the PT office regulary. I was also seeing a chiropractor and a massage therapist at the same time. Not seeing much improvement, I went to an orthopaedic specialist who advised another round of PT, and if not successful, the only medical treatment was forced manipulation under anesthesia. In other words, putting me under and forcibly pushing my shoulder "back to normal". Well, the thought of anesthesia was scary enough, but the clincher was that there was no guarantee it would "hold", and that the recovery was even more painful. (can you tell I'm a wimp when it comes to pain?!) And, as a subscriber of Dr. Ben Kim's newsletter, obviously I attempt to follow a more natural approach to healing and there was nothing natural about this procedure. Even though, many loved ones thought I should just bite the bullet and get it done, I knew in my heart there had to be another way. So my quest continued.
(We are now into late summer, early fall of 2008.)

I did not return to PT. I talked to everyone and anyone who would listen about my situation. I am fortunate to work in the whole food nutrition field so I am exposed to many health care practioners and modalities. I decided my next step was to try accupuncture. After less than 5 sessions, my pain was completely gone. That was a HUGE breakthrough, and, I couldn't have been more grateful. I could now sleep through the night. I had improved mobility to the point where I could now close my car door with my left arm instead of reaching across with my right arm, and could use my arm to do other "little" daily actions that we often take for granted and don't realize that we do until we can't do them. So, I returned to a somewhat normal existence. Now all that remained was return to full mobility. I began working with another chiropractor
in conjunction with accupucture. He was instrumental in the final break-through, literally...and without anesthesia! By April of 2009...exactly one year after it became frozen, my left shoulder was returned to 99% normal. My right arm can still stretch a few inches farther back than my left, but hey...compared to what it was, I'll take it!!!

My purpose of this long-winded comment is many-fold...first and foremost to encourage everyone to listen and heed Dr. Kim's advice and do the exercises!! Prevention is easier and much less expensive than treatment( this applies universally) Not to mention, the precious time that is wasted dealing with a situation that could have been prevented...in my case over one year of my life!! Secondly, listen to your body and trust your instincts. I have learned that the body is an amazing machine and given the right tools it has the capacity to heal itself. Explore all possible options before you surrender to surgery or other invasive procedures. And thirdly, just as with any other profession, health practictioners come with different levels of skills, abilities and philosophies. If you are not having success with your chiropractor, for instance, don't assume chiropractic isn't working. My son is currently on his third chiropractor in an attempt to eliminate his backpain. Third one must be the charm because he has had amazing results. Coincidentally, it's the same DC who helped heal my shoulder. So,the lesson is... never give up or give in.

Best of health to all,

Mercedes

Frozen Shoulder

Thanks for the encouragement. I have been suffering with a frozen shoulder since June. I have eliminated 60 to 70% of the pain with a frozen shoulder workbook that deals with trigger point therapy. I am going to try Physical therapy but I am very cautious and concerned they well try to push thur the pain. I'm not into that. I will continue to search for a chiropractor and possibly a acupuncturist . Thanks again for your success story!
Gayle

Dear Mercedes, I, too have a

Dear Mercedes,

I, too have a frozen left shoulder. This is the second time it happened the first being on the right shoulder. I just had an x-ray and after an Orthopedic Doctor took a look at my xray, he said that I had Adhesive Capsulitis which is another name for Frozen Shoulder. I asked him about accupuncture and he seems not to believe in it. But after reading your story, I think I am prone to go to an accupuncturist. Although, I wouldn't know it this will affect my blood pressure since I am on maintainance medicines. I'd really like to take this step since I am in pain, couldn't even get a really restful sleep at night. I hate taking painkillers as I know it is not too good for the livers and kidneys.

Thank you for sharing your story.

Hope I get around taking that step to go to the accupuncturist.

Sincerely,

Veca

frozen shoulder

Hi. I too am on my second frozen shoulder. The first was five years ago on my right side and now my left one is the problem. When my first one started my doctor told me that we could treat it and it would get better in about twelve months or leave it alone and it would take a year. However he did send me to the physiotherapist and I went and did all I was told, however painful, until one day the therapist told me not to come back as I was still getting worse and we weren't doing any good. So, from then on I left it alone until gradually I was able to move it normally again. I remember well the day I showed my husband how I could again tie my apron up behind me instead of tying it in the front and spinning it around. And now I wait for this one to get better and the best thing I can say is that I know it will. Unfortunately I am still only four months into it and it is very painful and makes sleeping very difficult. Everyday I discover new things that I can't do with my left arm that I have taken for granted. I am looking forward to the turning point.

Frozen Shoulder

I, too, suffered from Frozen Shoulder. However, I DID go through with the operation to have it manipulated while under, and also cleaned out. The doctor did the procedure in early April - and now, in December, I am still having problems with it. Talking to others who have had Frozen Shoulder, almost all of them told me - whether I go through with the operation or not - it takes 12 months to clear up and thaw. So, I have another few months to go. It has been excruciating - and one of the worst experiences of my life. Now, my other shoulder is in the beginning stages of Frozen Shoulder. I'm going to use Dr. Kim's suggestions - but also try acupuncture as I've heard from many that it worked.

Thanks Dr Kim, I had frozen

Thanks Dr Kim,

I had frozen shoulder for the better part of last year and it's gradually got better. Now I am feeling things aren't right in the other shoulder! I would hate to go through this lack of motion and physical impairment AGAIN. I'm glad I found your article, and am sure that it's the lack of mobility and strength that I need to work on. I'm off to find a bar to hang on to :)

frozen shoulder

I suffered for over 20 years off and on with a frozen shoulder. finally it stayed that way for six months. The local Chiropractors could only provide a little relief. On referred me to an old Osteopath. After viewing my Xrays and giving me a full physical and history she said, "You did it first playing H.S. football and never got it cared for properly. I can take you into surgery and chop it loose or I can manipulate it loose, put you on a cleansing diet and keep working it into alignment as it heals.

The surgery will never properly cure it and the manipulation must be done without anathesia or pain killers. They would not allow the body to properly align itself. For six weeks I was in constant pain, I found blessed sour cherry juice near the end. Then for a year I followed her diet and exercise routine. Today 20 years later am still pain free with full motion. Still follow her raw juice, full grain, fermented food diet and exercise plan and take three brisk walks daily. Also ended up as the academic dean at Logan College of Chiropractic.

Thanks to Dr. Kim and his enlightening columns.

 

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