Some of my patients tell me, “All I did was turn to get my purse from the back seat of the car and felt an aching in my shoulder.” The pain seemingly comes from nowhere and movement is markedly limited in all directions, hence the term “frozen shoulder.”
The ligament surrounding the shoulder joint gets very tight and sticks to itself, making overhead movements particularly difficult. A portion of this ligament in the armpit region has enough “material” to allow the arm to go overhead, similar to the underarm region of a jacket sleeve.
It may help to understand the construction of the shoulder joint to see how this “frozen shoulder” condition might be prevented. The shoulder consists of a system of four joints: the breastbone, the collarbone, the shoulder blade and the upper arm bone, which attaches onto a fairly flat socket on the shoulder blade and is suspended and supported by ligaments and muscles.
Tendonitis is inflammation of a tendon, the part of the muscle attached to the bone. Inflammation is the body’s way of healing an injured area and usually warns of an injury caused by overuse or strain.
To treat tendonitis, you need to rest from activities triggering the pain and swelling. The body cannot heal an injured area if you continue to use it.
Ice often helps decrease swelling. The swelling puts pressure on nerves and causes pain. Reducing any scar tissue with special massage techniques helps by reducing tension occurring from these tight structures pulling on the bones. Finally, the muscles need to be retrained to move in a balanced fashion so the strain does not recur.
A bursa is a fluid-filled sac covering adjacent areas reducing friction over the two surfaces and allowing better gliding. Sometimes due to abnormal stress an inflamed condition, bursitis, occurs. Shoulder pain may increase at night due to your arm position, causing more pressure on the injured structures.
The body uses pain as a means of communicating potential injury, warning you to change positions. I also believe the body heals more during sleep, so the inflammatory process may be greatest at night.
Use extra pillows to support the arm and shoulder. A cold pack decreases pressure and may slow down pain impulses. Drinking chamomile tea, which is an herbal anti-inflammatory, practicing deep breathing and doing relaxation exercises may also help.
Since the shoulder relies on the balance between the muscles surrounding the joint, influenced by posture and activity, it is important to maintain a balanced length, strength and proper coordination of muscle activity. Hopefully, by doing this you will get a peaceful night’s sleep.
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Sheila Yonemoto, P.T., has been a physical therapist for over 30 years, specializing in Integrative Manual Therapy utilizing a holistic approach. She can be reached at Yonemoto Physical Therapy, 55 S. Raymond Ave, Suite 100, Alhambra, CA 91801. Call 626 576 0591 for a free consultation and free insurance verification, or visit www.yonemoto.com for more information.