Rotator Cuff and Frozen Shoulder
The shoulder joint is basically a ball and socket arrangement. The four muscles of the rotator cuff are the main shoulder stabilisers. They hold the ball in the socket. It is quite common for these muscles to cause pain and restrict movement.
The most common problem that I see in clinic is pathology related to the supraspinatus muscle. This is the the muscle which sits on the top of the shoulder blade, and passes under the AC joint to attach to the upper part of the humerus of the arm.
​
​
The above image shows two of the rotator cuff muscles, the supraspinatus and the subscapularis. Notice the tear of the supraspinatus, this is quite a common injury in post menopausal women.
Pain from this injury will often refer into the top of the arm, and can reach as far as the wrist and fingers.
The other common presentation is inflammation of the subacromial bursa, or bursitis. Bursa are fluid filled sacs that act as a protective barrier so the muscle isn't shredded as it passes underneath the bony AC joint.
Factors that cause this issue can include, age, sex (females appear to be more vulnerable), repetitive movement and strain. Examples include long distance swimming, overtraining with weights and boxing.
This can be managed using electro-acupuncture, massage and laser treatment. Surprisingly, a full tear of this muscle can be less painful than a partial tear.
Western medicine approaches include the use of anti-inflammatory and pain medications, and in the case of a tear, possibly surgical repair.
​
Frozen Shoulder
This condition occurs when the shoulder joint capsule tightens and retracts, it is medically known as adhesive capsulitis. The three stages are freezing, frozen and thawing.
Freezing can last from 6 weeks to nine months. The shoulder is usually quite painful and slowly losing mobility. The frozen stage ranges between four and six months, pain reduces however the shoulder may fully restricted.
Thawing can take anywhere between six months and two years to complete.
To help your body overcome these phases faster, targeted trigger point needling of the rotator cuff muscles is a must.
This includes the supra and infraspinatus, subscapularis and teres minor. Added to this is a comprehensive Chinese Medicine assessment to discover what underlying issues have possibly contributed to the frozen shoulder in the first place.
These may include a deficiency of yin and blood or qi (energy). Acupuncture points on the hand can also promote energy flow through the shoulder. For example Small Intestine 3 is a shoulder master point as the Small Intestine meridian passes right through the shoulder region.
​
I will fully assess your shoulder, and offer a way forward, including strengthening exercises.