What is Adhesive Capsulitis?

Frozen shoulder is a condition where the shoulder joint feels stiff and exhibits limited range of motion. External rotation is the most limited movement, so it feels like the shoulder is stuck in a forward and rotated position. In adhesive capsulitis of the shoulder, this occurs when the joint capsule within glenohumeral joint becomes inflamed and scar tissue forms. There may also be a reduction in synovial fluid

The three stage process of developing Frozen Shoulder

Stage 1 – the “freezing” stage, marked by pain that gradually worsens over the course of 6 months, and range of motion becomes limited. Evidence for inflammatory cytokines within the synovial has been found during this stage.

Stage 2 – the “frozen” stage, or the adhesive stage, the stage where pain lessens but the joint stiffness persists. This stage can last from 4 to 12 months

Stage 3 – the “thawing” stage, or the recovery stage, where the shoulder gradually improves its range of motion over the course of 5 months to 2 years.

What causes it?

Strangely, not a lot is understood as to why this condition develops. However, there are certain conditions that seem to track across many of those who suffer from frozen shoulder:

• Diabetes
• Thyroid disease (hypothyroidism)
• Surgery or injury to the shoulder
• Women aged 40-60
• Autoimmune diseases
• Connective tissue diseases

Standard treatments for this condition would include NSAIDS, steroids, and physical therapy

Massage for Frozen Shoulder

There are many muscles that surround the shoulder that can develop trigger points (overuse adhesions in the muscle), that targeted massage therapy can help relieve.

• Subscapularis – deep muscle used to medially rotate the arm (chronically shortened and tight in frozen shoulder)
• Biceps brachii – used for flexing the arm
• Deltoid (anterior and posterior) – used for multi-directional movement of the arm
• Pectoralis major – used during push ups
• Teres major & minor – used for external shoulder rotation
• Latissimus dorsi – used for pull ups or shoulder adduction
• Supraspinatus – used for raising arm above the head
• Infraspinatus – used for external shoulder rotation

Several of these trigger points are linked, and when massaged together can provide relief beyond addressing single trigger points at a time. For example, the following are some of the connected trigger points found in frozen shoulder:

Infraspinatus – Biceps brachii – Deltoid (anterior)

Infraspinatus – Supraspinatus

Subscapularis – Pectoralis major – Teres major

Deltoid (posterior) – Pectoralis major