The shoulder is one of the largest and most complex joints in the body. It is a ball and socket joint which consists of three bones (humerus, scapula and clavicle). There are some important bony landmarks in the shoulder include the acromion (a bony projection from the scapula), the clavicle (the collar bone) and the coracoid process (a hook-like projection which comes from the shoulder blade). There are 18 muscles which control the range of motion of the shoulder. Another key point is that these muscles provide the shoulder’s stability and strength. The rotator cuff consists of four of these muscles: supraspinatus, infraspinatus, subscapularis, teres minor. Each of these muscles has a tendon that attaches to the bone of the upper arm.
Chronic shoulder pain, stiffness and restricted range of motion are often caused by a condition called frozen shoulder. There are two types of frozen shoulder. The first is adhesive capsulitis (where small fibrous adhesions on the head of the humerus interfere with normal range of motion). The second (and much more common) type is a neurologically mediated frozen shoulder. This type is caused by a disruption of the neurological control of the various muscles of the shoulder. Accordingly, muscles don’t move on their own, they require input by the nervous system. People who cannot move their shoulder in full range of motion frequently have a problem with their neurology. Because of this, a neurologically-based therapy is needed to correct the problem.
Examination & Diagnosis
To determine the severity of the problem, we first need to do a proper work up. This consists of reviewing your medical history, followed by an examination and possible x-rays of the affected areas. Additionally, orthopedic tests, neurological tests, functional range of motion, and muscle testing all need to be done. Afterwards, the Doctor will be able to prescribe the appropriate therapies to get you well.
The most effective therapies and treatments for frozen shoulder include Trigenics (which can get phenomenal results in as little as one session), cold laser therapy and rehab. The number of treatments you will need will be determined based on your age, and the severity of the problem.
To schedule an exam, call us at 412-595-7332.