Frozen shoulder is a debilitating issue that affects 2-5% of the population. The worst part of the issue is the timeline to recovery can drag out for many years with little way of knowing the prognosis.
We have had the opportunity to help address many shoulder issues over the years and frequently have people reach out to us hopeful that the Crossover Symmetry System can help with Frozen Shoulder.
An exercise plan like Crossover Symmetry is a crucial part of the recovery process, but the full scope of the issue is a bit more complex. Continue reading for insights into what is Frozen Shoulder and how best to manage it.
What is Frozen Shoulder?
Frozen shoulder, also known as adhesive capsulitis, is caused by inflammation and thickening of the connective tissue that surrounds the shoulder joint. The underlying causes remain uncertain and even sometimes just appear out of the blue.
Although there is a higher incidence in people with Diabetes, shoulders that have been immobilized for a period of time (often following injury or surgery) and women; specifically, those women who are pre-menopausal or menopausal. There is also mounting evidence that the condition is driven by low levels of system inflammation (ref).
Here is a rough timeline of frozen shoulder which is broken into 3 phases: Freezing, Frozen, and Thawing.
- Freezing (2-7 months) – During this stage, the shoulder is typically painful at end ranges of shoulder movement in all directions and often very painful at night.
- Frozen (4-12 months) – At this time the shoulder is primarily limited by stiffness. There may still be some pain but it’s less than experienced during the freezing stage.
- Thawing (5-24 months) – The thawing stage is the light at the end of the tunnel, albeit it may be a long tunnel. There’s typically minimal pain and a progressive improvement in range of motion.
Depending on where you’re at in the process you’ll have different directives for treatment.
Getting Past Frozen Shoulder
The good news is that 90% of people with frozen shoulder will recover with conservative management strategies like exercise and stretching (ref). However, it can be a long and frustrating road, especially for the active individual.
Here we’ll highlight the current best practices in dealing with frozen shoulder and help identify the best strategies for getting past it, and more specifically how Crossover Symmetry can support this plan.
During the Freezing Stage
In the early stage of frozen shoulder, the primary issue is pain.
NSAIDs and other oral steroids can be somewhat useful during this initial “freezing” stage. Both have been shown to offer moderate pain relief, however, no significant change in overall recovery or duration of symptoms have been noted with these treatments. Additionally, long term use of NSAIDs and oral steroids are linked to stomach ulcers, weight gain and adverse effects of the liver and kidneys.
Another option shown to be more effective during the early parts of the freezing stage are Corticosteroid injections. More recently, it has been proposed that a cocktail of corticosteroids alongside a high volume dose of saline and localized anesthetics offers very promising results during this early stage. Despite the risk of infection, the side effects are fewer, and it has better long term pain reduction.
During this time, aggressive stretching is counterproductive but gentle and light exercise in pain-free range is a good thing. So something like Crossover Symmetry would be recommended, but stick with the movements that you can perform with little pain and without having to compensate too much to achieve a decent range of motion.
The best Crossover Symmetry options are usually:
- Reverse fly (with a modified range)
- Scaption (just to shoulder height or pain limitation)
During the Frozen and Thawing Stages
Unfortunately, despite one’s best efforts during the freezing phase, most will spend some amount of time in the “frozen stage”. During this time there is usually less pain but the shoulder remains stiff and range of motion is limited. Because pain becomes less of an issue, injections and other pain relief agents are not as effective. Instead the focus transitions to more aggressive stretching and physical therapy.
Eventually, the stiffness will decrease and individuals will note an improvement in ranges of motion and little pain. This is considered the “thawing” phase. Continued aggressive stretching, physical therapy, and regular aerobic and basic strength training is encouraged during this stage.
So keep up with Crossover Symmetry as range of motions allows, even trying the Strength program as mobility improves. This will help to limit the limitations caused by frozen shoulder and improve strength as you work through the issue.
Bringing Out the Big Guns
Despite injections, physical therapy, and pain medications, some will need more advanced treatment. If pain and limited range of motion persist for more than 6-9 months more advanced medical procedures may be indicated.
These are invasive protocols that aggressively attack the contracted shoulder tissue. Methods such as using anesthesia to put the patient out and then cranking on the shoulder, or more popular these days is arthroscopically cutting the capsule.
Of these more advanced methods, they do show good results but create lasting changes to the shoulder structure. Therefore, they should be used as a last-ditch approach in treating the condition, especially for one who hopes to return to more strenuous activity.
The Magic Pill for Frozen Shoulder
Unfortunately, there’s no slam dunk for frozen shoulder.
There is a lot that remains unknown, paired with the fact that each episode is unique, so what works for one may not help the other. Although what we do know is that movement is an important part of the recovery process for any ailment. Read here why people in pain need movement.
Specifically for frozen shoulder here is quick take-home summary of a plan to help you get past the issue using your Crossover Symmetry System.
Frozen shoulder has 3 stages:
- Freezing – primarily pain limited range of motion. The use of corticosteroid injections and high volume injections have been shown to be useful during this stage. This is not the time for aggressive stretching or strength training, but some light use of Crossover Symmetry exercises is beneficial for reducing the pain and limitations.
- Frozen – primarily stiffness limited range of motion. This is less painful, but there is significant limitation in range of motion due to stiffness. Some pain may still be present but is not the primary limiting factor. More aggressive stretching and a shoulder focused strength program like Crossover Symmetry (but with modificaitons for the limited range of motion) is important during this stage.
- Thawing – In the final stage, range of motion progressively improves along with minimal pain. Keep up with aggressive stretching and you can progress your resistance training within available range of motion.
I hope this is helpful in getting past your issue of frozen shoulder. Please send any questions my way at email@example.com. I would be more than happy to support you in the recovery process.