Frozen Shoulder
What is Frozen Shoulder?
Frozen shoulder is a debilitating condition that affects a small population each year. It has also been known as “adhesive capsulitis” however only 5% of clients have adhesions. It is characterised by
extreme shoulder pain mostly at night
and an equally extreme loss of both active and passive range of motion.
In other words, the shoulder cannot even be “forced” beyond its limited range of motion by a practitioner. It commences usually with some sort of trauma to the shoulder (surgery, a fall etc) although some common conditions such as diabetes can increase risk. From there, it becomes very painful before the substantial loss of both active and passive range of motion. The shoulder continues to stiffen considerably to where a person cannot complete even the simplest tasks such as:
brushing their hair
putting the seat belt on in the car
washing under their armpits
or even wiping their bottom after going to the toilet.
The condition lasts for on average 18-24 months (sometimes longer) before it slowly (6 months) resolves. However around 70% of the population are left with some movement deficit after it subsides. The condition affects women more than men, mostly on the non-dominant arm, and commonly over the age of 40. Unfortunately, some people may suffer it on the other side and sometimes at the same time as the original injury.
How is it Treated?
Currently the consensus is for ultrasound guided steroid injection, or surgeon manually “breaking the adhesions” under anaesthetic, or exercise programs or even “professional neglect” (not doing anything). Of these treatments, none have even a fair success rate where full range of motion is restored within an acceptable timeframe. Some of these are also quite barbaric which may leave the person with either greater pain, or a greater loss of movement than before.
What is Niel Asher Technique for frozen shoulder?
Niel-Asher Technique was devised by British Osteopath Simeon Niel Asher approximately 15 years ago through frustration whilst treating a friend’s mother for this debilitating condition. The technique is a neurophysiological based manual therapy. The technique concentrates on introducing a nociceptive stimulus to certain parts of the shoulder, in a precise order and at a precise pressure to retrain it out of this restrictive holding pattern.
What can be expected from a NAT treatment?
Firstly, NAT is a series of treatments that can be used in all phases of a frozen shoulder, and even when a painful shoulder is showing warning signs that it may become frozen. The client is carefully interviewed and assessed not only to ensure whether it is a frozen shoulder, but to explain what is happening and approximately how many treatments will be needed. The first few initial treatments take 60 minutes once a week but as the shoulder firstly loses its night pain and then becomes more mobile, 30 minute appointments are all that is needed. The average treatment time varies between clients but treatment lasts until optimal range of motion is achieved. Treatments consist of various manual therapy techniques, some of which may cause a bit of discomfort, but the aim is not to create noxious pain within the body: it is to break a neurophysiological holding pattern that is restricting the shoulder.
Are there any exercises prescribed between treatments?
No not initially. It is in fact counterproductive to give exercises due to it reinforcing the holding pattern of the shoulder. Also it is very difficult to exercise a shoulder that does not move.
If you think that this could be you please do not hesitate to give me a call to book an appointment on 5310 6259
Ian Fischer
Central West Mywotherapy
