Frozen Shoulder – What’s the 411?

(photo courtesy of Joe Shlabotnik)

Lauran Neergaard an AP medical writer has written an article entitled “Early Care Helps Frozen Shoulder” in which she illustrates some of the mysteries surrounding frozen shoulder.

• Why doesn’t adhesive capsulitis (frozen shoulder) affect the same shoulder twice?
• Why does frozen shoulder occur most often in women?
• Why does frozen shoulder sometimes migrate to the other shoulder?

Please note the title of Lauran’s article – Early Care Helps Frozen Shoulder. If you’re having shoulder issues and you fit the demographics outlined in the article and you don’t remember injuring your shoulder, then don’t waste any time - see your physician immediately.

Basic Shoulder Rehabilitation

Mednets has produced a basic, but thorough Patient Information Guide to Shoulder Rehabilitation with real pictures of shoulder rehab exercises (not drawings) and clear, understandable instructions that describe how the various exercises are to be performed.

It’s not flashy. It’s not high-tech. All of the exercises can be performed at home with items that you already have or can easily acquire.

What is a Rotator Cuff Injury?

Ask almost anyone this question and you’re likely to get a wide variety of vague answers. So what is a rotator cuff injury? Here is a very short (about 45 seconds) and very basic video animation that does a very good job of illustrating and explaining the injury. I must warn you that you will have to sit through a short commercial (about 30 seconds) at the beginning.

Shoulder Rehab for Baseball Pitchers

(photo courtesy of Glover Bryant Communications)

Kris Bensen, a starting pitcher for the Baltimore Orioles, has written an article – Shoulder Rehab: A Shoulder Rehab Throwing Program For Baseball Pitchers. Kris describes a progressive throwing program designed to rehab a pitcher’s shoulder while rebuilding his arm strength.

Shoulder Strength and Stabilization

(photo courtesy of Cronfeld)

Mark Dilworth, a certified fitness trainer, former NCAA division I athlete and creator of My Fitness Hut Blog wrote an article entitled “Strengthen and Stabilize Your Shoulder Girdle”.

Mark explains three of the most common shoulder injuries (frozen shoulder, shoulder tendonitis and rotator cuff injury) and some of the steps that you can take during your training to avoid them.

It has been a few months since I met the Rotater gang at the APTA conference in Denver, CO. I was quite intrigued with their product, and purchased one for use in my clinic. Since then, the Rotater has been used daily and I am in need of a new one or three.

The Rotater itself has proved invaluable to my patients� shoulders and their subsequent recovery. It has been used for a variety of overuse, sports, orthopedic, and post-surgical conditions to date, and on a large group of patients as well. Everyone from grandma with adhesive capsulitis to the major league baseball pitcher has reaped its benefits, and I look forward to many more.

In fact, I am currently planning a youth baseball camp for the little leagues in my area. I plan on performing mechanical examinations and coaching; rotator cuff, scapular, and core strengthening; and shoulder stretching (with the Rotater of course). I�ll keep you guys updated with the progress on the camp.

In summary, great job guys! I truly appreciate your ingenuity in creating the Rotater. It has been a great addition to my clinic. Keep up the good work.

Sincerely,

Kevin Rausch, MPT, CSCS
Rausch Physical Therapy, INC.
www.rauschpt.net

We met Kevin Rausch in August of 2007 at the American Physical Therapy Association�s annual convention. Kevin was introducing a revolutionary rehabilitation service that combines the convenience of a menu of internet based rehabilitation exercises with the expertise of member physical therapists.

An idea that is grabbing the attention of the press

Kevin�s internet based exercise program has caught the attention of Physical Therapy Products magazine, where his program has been featured a number of times.

Products on the Market ( Oct 2007 ) � a section of Physical Therapy Products magazine that features new and innovative products for the physical therapist. Scroll down to �Web-based Exercise Programs�

Soap Notes ( Dec 2007) � Physical therapy products.

Fitness Focus ( Jan 2008 ) � an article by Alan Ruskin entitled �Exercise Software�.

Visit Home Programs.net to find out if Kevin can help you.

• How serious is this?
• What are my chances?
• Is there anything that I can do to change it?
• What caused this?
• What is the survival/mortality rate?
• Can the surgeon remove it?
• Has it spread?
• What is the treatment protocol?

And this is only the tip of the iceberg. Imagine the thoughts that would race through your mind if you were confronted with the knowledge that you had been diagnosed with a potentially life-threatening disease.

Knowledge through research

These women immediately start researching books, magazines, the internet and friends in search of:

• physicians
• treatments
• hospitals
• cutting edge technology
• cancer treatment centers
• side effects
• survival stories

Knowledge is power. The power to survive.

Meetings

Soon they meet with:

• a surgeon
• an oncologist for the radiation treatments
• another oncologist for the chemotherapy treatments
• and possibly another surgeon for reconstruction

…so that they may understand the best ways to treat this disease and ensure their highest chances of survival.

Rehabilitation may be overlooked

Due to advances in technology and research, the management of breast cancer has improved greatly over the years resulting in much higher survival rates. However, even with successful surgery and treatment, survivors are often left with reduced strength and mobility. Common problems are:

• adhesive capsulitis (frozen shoulder)
• back problems
• postural alignment problems

Because of this, everyday tasks can become difficult.

When a person can�t perform simple tasks that they are used to performing, they can start to feel inadequate. This is detrimental to their emotional well-being and state of mind. Certainly, they�re grateful to have survived surgery and treatment, but they think that their incapacity is the price that they had to pay in order to survive.

This should not be the case. Breast cancer survivors are not necessarily destined to be limited.

All women who have undergone breast cancer treatment and feel that they have become physically hindered as a result, should consult with a physical or occupational therapist trained in the particular needs of breast cancer survivors. These specialists may be able to develop a program, catered to the individual, for the purpose of regaining lost strength, mobility and function.

More research

Search for breast cancer rehabilitation on the internet, in books and in magazines. Here are a few names to consider:

• Trish Muse
• Naomi Aaronson
• Linda T. Miller
• Stephanie Davies

Don�t accept a lifetime of limitations and restrictions. Talk with someone who can safely and effectively give you a rehabilitation program to get you back to the point where you can live your life to the fullest and have a satisfying life after breast cancer.

1. Breast cancer is the fifth most common cause of cancer-related deaths world-wide.
2. In the U.S. breast cancer jumps to third in the ranking of cancer-related deaths.
3. Women in the U.S. have a 1 in 8 chance of being diagnosed with breast cancer.

How does all of this relate to Shoulder Performance and Rehab?

Until recently, we had no idea of the shoulder complications that are created as a by-product of the treatments and procedures that are used to help breast cancer patients in their fight against this dreadful disease. In Denver, at the American Physical Therapy Association�s annual conference, we were approached by a nurse, who bought a Rotater and said that she wanted to use it with her breast cancer patients.

Shoulder complications in breast cancer patients?

We were intrigued and asked her to explain what she was talking about. Her explanation and subsequent research on our part has revealed to us that there are indeed a number of women who face shoulder mobility issues due to the removal of the lymph nodes that are located under their arms.

This procedure is often done to prevent the spread of the cancer cells to the lymphatic system and the rest of the body. The side effects produced are:

• the possible development of lymphedema � the retention of body fluids in the affected limb
• shoulder mobility issues due to the need to limit the movement of the shoulder during the healing process which increases the likelihood of scar tissue development in the shoulder � this is known as adhesive capsulitis (frozen shoulder)
• physical therapy may be required to deal with both the lymphedema and mobility issues

Our research led us to Trish Muse and her free e-booklet: 20 Tips to Safe and Effective Exercise Programming for Breast Cancer Survivors

Trish Muse has a list of credentials a mile long and has devoted a great deal of her life to helping breast cancer patients deal with the rehabilitation issues resulting from the treatment of breast cancer. We have been in awe of her commitment and effort to develop a system/procedure dedicated to the breast cancer survivor. Please take the time to investigate her free e-booklet as well as the other products she offers.

Pink Rotaters

We are still in the process of developing our �pink Rotaters� which will debut soon. As I stated in an earlier posting, we will set aside a specified percentage of revenues of these �pink Rotaters� which will be donated to help fund Breast Cancer Research. We will alert you as soon as all the parts of the process are in place. Quickly, we hope.

Breast cancer patients need shoulder rehabilitation

This nurse went on to explain to us that when a woman goes through breast cancer treatment, there are a number of procedures that can require her to have her shoulder immobilized for an extended period of time. This lack of movement can result in adhesive capsulitis or �frozen shoulder� � a term used to indicate a loss of the range of motion in the shoulder joint. Please check out the following sources:

• www.medicinenet.com/frozen_shoulder/article.htm
• www.susanlovemd.com/breastcancer/content.asp?L2=5&L3=2&SID=199
• www.healthsearches.org/Categories_of_Q&A/Q&A_for_Survivors/1120.php

How can the Rotater guys get involved?

We began doing research into the issue and realized that there was a need for the Rotater among breast cancer survivors. About the same time, I learned that one of my aunts had discovered that she has breast cancer and Scott found out that one of his sisters has breast cancer.

The �Pink Rotater� plan

Motivated by this information, Scott and I developed our �Pink Rotater� plan. Basically, this is the idea � we will manufacture a Rotater that is pink and has a distinct product number ( for tracking purposes ). Every time someone orders this pink Rotater, a portion of the proceeds will be donated to one of the breast cancer awareness/research charities. We will be clear as to the exact amount that will be donated once all the details are worked out. Stay tuned � an announcement will be posted here in the next couple of days.

The Law of Attraction leads us to Jane Ali and Survivor Celebration

We have just returned from Las Vegas where we had been prompted to go the PGA Expo and demonstrate how the Rotater could help golfers increase their shoulder flexibility which can result in more power and greater striking distances.

We received a huge response, especially from the PGA teaching pros that came by and tried out the Rotater. Many indicated that they would contact us later to purchase more or that they would send their clients to our web site. One professional long drive champion was especially enthusiastic about his Rotater ( we will reveal more at a later time ).

While in Vegas, we met Jane Ali of eclipse sports who is involved in Survivor Celebration . Jane is a breast cancer survivor with a passion for helping others overcome this devastating illness. We explained our idea to Jane and then demonstrated the Rotater to her. Being a breast cancer survivor, she immediately recognized the need that breast cancer patients have for the Rotater.

We have committed to making this project happen and we are trying to have everything in place so that when the Survivor Celebration Tour begins on Sept. 23^rd, we will be ready.

Stay tuned for updates.

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Justin Spooner received his Rotater at the APTA conference in Denver and writes:

Hi, I am Justin Spooner ,MSPT, I want say that using the “Rotater” on a regular basis has had a positive effect for many of my shoulder patients I see from S/P RTC Repair Surgery to Adhesive Capsulitis. It is much more effective than the old doorway and towel stretches plus patient’s seem to be more motivated to do it at home than giving them these stretches. It does a better job at isolating than anything I have come across and when it comes to shoulder impingement, etc, having good ER/IR is huge and very well could mean the difference in having surgery or not.

• the development of scar tissue within the joint
• lack of use
• both

In all likelihood, you don�t throw a baseball, softball or football as much as you did in the past. Or, maybe you don�t work around the house hanging wallpaper, painting, doing carpentry or any of the things you used to do that required you to use your shoulder throughout it�s full range of motion.

In my case, this condition was a byproduct of shoulder surgery. Following surgery, I was required to have my shoulder immobilized for an extended period of time. This lack of movement for a considerable amount of time, resulted in a diagnosis of �frozen shoulder�. My orthopedic surgeon recommended physical therapy.

At this point, my curiosity was stimulated. I wanted to know more about adhesive capsulitis, so I did some research. I found out that �frozen shoulder� is most prevalent in women who were middle-aged and older. This was very sobering to me since I thought that I was a fairly healthy man. My ego was crushed to find out that I had a condition that most commonly occurred in women.

All jokes aside, �frozen shoulder� affects nearly everyone (man or woman) who has shoulder surgery because the joint must be immobilized and stabilized to reduce the chances of damaging your newly repaired shoulder.

The logical course of action to regain your range of motion involves your participation in a program of physical rehabilitation. This process of physical rehab can be long, tedious and painful � the variables being:

• your willingness to work hard during your recovery/rehabilitation
• the amount of time you invest in performing your exercises
• your desire to regain the full use of your shoulder
• your pain tolerance

Physical therapists are some of the nicest people you will ever meet, but they have a job to do. Regardless of what you may think, they take no pleasure in causing you pain and you will experience pain during the rehab process. But it is necessary and it is the only way for you to regain your range of motion. This is a small price to pay for a fully functioning shoulder. Be sure to thank your therapist.

I suffered another blow to my ego when I started some basic flexion exercises. My physical therapist handed me a pink dumbbell. I thought to myself, �I am six feet tall and weigh two hundred and twenty pounds. I need a manly colored dumbbell.� My physical therapist explained to me that the pink dumbbell weighed only one pound and the �manly� colored dumbbells started at about seven or eight pounds.

So, I started with the pink one � I wasn�t even strong enough to lift it � especially laterally (out to the side). I had to work with the pink one for a long time. I couldn�t wait to advance to the purple one, which was right before the pastel green one.

I was always glad to finish my dumbbell exercises so that I could start on the pulleys. I was able to control this motion and provide a smooth, gentle stretch. This actually felt good.

After all the exercises were completed, I had to get on the physical therapist�s table and hope that they were in a good mood ( no family squabbles and no speeding tickets on the way to work � just happy). I wanted them as calm, relaxed and happy as possible. As I stated earlier, your PT�s job is to help you regain the mobility of your shoulder. This process involves them manipulating your joint in order to break up the scar tissue. There will be some discomfort involved.

Most of the time, you will be given a prescription that allows you to see your physical therapist three times per week. Since there is only so much that can be done in only three visits per week and there is only so much discomfort that you can stand during each visit, the rehab process can be lengthy.

If you are in this predicament and are looking for a way to speed up the process, have your therapist go to www.therotater.com and check out the shoulder rehab device video. Ask you physical therapist if you could benefit from using the Rotater during your off days.

Physical rehabilitation can be a long process, but the rewards are worth it. The ability to use your shoulder as it was intended and to do the things that you want to do without limitations is priceless.