At present, the diagnostic usage of “frozen shoulder” is rather confusing, and there are three meanings in general: First, it is shoulder pain, but the diagnosis is unclear, that is, a “waste paper basket” diagnosis, a diagnosis that is not well understood, which is still relatively common in China at present. Secondly, it refers to the pain syndrome that causes shoulder dysfunction, i.e. “frozen shoulder” in the broad sense. Thirdly, it refers specifically to “frozen shoulder”.
How should it be treated? In my clinical practice, I found that most of the patients who came to see the doctor had gone through inappropriate treatment, such as relying heavily on painkillers, looking for others to massage and break the shoulder, and using hot water for heat therapy. In fact, they all missed the best opportunity for treatment.
The best opportunity is at the time of the onset of the disease, and often through reasonable rest and ice treatment can get a rapid and complete recovery. In fact, patients who come to the clinic are usually very late, and the course of the disease is usually more than 3 months old. This treatment can only be obtained through a longer scientific rehabilitation. What is scientific recovery? The following is a brief description.
Principle: General Frozen Shoulder Treatment “Trilogy”
1. Hot compress.
The temperature can be around 40 degrees. Hot towels are not as easy to control as hot water bags. Each time 20-30 minutes is enough. It can properly promote local blood circulation and help the next step of shoulder joint function exercise.
2. Shoulder joint functional exercise.
The most common functional deficiencies of the shoulder joint seen in patients are abduction (shoulder lift), external rotation and internal rotation (shoulder turn). Therefore, the content and methods of exercise are mainly based on the deficient functions.
The main movements are as follows.
A：Bending and turning the shoulder
B：Finger climbing wall
C: Normal side of the shoulder and hand to help pull the affected side of the hand and shoulder.
This consists of two main movements: internal retraction (in front of the chest) and internal rotation (behind the back)
D: The shoulder and upper arm of the affected side are held close to the side of the body, and the hand of the normal side is used to push the forearm of the affected side outward (external rotation of the shoulder joint at 0 degrees)
E: Pulley pulling exercise
The action is important, that is, to try to make each action to the maximum extent, that is, to feel more pain, or feel the limit. However, special attention needs to be paid to never over-involvement, so as not to cause unnecessary damage. This degree in your exercise is gradually experienced. When the action reached the maximum degree after, generally maintain 1-2 minutes on it.
Above the main 5 kinds of movements, as long as you practice a cycle can be completely. If there is no condition, E action is not necessary to practice. The other movements are well practiced, you can get good results.
3, the last part of the trilogy is the ice pack
It is also an extremely critical step. Because in the process of exercise, the tissues around your shoulder joint are stretched to the maximum extent, so it is likely to cause swelling or even small bleeding of the tissues, and it is necessary to cool down such tissues to reduce the further aggravation of the limited mobility of the shoulder joint caused by tissue damage and bleeding.
Of course, the point to note here is that after these 3 steps of exercise every day, the pain can be restored to the level of the previous day or even lighter the next day. If there is a significant trend of aggravation, it means that the method of exercise may not be right or the exercise is too much, etc., and you need to find a doctor immediately for another consultation.
Scientific icing
Seniors do not have to worry too much, as icing after an activity does not usually have an adverse effect on your shoulder joint. Of course, the method of icing must be scientific. Ice is a very important and essential treatment for sports injuries. In clinical work, we found that patients generally do not know what is the scientific method of icing, so we would like to tell you about it here.
First of all, the principle of icing is.
Reduce as well as slow down the release of histamine, reduce the sensitivity of tissues to pain; reduce microcirculation and surrounding tissue exudation and swelling; reduce the action of vascular endothelial cells and thrombus formation; reduce the release of oxygen free radicals and so on.
There are also many studies showing that the microcirculatory disorders and the tissue damage response secondary to them are not obvious within the first 24 hours after trauma. Therefore, ice should be applied as early as possible and should be continued for some time.
In this way, early and reasonable icing can achieve the purpose of reducing the degree of tissue trauma and accelerating tissue repair.
So what should be done with ice? To introduce to you.
1. location: the area where the pain or swelling occurs.
2. material: ice and water mixture is the best (my favorite description to patients is like the “ice drink” sold in KFC), followed by, for example, ice sticks, chemical ice packs, cold water, etc.
3, time: generally 20-30 minutes each time; (this is generally the time it takes for the ice to melt away)
4, frequency: every 3-4 hours is a common method.
5, the course of treatment: generally used within 48-36 hours after the injury. (This is the general traumatic inflammatory effect of the basic elimination of time)
To post a few pictures for your understanding.
Figure 1: Take some ice cubes frozen by ice grid or other methods and put them into a plastic bag (should not leak, you can use double plastic bags)
Figure 2: Add the right amount of cool water to make an ice-water mixture (the temperature is basically kept at zero degrees, which is easy to control and less likely to cause frostbite)
Figure 3: placed on the painful or swollen parts, each time 20-30 minutes is enough
After the above 3-part exercise, generally 3-6 months, will see significant results. There is also generally no need to take any pain medication during the whole process. This is because the majority of people do not have pain to the extent that it needs to be reduced with medication.