What is Adhesive capsulitis?

Adhesive capsulitis, also known as frozen Shoulder, is a disorder of the shoulder in which the capsule surrounding the joint becomes inflamed and stiff.  As the condition worsens range of motion of the shoulder is severely reduced.  The exact cause of frozen shoulder is unknown.  However, there are a number of risk factors for this problem including diabetes, stroke, trauma, lung disease, connective tissue disorders and heart disease.  Frozen shoulder usually occurs in 3 phases:

People with Frozen Shouler typically lift the entire shoulder girdle when attempting to lift the shoulder.

1. The Freezing Phase: This is the most painful stage.  Pain occurs with any movement and there is a gradual reduction in range of motion.
2. The Frozen Stage: During this stage the pain in the shoulder gradually decreases.  However, the shoulder is extremely stiff during this stage.
3. The Thawing Stage: During this stage range of motion of the shoulder gradually returns to normal.

Each stage can last months and full resolution can take over a year.

What is The Best Treatment For Adhesive Capsulitis?

Physical therapy can be very effective in decreasing the duration of frozen shoulder as well as improving function during this period.  However, it is important that the physical therapist use effective treatment techniques.  A recent study in the Physical Therapy Journal examined the records of 2,370 patients (That’s alot of patients!) with adhesive capsulitis to see which treatments were effective in decreasing pain and improving function and which treatments were not effective.

The treatments that increased the likelihood of pain reduction and improved function were:

1. Joint mobilization performed by a licensed physical therapist.
2. Exercise

The treatments that decreased the likelihood of pain reduction and improved function were:

1. Ultrasound
2. Massage
3. Iontophoresis (Delivery of steroid with electrical stimulation)
4. Phonophoresis (Delivery of steroid with ultrasound)

You can view a synopsis of the article here.

If you think you may have adhesive capsulitis (frozen shoulder) we would be glad to help you. Please contact Belmar Physical Therapy at (303) 274-2404.

If you desire a long and successful career in baseball, at any level, read further to see how Belmar Physical Therapy can help you achieve your goals.

In the last two decades, top level managers have focused less on speed and more on injury prevention for success in the sport of baseball.

My Shoulder Already Hurts, What Do I Do?

Even if you’re currently experiencing shoulder pain, it’s not too late!

Many injuries can be successfully treated with a well-structured and carefully implemented non-operative rehabilitation program by a Physical Therapist.

The overhead throwing motion is an extremely skillful and intricate movement that is very stressful on the shoulder joint complex.

The overhead athlete places extraordinary demands on this complex. The thrower’s shoulder must be loose enough to allow extreme motion, but be stable at the same time. This requires a delicate balance. Experts refer to this balance as the “thrower’s paradox.”

Scientific studies show that changes occur in the shoulder from the repetitive microtrauma that occurs during overhead throwing.

The Types of Injuries That Occur Are:

1. Anterior Instability
2. Impingement
3. Biceps Tensonitis
4. Rotator Cuff Tendonitis

The physical therapists at Belmar Physical Therapy continuously review the scientific literature in order to provide the most successful treatment possible. Physical therapy treatment focuses on the restoration of normal movement of the shoulder complex during the rehabilitation program.

The Treatment Consists of:

1. Controlling inflammation.
2. Restoring muscle balance.
3. Improving soft tissue flexibility.
4. Improving strength of the throwing muscles.
5. Enhancing control of the shoulder complex.

Call Belmar Physical Therapy today at (303) 274-2404 to start improving your performance through injury prevention or treatment.

For years, the first line of treatment for painful tendons has been anti-inflamatory treatments such as medication and ice.  However, recent studies have concluded that inflamation is not a factor in persistent tendon pain explaining the lack of results with this treatment approach.  These studies have concluded that excessive loading causes weakening of the tendons structure leading to pain. These recent advances in the understanding of tendon problems have lead to the development of the EdUReP (Education, Unloading, Reloading, Prevention) model for treatment.

Treating Tendonitis with EdUReP

Following is a summary of the EdUReP approach.

• Education: The patient is educated in the basic physiology of tendinopathy as well as how their posture and activities may be contributing to overuse of the tendon. The patient and the physical therapist work together to find ways for the patient to perform activities while minimizing stress to the tendon.
• 

  Kinesio tape can help "unload" the painful tendon.

  Unloading: During this phase of treatment the therapist uses patient specific strategies to minimize load to the tendon.  These strategies may include external supports (braces, orthotics or taping), strengthening of other structures that may be underused or stretching of tight structures that are placing more strain on the tendon.

• Reloading:  Once adequate pain control has been achieved through unloading the tendon needs to be strengthened in order for the patient to return to regular activity.  One such strategy is the use of eccentric strengthening exercises discussed in our Get Eccentric” post.  During this stage exercises of progressive difficulty are administered until the patient is able to tolerate the loads required for their particular activity.

• Prevention:  This phase occurs once the patient is able to return to their activities pain free.  Prevention may include re-emphasis of prior education as well as adaptation to technique and form.  The ultimate goal is the patients independence in self-management.
  

  Once adequate pain control has been achieved the patient is given progressive exercises to "reload" and strengthen the tendon.

Have you ever experienced nagging pain in your upper arm? Chances are you have a rotator cuff problem. Because of common work and sport activities, including painting, construction work, playing tennis, and swimming, the rotator cuff is a frequently injured structure.

What is the rotator cuff?

Anatomy of the Rotator Cuff

It is a set of four muscles that work together to keep the shoulder stable. Because of the anatomy of the shoulder, there is very little space around the tendons of the rotator cuff, often causing them to be pinched underneath surrounding bone. This causes irritation in the tendon, a condition known as tendonitis or Impingement Syndrome. This condition, if left untreated, may lead to a tear in the rotator cuff. A tear can be very serious because it often requires surgery and a lengthy period of recovery.

Treat Rotator Cuff Injuries with Effective Physical Therapy Exercises

Research has found that the tissue of the rotator cuff deteriorates over time. Normal daily activities cause the tendons to thin and fray. In many middle aged or older patients, this wear and tear alone can cause a rotator cuff tear. Often, a tendon tears with something as simple as picking up a suitcase. The good news is that many rotator cuff conditions can be treated effectively with the proper physical therapy exercises, even a partial tear. A combination of proper stretching and strengthening prevents the shoulder from moving in positions that cause added stress to the rotator cuff tendons.

We have designed a collection of exercises to help treat irritation or tendonitis of the rotator cuff (click the link to download). These exercises can also help prevent a rotator cuff injury in people that are prone to them, such as athletes that perform frequent overhead motions and middle-aged or older adults. If you’re interested in keeping full strength and motion in your shoulders, contact us at Belmar Physical Therapy for more information.