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Frozen Shoulder (冻结肩 )

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain, stiffness and restriction of motion in the shoulder joint. It usually starts with pain, especially with movement of the shoulder. You may have difficulty executing simple daily actions like combing hair, wearing clothes or reaching for something on a high shelf.  

Frozen shoulder often occurs with no associated injury or discernible cause. It usually affects patients between the ages of 40 to 60 years old and it is twice as common in women than in men.

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The smooth tissues in the shoulder capsule become inflamed, thickens and tightens around the capsule of the shoulder joint. Scar tissues develop over time and your range of motion becomes restricted. 

Any shoulder injury like rotator cuff injury, tendinitis or long-term immobility of the shoulder joint can lead to frozen shoulder too. 

Stages of Frozen Shoulder

Frozen shoulder develops slowly through three stages. Each stage can last for a couple of months. 

Freezing stage: 

  • You slowly experience more and more pain
  • You feel pain (sometimes severe) with any movement of your shoulder
  • As the pain worsens, you lose your range of shoulder movement 
  • It typically hurts more at night, affecting your sleep

Frozen stage:

  • Your pain may actually improve but your shoulder becomes stiffer
  • Range of motion of the shoulder is very limited and it is difficult to get through daily activities

Thawing stage:

  • Your range of motion of your shoulder begins to improve
  • Complete return to normal strength and motion typically takes from 6 months to 2 years

TCM perspective of Frozen Shoulder 

Kidney and Liver Deficiency

In TCM theory, the kidney dominates the bone and kidney energy is progressively depleted with age. The liver regulates the circulation of qi throughout the body, stores blood and regulates blood volume in the body. As one ages, the kidney and liver energy decline through a weakening of yang qi and cannot nourish the collaterals of the body as before.

Stagnation of Qi and Blood

Long term exposure to excessive wind, cold and damp can lead to stagnation of qi and blood in the meridians of the shoulders. Some examples are accumulative exposure to air-conditioning, wind or daily consumption of icy cold drinks. There is a common saying in TCM: If there is free flow, there is no pain; if there is no free flow, there is pain (通则不痛,不通则痛). Overtime, these factors causes qi and blood stasis (气滞血瘀), resulting in shoulder pain and subsequently frozen shoulder.

TCM Approach to Frozen shoulder

Depending on the cause, symptoms and duration as diagnosed by the TCM practitioner, the following combinations of methods are used to treat frozen shoulder

  1. Acupuncture 
  2. Cupping/Tuina massage
  3. Moxibustion
  4. Herbal medication

The key to recovery and preventive care is doing physical therapy exercises at home daily. 

You need to be actively involved in treating your shoulder too! 

Physical Therapy Exercises to improve shoulder mobility 

Note: Do the exercises at your own comfort level. Gently and slowly increase the range of motion as much as possible, on a daily basis.

Climb the wall  (Finger Walk)

  • Facing a wall, reach out and touch the wall with your fingertips starting at the waist level and slowly walk your fingers up the wall, until you have raised your arm as far as you comfortably can
  • Lower your arm slowly
  • Repeat this exercise 10 to 20 times a day

Note: Your fingers, not your shoulder muscles should be doing the exercise. 

Comb the hair

  • Slowly raise your affected shoulder till above head level and do a combing hair action
  • Repeat this 10 to 20 times

Back Stretch

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  • Interlace your fingers behind your back
  • Use your good arm to pull the affected shoulder upwards to stretch it
  • Repeat this exercise 10 -20 times a day

Cross- body stretch

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  • Use your good arm to lift your affected arm at the elbow, bring it up and across the body
  • Stretch the shoulder and hold it for 10-15 seconds
  • Repeat this exercise 10 to 20 times a day

Acupoint Massage to relieve frozen shoulder 

Massage 阳陵泉穴 (Yang Ling Quan, GB34) and gently abduct your shoulder. 

Location: In a depression anterior and inferior to the head of the fibula 

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Note:

  1. Massage the 阳陵泉穴 (Yang Ling Quan, GB34) point on the opposite side of the body from the shoulder pain. If the left shoulder hurts, massage the point on your right knee.
  2. Massage the point with the tip of your finger till you feel soreness.
  3. Maintain that pressure while making very small circles.
  4. Gently raise and lower your shoulder while stimulating the acupoint. You should slowly begin to notice a decrease in shoulder pain and increase in your shoulder range of motion.

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.




ABOUT THE AUTHOR

Physician Kang Ting Tan

TCM Physician,

Lead (Platform Development and Training)

Double Degree (First Class Honours): Bachelor of Science in Biomedical Sciences & Bachelor of Medicine (Chinese Medicine), Nanyang Technological University and Beijing University of Chinese Medicine

Physician Tan Kang Ting graduated with a First-Class Honours in B.sc. in Biomedical Science and Bachelor’s Degree in Traditional Chinese Medicine from Nanyang Technological University and Beijing University of Chinese Medicine. She was a scholarship recipient of Beijing University of Chinese Medicine Foreign Student Scholarship. She was also awarded the Lee Kuan Yew Gold Medal in NTU.

She has a passion for learning. She continuously upgrades herself by reading TCM books, journals and e-learning platforms. Her caring personality is well-liked by her patients.

Physician Tan’s expertise: General Wellness, Pain Management, Injury Management and Women’s Health

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