She is a 62 year old woman who loves to swim and does so regularly.

One day in the pool she noticed that she couldn’t move her left arm as much as she normally could and her shoulder felt a bit stiff. She found it odd, but didn’t think much of it, believing it would go away. As her swimming sessions continued, the mobility of her shoulder continued to worsen.

Clearly something was wrong, but what was it?

Sure, she had some soreness and fatigue around her shoulder blades and in her neck. But she wasn’t really in much pain. And she couldn’t really remember any time when she might have hurt her shoulder. Still, the loss of shoulder motion was unmistakable and it seemed to be getting worse.

She went to the doctor and found out she had frozen shoulder, also known as adhesive capsulitis. She started on a course of physical therapy. She also worked with a chiropractor. She did not feel that either one of these options really helped all that much, but also shared that the time she allowed for positive change may not have been long enough.

After six months she was no longer swimming, had also given up weightlifting, and the mobility of her left shoulder was very limited, as seen in the pictures in this article. She found out about our chiropractic practice, and in February of 2024 she had her first appointment at Life In Alignment Chiropractic.

In just a few minutes she was able to raise her arm a little bit higher. And six weeks later she had regained much of her lost mobility. We are going to reveal how she fixed much of her frozen shoulder working with our office…But first, we should learn…

What is frozen shoulder?

If you’re imaging a shoulder locked in by ice, you’re only partly correct. Frozen has little to do with the temperature and more to do with extreme stiffness that overtakes the joint, sometimes very quickly, like it is being frozen in place.

Also called adhesive capsultitis (think sticky, inflamed joint capsule), the ball of the shoulder becomes to difficult to move in almost all planes of motion (forward, backward, out to the side, across the body, and rotating).

What does frozen shoulder feel like?

How does frozen shoulder happen?

Most frozen cases happen without any known reason (also known as idiopathic). These are called primary frozen shoulder. Others may start after physical trauma, and these are called secondary frozen shoulder. In either case, they all happen due to inflammation, thickening and tightening of shoulder tissue, and the eventual development of scar tissue.

Will frozen shoulder go away on its own?

Frozen shoulder does tend to get better on its own, even without treatment. And in research that tracked frozen shoulder patients over time, those who did and did not receive treatment showed similar satisfaction with shoulder function as those who did receive treatment.

So how long does it take? In a study of long-term frozen shoulder recovery, the median recovery time was 30 months. But many patients had recoveries that took much longer, and some continued to have symptoms that impacted daily living from time to time.

Should I seek treatment for my frozen shoulder?

As I clinician who helps people with frozen shoulder, I can say that what qualifies as “better” and “satisfied” will vary from patient to patient. Whether or not a patient should seek treatment is personal and up to the patient. However, there are many people who would be very unsatisfied with a 30 month recovery time, and they should consider their treatment options.

For example…

An inactive person getting some movement back after 18 to 30 months months may be good enough. The avid pickle ball player, on the other hand, wants resolution of their frozen shoulder as soon as possible, and just waiting for the condition to improve is not an option for this patient.

It also tends to matter if the shoulder freezes on the dominant or non-dominant side. Good enough on the non-dominant side may not be what’s necessary on the dominant side.

Research says one thing, but in real life this is a hard question to answer as patient experience with frozen shoulder varies.

The three stages of frozen shoulder?

Typically, frozen shoulder goes through three stages appropriately called: freezing, frozen, and thawing.

In some patients, a portion of the shoulder mobility will return on its own in several planes of motion. For example, raising the arm forward may return to a large degree, while raising the arm out to the side stays somewhat limited.

In my own personal experience working with patients who have not received any consistent treatment for frozen shoulder, their external rotation remains very limited, which makes it hard to put an arm in a sleeve.

Who tends to get frozen shoulder?

All kinds of people can get frozen shoulder. That said the classic frozen shoulder patient is a woman around the age of menopause, who also has thyroid issue, and/or has issues with sugar handling (diabetic or pre-diabetic). This is due to the fact that:

Still it should be said again, that any shoulder, especially if its not being used after an injury, can end in a frozen shoulder.

What treatment options are usually recommended for frozen shoulder and do they work?

The most recommended treatment options for frozen shoulder are:

• Physical Therapy
• Prescribed and over the counter non-steroidal anti-inflammatories (NSAIDS)
• Corticosteroid injections of the shoulder
• Manipulation under anesthesia (MUA)
• Surgery
• Watching and Waiting

Of the above frozen shoulder therapies, there isn’t clear evidence that one is better than another in the long-term.

In terms of short term pain control and improving function, at least one study recommends a round of treatment with corticosteroid injections for pain control with physical therapy for rehabilitation.

There are more risks associated with surgery and MUA, but patients may opt for these treatments if nothing else works.

One long term study also emphasized that frozen shoulder should be assessed on a case by case basis, and that while many patients do spontaneously get better quickly, many do not, and some have more severe symptoms than others and should have access to a variety of treatment options.

Can manual therapy help symptoms of frozen shoulder?

Manual therapy is term that includes a lot of treatment options or modalities. Massage, joint mobilization, joint manipulation, and passive stretching are examples of manual therapy.

Many physical therapy treatment plans will include rehabilitation exercises and manual therapy. And when it comes to research, chiropractic adjustments are classified as a form of manual therapy since they include joint manipulation.

When it comes to answering the question of whether manual therapy techniques can help patients with frozen shoulder, it depends on what evidence you’re seeking.

Many, many patients with frozen shoulder have been treated with manual therapies of all kinds and they have found it helpful. I have personally seen and experienced this both in my office, and working with patients who have also been treated by other providers.

So, there are many case studies of manual therapies, including chiropractic adjustments, helping frozen shoulder. Some of these case studies have been published, but most haven’t been.

However, when it comes to showing how well manual therapy techniques work for frozen shoulder in research, this can be very complicated. Almost all systematic reviews cannot say that there is strong evidence for using manual therapies with frozen shoulder.

Why? Because systematic reviews are looking for a large group of individual studies that include:

• A randomized control trial that compares the treatment to a placebo
• Similar study design
• Near uniform treatment types and treatment amounts, including how long the patient was treated and visit amounts
• Near uniform ways of measuring patient outcomes and satisfaction

Even though there is a lot of personal patient and practitioner experience with treating frozen shoulder, there are so many kinds of manual therapies that one standardized treatment hasn’t been studied.

why we throw the kitchen sink at frozen shoulder

In fact, frozen shoulder is found to be difficult to treat, and so many practitioners are known to “throw everything but the kitchen sink” (sometimes shortened to “everything and the kitchen sink” or just “throwing the kitchen sink”) at frozen shoulder.

With so many practitioners trying all kinds of therapies for frozen shoulder, it is difficult to document and prove a single path for helping frozen shoulder patients. Whereas, a single injection of corticosteroid is very easy to document and measure.

Case in point: everything we did for the woman in this article was part of a program that helped her regain use of her shoulder and return to swimming in about six weeks. Because of the variety of tools and manual therapies used, it would be hard to document and prove that we helped her as part of a larger study.

Can chiropractic care help frozen shoulder?

While there are far less studies of chiropractic care and frozen shoulder, there is some evidence that working with a chiropractor is an important option for patients with shoulder frozen. Because chiropractic care is classified as a manual therapy in the research, everything we said about manual therapy in the section above we can say about chiropractic management of frozen shoulder.

There are individual studies that show benefit with manual chiropractic adjustments, especially when included with other treatment modalities.

What did we do to solve this woman’s frozen shoulder problem

I used a used a combination of specific tools in a certain sequence (our frozen shoulder program) to help this woman’s case of frozen shoulder. In short, this is what we did:

• upper cervical chiropractic procedures
• specific soft tissue release in the neck for posture shift
• thoracic and rib-cage adjustments and soft tissue work
• release of the scapula
• one to two specific exercises to repeat multiple times per day
• frequency specific micro-current
• laser for clean up

At the time she started care she was six months into her “freezing” process and did not have much pain. Here is short explanation of the above sequence.

Our frozen shoulder program in detail

1. I looked at the neck (with upper cervical chiropractic procedures)

It’s hard to rehab the muscles of a frozen shoulder shoulder like this when the neck is locked in a certain way. The photos in this article reveal how this patient’s shoulder mobility was negative impacted by her neck alignment.

I used x-rays and a gentle adjusting instrument to achieve this change. No forceful manipulation was used.

Once the C0/C1 joint (upper cervical spine) were stimulated and unlocked, a gentle alignment procedure in the rest of the neck was used using the hands. This has the effect of releasing the posture in many patients.

2. I looked at the mid back/thoracic rib cage and shoulder blade

Most frozen shoulder patients have more than just neck and shoulder issues. They have bony and soft tissue fixations in the thoracic spine and thoracic ribcage that should be released. Because of the variability in the rotation and wedging (curves) of the mid-back, x-rays were used to help understand how the thorax was locked and how it might best be released.

The scapula bone is a part of the shoulder complex and often has a fixed, forward position that needs to be corrected in frozen shoulder cases.

3. She did some focused rehab work in the comfort of her own home

I correctly identified a muscle chain that had been inhibited by the above problems and gave her one to two exercises to work on consistently at home once her neck and scapula were more free to move.

She worked hard at home for several weeks just focusing a few minutes per day on these exercises.

4. She used an FSM machine, also in the comfort of her own home

She also used frequency specific microcurrent at home with certain frequencies (approximately three different programs) to help get the tissue ready for transformation since the shoulder had been stuck for six months. You can read more about FSM and the technology I use here.

5. She received infrared laser in the office

Towards the end of the frozen shoulder program, the patient still had limited external rotation of the shoulder, while much of her other motion was restored. We chose to focus on the external rotation with a series of visits using a Class IV Infrared laser. This helped the overall healing of the frozen shoulder, and helped get some improvement in that pesky loss external rotation.

Towards the end of her program she successfully returned to swimming with few to zero limitations from frozen shoulder in almost all planes of motion.

Can you help me with frozen shoulder?

If you’re in my area of Southeast Michigan, you’re welcome to set up a consultation to discuss if our treatment program for frozen shoulder is right for you.

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