Case Summary: 65yo woman with frozen shoulder

Posted Nov 8, 2017 by Pinnacle Spine & Sports

These case summaries are examples of real people treated here at the clinic (names changed for privacy). They are not an exhaustive study of the whole condition, merely an opportunity for you to see the sort of things that we have been able to help with in the past, and how we may be able to help you if you’re suffering a similar condition.

“I’ve gradually lost movement in my shoulder for a couple of months, to the point that I can’t hang clothes on the line any more.”

Sandra (name changed to protect privacy), A 65 year old woman presented with frozen shoulder. She had noticed that she was gradually losing range and mobility over the last two months. She was not physically active, did no exercise, but did work full time in a role supporting teachers in the Catholic School system. Her work was mainly computer based and also face to face consultations with teachers and parents.

Examination

Active range of motion shoulder tests revealed restricted movement for abduction (lifting arms up sideways and upwards). She could not lift the right arm up to shoulder level, the maximum was a 45 degree angle away from the body. Internal and external rotation (twisting shoulder inwards towards the body and away from the body) was also restricted to 45 degrees when it should have been 90 degrees. Resisted range of movement (creating a load against the movement) produced no pain, but the restriction was the same. Passive range of motion (the therapist moving the arm in the shoulder joint), produced no pain, but still the same restriction.

Because the movement was restricted with no pain, the problem was determined as being in Sandra’s joint capsule, not the muscles.

Treatment

The treatment was to free the right shoulder joint capsule so the arm could return to its full range of movement. It was recommended that Sandra start with a weekly massage for one month, progress to fortnightly for six weeks and monthly thereafter.

The massage started with warming the neck, shoulder and upper arm area (Swedish massage), then encouraging the fascia to let go of adhesions with gentle stretching and passive range of movement done by the therapist (myofascial release), then remedial massage of all the muscles of the rotator cuff that support the shoulder and other accessory shoulder muscles. The remedial massage included trigger point therapy.

Sandra was given gentle stretching and range of motion exercises to do at home on a daily basis.

Results

After ten massage treatments the right shoulder range of movement had improved, the right arm could be almost lifted to the shoulder and the client could sleep on the arm when she previously couldn’t.

After ten treatments theraband work was added to the home stretching routine to strengthen and activate the muscles around the shoulder joint.

Seventeen treatments were done before full range of motion returned and then Sandra continued with monthly maintenance massages, and treatments were needed for a lower limb injury.

Frozen shoulder is a common condition that can affect anyone, but tends to mainly occur in middle aged women. There is often not an obvious cause, but it can be treated.

By Wendy Watkins, Remedial Massage Therapist