Frozen shoulder, also known as periarthritis of the shoulder joint, is mainly characterized by pain in the shoulder joint in the early stage, which is called “Leaky shoulder wind” in Chinese medicine; if it is prolonged for a long time, muscle atrophy, adhesions and limited joint movement, it is called “shoulder coagulation”.
Frozen shoulder is an inflammatory degenerative disease of the shoulder capsule and the soft tissues around the joint. It occurs around the age of 50, with a slightly higher incidence in women than in men. It is more common in diabetic patients, especially in the current “four or nine” days, so patients are more common to visit the clinic, by taking the special Chinese medicine preparation in our department, Chinese medicine acupuncture point compress with Chinese medicine ion introduction treatment effect is satisfactory, now introduce related massage health care knowledge.
Etiology and disease]
1, blood deficiency: old age and physical weakness or due to overwork and lead to liver and kidney deficiency, blood deficiency, tendon loss of nourishment, blood deficiency and pain, for a long time, the tendons and veins are constricted and do not use.
2, external wind, cold and dampness: living in the wetlands, rain and wind, sleep at night when the shoulder when the wind, resulting in wind, cold and dampness in the blood and tendons. In the pulse is blood coagulation and does not flow, the veins and veins constricted and pain. The evil of cold and dampness overflowing in the tendons and flesh is flexed and not stretched, impotent and not used.
3, trauma to the tendons and bones: fall, flash setback, tendons and veins are damaged, blood stasis within the obstruction, the veins and veins do not pass, not pass is pain. After a long time, the tendons and veins are not nourished, constrained and not used.
Classification of evidence
1.Shoulder pain: Unilateral or bilateral shoulder joint pain, often sudden, gradually aggravated, radiating to the upper arm, scapula and forearm, painful day and night, especially at night, followed by restricted joint movement, unable to lift, abduct and extend, often starting from one side, then wandering to the other side or both sides at the same time, individual always see only one side of the lesion.
2.Shoulder coagulation: Shoulder pain decreases day by day, the muscle tissue around the shoulder joint atrophies and sinks, the muscles are flabby and weak, the bone and ilium are prominent, if not treated in time, the joint further coagulates and adheres, and the activity is obviously limited.
Diagnostic points]
1. Pain: Early on, the pain is paroxysmal, often triggered by weather changes and exertion, then it gradually develops into persistent pain, and gradually worsens, with light day and heavy night, unable to sleep at night, and unable to lie on the affected side. When the shoulder is stretched, it can cause severe pain.
2.Pressure pain: There is extensive pressure pain around the shoulder joint, and it may radiate to the neck and elbow.
3.Muscle atrophy: Atrophy of the muscles around the shoulder appears later, such as the deltoid, trapezius, pectoralis major, supraspinatus, infraspinatus, biceps and triceps are seen to be atrophied.
4. Restricted functional activity: upper limb lifting, abduction and posterior extension are difficult. Especially when the shoulder joint is abducted, the typical “shoulder carrying” phenomenon appears, and it is difficult to complete the movements such as combing hair and dressing.
5.X-ray examination: Generally there is no abnormality, and the lesion of the bone joint itself can be excluded.
Treatment principles
In the early stage of frozen shoulder, gentle manipulation is used for local treatment in order to relax the tendons and blood, and to relieve the pain; in the late stage, heavier manipulation can be used together with passive activities of the functional positions of the shoulder joint in order to release the adhesions and smooth the joint.
Chinese herbal treatment for frozen shoulder is also effective. Internal Chinese herbal medicine and external Chinese herbal medicine can help relieve symptoms.
Massage therapy
1.Torso massage method.
(1) The patient lies on his or her side, with the affected side up, the affected arm flat on the side of the chest, and the palm of the hand down on the outer thigh. Therapist with both thumbs placed on the affected side of the shoulder joint above the shoulder k point, the remaining two hands four fingers holding the upper limb, from the top down along the outer side of the upper limb, through the point to the tip of the elbow above the Tianjing point, repeatedly push 2 ~ 3 minutes. Then push the inner side of the upper arm with the same technique.
(2) Point the shoulder k point, shoulder s point, and shoulder ching point for 3 minutes each.
(3) With the patient sitting upright, the practitioner holds the patient’s forearm with the same arm as the patient’s affected side and fixes the affected shoulder with the other hand. Both hands work together to make the affected shoulder do forward flexion, backward extension, abduction, adduction and rotation. The range of motion should be gradually increased so that the patient has a sense of pulling, soreness and slight pain.
(4) Use the rubbing method to repeatedly rub from the shoulder to the forearm as the end action of the treatment.
2.Hand massage method.
Use the tip of the thumb and index finger to press the points of Zhongzhu, Shang Yang, Waiguan, Erma, Shaozhe, Yangchi and Pension, each point 50~80 times.
3, foot massage method.
Rub the feet hot, stimulate the shoulder, scapula, neck, trapezius and other reflex zones for 2 minutes each, the force should be large when stimulating the shoulder reflex zone. Stimulation at the same time let the patient bear the pain to move the affected shoulder, often can get twice the effect with half the effort.
Self-care]
1.Use the palm of your hand to do a loose and tight pinching method on the shoulder and upper arm, then use both palms to do a patting method on the shoulder, press the shoulder well, shoulder k, shoulder s, quchi, hegu and other points.
2.Wall climbing activity: face the wall, use both hands or one hand to slowly climb up along the wall, with the upper limb on the affected side as high as possible, and then slowly go back down to the original place, repeat several times.
3.Pulling hands behind the body: hands backward, the healthy side of the hand pulling the affected wrist, gradually pull upward, repeatedly.
4, external rotation exercise: back against the wall and stand, hands clenched fist elbow, two arms external rotation, try to make the back of the fist touch the wall, repeated several times.
5.Hand shaking exercise: Take a standing position, do shoulder forward flexion, backward extension and inward and outward movement, the action amplitude from small to large, repeatedly.