What is frozen shoulder?
"My GP says I have got frozen shoulder"This is what I hear nearly everytime a patient who visits me with shoulder pain.
The shoulder is complex and fascinating but when it sustains a trauma and is left the shoulder inevitable loses a range of movement as a result of damage to the soft tissues.
The shoulder is made up of several joints comprising several muscles and neurovacular ligamentous and fascial attachments.
In very simplified terms:
the Scapula (wingbone/Shoulder blade) is attached to the thorax(ribcage) via several muscles:
pectoralis minor, serratus anterior, rhomboids to name a few. These muscle slide the scapular over the thorax to change the angle and direction of the gleno-humeral joint. The scapula movement is also stabilised by the anterior thoracic attachment of the clavicle the (collar bone, the one horse riders, rugby player, motorcylist tend to break alot).
The Humerus which is the long bone forming your upper arm is then attached to you scapular via predominantly the rotator cuff! "Yeah i've got a RC tear grade 2" is another little throw away comment i hear alot around shoulders. The rotator cuff is made up by the supraspinatus infraspinatus, subscapularis and theTeres group major and minor. there are other muscle involved that make very important contributions to shoulder function, however we could be here for a very long time. Any injury strain, sprain, tear, avulsion of any of these tissues will cause the shoulder to disartculate. This will cause the shoulder to adopt a protective spasmed state which will generate a decreased range of movement a decreased profusion and drainage of tissue leading at first to a stiff shoulder and then to a freezing shoulder.
A crucial aspect of the shoulder's anatomy is that the Long head of the Bicep pireces the gleno-humeral capsule to find its insertion at the supra glenoid tubercle of the scapula. This aperture,sinus in a spasmed inflammed shoulder is the key to inflammation from damaged shoulder tissue entering the true shoulder joint. Once inside the inflammation changes the substance of the synovia and causes the synovial membranes to adhere(stick together). This is the definition of Frozen shoulder or the correct name for frozen shoulder Adhesive capsulitis.
My advice to any one with a painful shoulder is to get along quickly to your local osteopath (if that is me jolly good) to get the early advice and help during the stiffening, freezing stage rather than wait months for referrals and end up with an excrutiating shoulder problem that is very difficult to get rid of.