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Wednesday, June 27, 2012

Living “Day to Day” with a Frozen Shoulder

What you do with your shoulder on a daily basis is important both for managing pain and increasing the rate of recovery. There are simple things you can think about as you go about your daily life to make the ordeal of your frozen shoulder more bearable.

The instinct we have when something is hurting is not to use the painful area. Whereas this may be appropriate for other problems, such as a fracture or ligament sprain, it is not so for a “Frozen shoulder”.

Classically the frozen shoulder patient we see comes in to the clinic holding the arm in a protective posture. They tend to hunch the affected shoulder forward, bend the arm at the elbow, and cradle the arm close to the body even supporting it with the other arm. This position is very important to avoid as it only compounds the problem. In this position the biceps muscle is contracted, stressing the tendon and causing further shortening.

It is far better to try to keep the arm straight allowing the arm to hang along the side of your body. This position stretches the biceps tendon; the weight of the arm also slightly separates the shoulder joint which will allow fluid back into the shoulder capsule.

You can do most activities but avoid those that you know will cause that sharp catching pain. Use the arm where possible and don’t be too afraid, just try to avoid tweaking the tendon, you will not make it worse.

Walking

Walking through a busy supermarket or going on the Tube at rush hour may not sound much to most people, but for somebody with a frozen shoulder it can be a very stressful experience. The fear of a fellow shopper or passenger accidentally bumping into the shoulder is constantly present. In that type of scenario it may be difficult not to remain tense and protective towards the shoulder. However, whenever possible it is important to allow the shoulder to relax and straighten the arm when walking. The tension caused by fear of pain will only compound the problems.

This is what to do when walking:

- Relax the shoulder down

- Straighten the arm

- “Let it swing”, swinging the arm along the side of your body like you would under “normal”
circumstances. It may feel odd initially but if you persevere, you will soon get used to it.

- Breathe and relax

Swinging the arm during a very acute phase may be painful, so achieving the first two points is enough. This will help to separate the shoulder joint allowing fluid back into the shoulder capsule. Also gently moving the arm will improve blood flow into the shoulder area and thereby ultimately improve healing and reduce pain.

Sleeping

Night pain and sleeplessness are some of the worst aspects of the frozen shoulder, especially in the early days. At first, you will probably not be able to tolerate pressure on your affected side. As your symptoms ease, however, you will find you can gradually ease into some type of position. The degree of night pain is directly proportionate to the amount of inflammation within the joint.

Some comfort and relief may be obtained by:

- Lying on your back, with a pillow lengthways under the affected arm(s) and shoulders, supporting them

- Lying on the good side with a pillow or towel over your waist and under the arm

- Try to avoid sleeping with the arm above your head. This inhibits shoulder tissue repair,
which manly occurs manly at night

- Lying on your back with a good neck pillow

  1. Laura Bernard

    Monday, July 23, 2012 - 14:37:13

    I found this article really useful. I’m trying to keep up with my daily jog (about 2 miles) but my arm hurts too much as it swings. Do you have any suggestions?

  2. Laura Bernard

    Monday, July 23, 2012 - 14:39:27

    Should I try to let my arm hang straight down when I jog (which is what I am doing now) or should I try to hold it up against my chest (perhaps with strapping or some type of sling)?

  3. Baloo, Bristol, UK

    Wednesday, August 8, 2012 - 19:47:05

    Most impressed with all your articles. This one is so practical and addresses queries and provides information that would have been most useful at the start of this serious discomfort. In the beginning I was in so much pain I didn’t know what to do with myself or how to even begin to try and make things better. So thank you for this. Is it not possible to get some of your literature into GP’s waiting rooms round the country? I would have been glad to find it when I first went to my GP 5 months ago. I am just about to start reading your free download on exercises etc. that you kindly sent me - I am looking forward to learning some more tips. Keep up the good work!

  4. Cindy

    Saturday, October 6, 2012 - 15:45:15

    Dear Sirs,
    I am learning more each time I visit your site. Thanks for sharing. Question…how do I prevent further injury when I am asleep? During the day I have been following your exercise routine for phase 1 but at night I find that I am injuring my arm further by stretching and rolling. Also how will I know when my arm is in the frozen stage and then later in the thawing stage? Thanks C

  5. Lesley

    Thursday, October 11, 2012 - 10:23:55

    Hi. I have been struggling with menopausal shoulder for seven long months. I have symptoms in both shoulders but dominant arm is the worst. symptoms do not seem to fit into any particular description…it seems to be a mix of impingement, tendonitis, and now classic frozen shoulder. I do have painful arc, but sometimes I can move my arms in certain directions and sometimes I can’t. My left deltoid muscle/ tendon aches the most and I also have pain in my elbow and long bones of that arm. It is getting progressively worse instead of better and night times are hell. I cannot find pain relief that works, and have resigned my self to toughing it out for the long haul. Your blog is helping me and I am trying exercises although I still find them incredibly painful, especially the pendulum swing/noodle arm. Should I work through the pain? Also, do you recommend deep tissue massage. I have a shiatsu massage pad and wonder I if should try it, although I would have to lay it on the floor and lay on top of it to get to the area! Thank you for any advice. Lesley

  6. Diane

    Tuesday, October 16, 2012 - 04:41:57

    Had frozen shoulders in both for last 9 months, started on one side then the other only weeks apart. Have had cortisone in ‘Right shoulder and Hydrodylation in Left shoulder, if did help with pain and sleeping. I have done myotherapy, physio, chiro, osteo, and clinical pilates. It is starting to loosen up and the pain is less and I can sleep at night but awake when I turn over, arms still go to sleep in the night as well. Frustrating most days and the worse thing is people close to me are over me talking about it. Massage would be good to try and loosen the tight muscles inbetween the shoulder blades. I can at least drive now and not have the same pain I did have turning the car around corners. This has been the worst nightmare in my life and I am still in the middle of it but at least the pain is less now so I have turned a corner, or at least that is what I tell myself to keep trying to be positive. I do take Panamax for the pain and stiffness and on bad days take Voltaren. I ref basketball and continue to try and use my arms as much as possible and feel that they will eventually loosen up. Not sure what advice I can offer, accept just find something that suits you, whether pain killers, hot wheat sacks are good, massage. The shoulder I had the hydrodilation has the less pain but nothing seems to fix things, just time unfortunately. Good Luck !!