Using a Massage Gun for better sleep with frozen shoulder

Massage can be done by self through massage guns or a lacrosse ball. Massaging the small muscles of the shoulder like the pectorals, deltoid, and trapezius, with a massage ball can be painful in the inflammatory phase of the frozen shoulder. In this case, a low-intensity massage with a flat device head can help to soothe the muscles, improve flexibility for a short time and flush out the inflammatory metabolites. 

Best sleeping position for the frozen shoulder:

Sleeping on the other side of the affected shoulder with a pillow under the armpit of the affected one. This is the easiest solution, but if you are turning frequently in sleep, the painful side gets compressed intermittently and that again disturbs the sleep.This can be managed by sleeping on a recliner or using the support of pillows on the affected side.

Using pillows and cushions to improve your sleep:

Sleeping in supine or on the straight back position: 

This position can also be supported well with the pillows under the arm.

Sleeping in a quarter-turn reclined/side-lying position by keeping the pillows under the affected side:

This position elevates the affected side up and even if you tend to turn sides, the pillows would be there to block it.

Modified Foetal Position

Most of us tend to sleep in this easy-to-go position. Sleeping on the non-affected side in this position can be well supported with the pillows between the knees, under the head, and one supporting the arms.

In case of acute pain and swelling, biofreeze spray can be the preferred modality. But for any muscle spasm and fascial tightness issue, moist heat or a heating pad before you sleep generally works the best

Sleeping Positions to avoid:

• Sleeping side lying on the aching shoulder gives the utmost pain. 
• Also sleeping on the stomach frequently puts the shoulder in an elevated position which further strains the upper trapezius and increases the shoulder pain. 

Using a TENS Machine for better sleep

TENS machine helps in numbing down the pain by blocking the thinner pain carrying neural fibres. It is not a treatment modality but definitely can help to tone down the pain just before one sleeps. 

Read more about TENS machines for frozen shoulder

Magnesium Oil:

Magnesium has been used to relieve muscle cramps and facilitate recovery of the overworked muscles.Transdermal application of magnesium oil, helps in rapid absorption and  avoids any gastrointestinal distress symptoms which come with oral ingestion.  A warm water ipsum salt bath combines the dual benefits of magnesium and heat therapy and gives full body relaxation. Magnesium supplementation can also help in easing pain, but it should be taken according to the recommended dietary allowance along with a physician consultation.

THC/Cannabis Edibles:

Depending on where you live and applicable laws, THC, the active ingredient in cannabis, can help with sleep and pain management. 

THC edibles are not approved by FDA and frequently the composition of the compounds are not stringently regulated by the sellers.THC a derivative of Cannabis is the main psychoactive substance responsible for sense of giving a high. Used as a potent sedative and pain reliever in neuropathic pain and intractable cancer, it may have a longer sleep inducing effect.It has potential side effects of varying intensities on those who consume it. The research on use of THC edibles, specific to shoulder pain is lacking and may have some benefit in chronic cases not responding to other modalities of treatment. It is very important with regards to safety  to take any psychoactive substance with a prior consultation with a doctor in accordance with the legal laws of the country.

CBD (Cannabidiol):

Cannabidiol (CBD), also a derivative of cannabis, does not contain any psychoactive substance giving a high. CBD oil, through its anti-inflammatory effects, can be used as an adjunct to improve sleep and reduce pain. Though high-level evidence lacks for the use of CBD, specific to the frozen shoulder, it can be used with precaution and as an adjunct  when available as a well-regulated product.

Melatonin:

Melatonin is a sleep inducing hormone naturally produced by the body through the pineal gland in the night when the darkness sets in. Melatonin is available as a supplement and not controlled as drug by FDA and also as a drug Ramelteon, which is basically a melatonin receptor agonist.  Both of them influence the melatonin action and help in sleeping.Melatonin has a fewer side effects like drowsiness, headaches and dizziness and are seen when it is overdosed. It can be a good supplement for short term use for sleep induction.

Medications:

Anti-inflammatory/OTC Drugs:

Naproxen and acetaminophen, the OTC drug helps in controlling inflammation and blocking the pain and also have some effect on relaxing the muscles.

Muscle relaxants:

Muscle relaxants are generally not sold over the counter and when prescribed by the physician can surely help.

Timing the medications:

These medications especially in the inflammatory phase should be taken an hour before the sleep. Medications taken too early can lose their effect in the middle of the night due to their short half-life and bring back the pain. Hence the medications need to be timed well with the sleep schedule, following with the dosage and physician’s advice.

Cortisone:

A steroid shot coupled with physiotherapy has been shown to reduce the inflammation and pain with a long term effect. It is important to avoid repetitive steroid shots in shoulder as it affects the tendon health in long term, hence the use of exercise is important to sustain the effects of the steroid and maintain the pain free range of motion. Getting a cortisone shot isn’t a decision you make before going to bed tonight, but getting a shot can help you reduce pain and inflammation for several weeks, helping you get some sleep. 

You can find out more about Cortisone Injections and Frozen Shoulder here. 

Hydrodilatation:

Hydrodilatation is the infusion of combination of saline, steroid and local anaesthetic in the shoulder joint capsule to distend it and cause micro-ruptures. It can help in giving good short term results and improving function, but long term evidence for its use is inconclusive and deficient.

Sleep Hygiene:

Good sleep hygiene which incorporates environmental and behavioral modifications helping to facilitate a deeper sleep. Like:

1. Following regular sleep timings which affect your circadian rhythms
2. Reducing the use of bright lights and screen time
3. Abstaining from caffeine use near sleep time 
4. Avoiding alcohol use to facilitate sleep as it slows down the healing
5. Managing stress well and not ruminating at night by following relaxation techniques, mindfulness, and breathwork techniques like box breathing before you sleep.
6. Avoiding noise and making use of soothing music or the podcast  of choice to fall asleep.

The post How to Sleep With a Frozen Shoulder appeared first on Siphox Health.

Here are a range of exercise videos for frozen shoulder in the thawing stage. The isometric exercises from the frozen stage should have helped you build strength in your shoulder. Now with increased range of motion as your shoulder starts to thaw, you can move to more exercises that promote range of motion recovery, strength, and mobility in your shoulder joint.

As you’re starting to see your range of motion return, check out our iOS app Reflex that allows you to accurately measure your shoulder range of motion just using the front-facing camera. It’s a great tool to see your progress and highlight which movements are returning faster and which ones you can work on to get better results. In the premium version you can get all the frozen shoulder exercise videos in the app.

Click here to download Reflex from the App Store.

Signs that frozen shoulder is starting to thaw

Entering the thawing stage is a process that happens gradually over weeks or months. You’ll be relieved to be out of the frozen stage and feel like there is hope after what may seem like an endless lifetime of reduced mobility.

Here are some signs that your frozen shoulder is thawing:

– You have more range of motion in your shoulder

– Your pain is decreasing

– You feel achy or stiff instead of sharp pain

– Your shoulder feels “looser”

As the adhesions in you shoulder start to break up, you’ll feel an increase in range of motion. This is followed by a decrease in pain as the tissue starts to heal. Some people do experience fluctuations in pain during the thawing stage.

Your frozen shoulder will likely thaw on its own given enough time, but there are some things you can do to speed up the process.

• Physical therapy: A physical therapist can help break up the adhesions in your shoulder and stretch the tissue.
• Massage: Massage can help increase blood flow and loosen the muscles around your shoulder.
• Heat: Applying heat to the area can help increase blood flow and loosen the muscles.
• Exercise: Exercising the shoulder, within the limits of your pain, can help break up the adhesions, and strengthen your muscles.

Exercises for the thawing stage are designed to increase your range of motion and strength in the shoulder. You are more likely to be injured if you have limited range of motion and limited strength in your shoulder. Increasing your strength and flexibility will also mean you can return to sports and other activities you may have had to give up during the frozen stage.

These exercises are designed to help with that.

Stabilization Flexion and Extension

Equipment Required: Resistance Band

Steps to follow:

1. Tie a band in front of you at waist level.

2. Firmly hold each end of the band with each hand.

3. Place your hands and arms in line at shoulder level with your palms facing down.

4. Move one arm over your head, keeping it straight, while the other moves close to the body downwards simultaneously.

5. Slowly return to the starting position, and repeat going the opposite way.

Scapula Retraction

Equipment Required: Mat

Steps to follow:

1. Lie on your stomach, face down with your hands on the back of your head.

2. Lift your elbows off the surface while squeezing your shoulder blades together.

3. Let your elbows down and repeat.

Supine Chest Stretch with Hands Behind Head

Equipment Required: Mat

Steps to follow:

1. Lie on your back.

2. Place your hands behind your head with your elbows bent.

3. Let your elbows drop gently towards to the floor, as low as possible.

4. Hold the position.

Shoulder Internal Rotation with Elastic

Equipment Required: Resistance Band

Steps to follow:

1. Stand and tie an elastic behind you at head level.

2. Hold the end of the elastic, bend your elbow to 90 degrees and lift your arm out to the side to 45 degrees.

3. Rotate your forearm downward, keeping your elbow bent.

4. Slowly return to the start position and repeat.

Shoulder Flexion Stretch with Swiss Ball

Equipment Required: Swiss Ball

Steps to follow:

1. Stand facing a wall and hold a ball against the wall with one hand. The arm is straight horizontally in front of you.

2. Roll the ball upward by getting closer to the wall and by raising your arm as high as possible until you feel a gentle stretch.

3. Maintain the stretch and lower your arm.

Shoulder Abduction with Elastic

Steps to follow:

1. Tie an elastic beside you at hip height and hold it firmly with one hand.

2. Straighten your arm on the side and raise it overhead as high as you can, keeping the elbow straight.

3. Lower your arm slowly and repeat.

Shoulder Flexion with resistance band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic in front of you at waist level and hold it in your hand.

2. Straighten your arm in front and raise your arm forward as high as you can, keeping it straight.

3. Lower your arm slowly and repeat.

External rotation, 90° Abduction with Resistance Band

Equipment Required: Resistance Band

Steps to follow:

1.Tie a resistance band in front of you at shoulder level.

2. Hold the end of the band, bend your elbow to 90 degrees, and lift your arm out to the side to 90 degrees.

3. Rotate your forearm upwards, keeping your elbow bent.

4. Slowly return to the initial position and repeat.

Pectoralis stretch, mid fibers – Right Shoulder Exercise (Shorts)

Equipment Required: None

Steps to follow:

1. Stand next to a wall and put your hands on the wall behind you at shoulder level, with your fingers pointing backwards.

2. Without turning the trunk, take a few small steps forward until you feel a comfortable stretch in the pectorals major.

3. Hold the stretch.

Tennis Backhand with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind you at waist level and hold it with your hand in a tennis backhand position.

2. Pull the elastic forward in a tennis backhand motion.

3. Return your arm slowly to the start position and repeat.

Tennis Forehand with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind you at waist level and hold it with your hand in a tennis forehand position.

2. Pull the elastic forward in a tennis forehand motion.

3. Return your arm slowly to the start position and repeat.

Thoracic Extension Mobility with Roller

Equipment Required: Mat and Roller

Steps to follow:

1. Place your foam roller on the floor and take a kneeling position with your wrists on the foam roller in front of you.

2. Roll the foam roller forward by lowering your chest towards the floor and stretching your spine.

Throwing Motion with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind your head and hold it with your hand in a “ready to throw” position.

2. Pull the elastic forward and down in a throwing motion.

3. Return your arm slowly to the start position and repeat.

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Age

One factor that may influence your decision is age. If you are over the age of 60, you may be less likely to have a successful surgery. This is because the tendons and muscles around the rotator cuff may have become weak due to age.

Activity Level

Another thing to consider is your activity level. If you lead a sedentary lifestyle, you may be able to get by without surgery. However, if you are active and participate in sports or other activities that require use of your arms, you may be more likely to need surgery.

Type of Tear

There are two main types of rotator cuff tears: partial and full-thickness. Partial tears are less serious and may not require surgery. Full-thickness tears, on the other hand, are more severe and often require surgery to repair.

Size of Tear

The size of the rotator cuff tear may also influence your decision to have surgery. Smaller tears may be able to heal on their own, while larger tears may require surgery.

Your doctor will also take into consideration your overall health and any other factors that may influence your ability to have a successful surgery.

The decision to have rotator cuff surgery is a personal one and should be made after careful consideration of all the facts. If you are still undecided, speak with your doctor about other options that may be available to you.

You can choose not to have rotator cuff surgery if the following treatments work:

• Anti-inflammatory medication
• Physical therapy

The post When not to have rotator cuff surgery appeared first on Siphox Health.

Driving with one arm is dangerous as you do not have full control of the car. Additionally, you may have to react quickly to conditions on the road which could put immediate and destructive strain on your vulnerable shoulder.

The post How long after rotator cuff surgery can you drive? appeared first on Siphox Health.

 This blog will provide information about subscapularis tendon tears – what they are, how they are caused, and how to treat them – as well as ways to prevent them from occurring.

What is a subscapularis tendon tear and what causes it

A subscapularis tendon tear is a tear of the subscapularis tendon. This tendon attaches the subscapularis muscle to the upper arm bone (humerus). It helps to rotate the arm inward and stabilize the shoulder joint. A tear of the subscapularis tendon can cause pain and difficulty rotating the arm.

There are two types of subscapularis tendon tears:

Partial Tear

A partial tear is a small tear that does not completely sever the tendon. These tears are often the result of overuse or repetitive motions.

Complete tear

A complete tear severs the tendon completely. These tears are often the result of a single, traumatic event.

Symptoms of subscapularis tendon tear

The most common symptom of a subscapularis tendon tear is pain. This pain is often located near the shoulder joint and may radiate down the arm. Other symptoms include:

– Weakness in the shoulder

– Difficulty moving the arm

– Tenderness when touching the shoulder

– Swelling in the shoulder

– Bruising in the shoulder

How to prevent subscapularis tendon tears

There are several things you can do to help prevent subscapularis tendon tears:

– Make sure you warm up properly before any physical activity. This will help to loosen the muscles and prepare them for exercise.

– Stretch the muscles around the shoulder joint regularly. This will help keep them flexible and less likely to tear.

How to treat subscapularis tendon tears

If you have a subscapularis tendon tear, there are several things you can do to help treat it:

– Rest the shoulder joint as much as possible. This will allow the tendon to heal.

– Ice the shoulder joint regularly. This will help to reduce inflammation and pain.

– Apply compression to the shoulder joint

How subscapularis tendon tears can affect shoulder range of motion

Subscapularis tendon tears can affect shoulder range of motion in several ways. First, a tear in the subscapularis tendon can cause pain and inflammation, which can limit the range of motion in the shoulder joint. Second, if the subscapularis tendon is severely torn, it may not be able to function properly, which can also limit the range of motion in the shoulder joint. Finally, if the subscapularis tendon is completely torn, it will need to be surgically repaired, which will require a period of immobilization and physical therapy to regain full range of motion in the shoulder joint.

Using the Siphox Health app to measure subscapularis tendon tears

The Siphox Health app is a great tool for measuring subscapularis tendon tears. The app allows you to track your pain levels and range of motion so you can see how your injury is healing over time. It also provides helpful tips and exercises to help you recover from your subscapularis tendon tear.

The post Subscapularis tendon tear: causes, treatment, and symptoms appeared first on Siphox Health.

AC Joint Degeneration most commonly affects middle-aged and older adults. However, the condition can also occur in younger adults, particularly those who participate in contact sports or other activities that put repetitive stress on the shoulder. In this article we will explore AC Joint Degeneration, what causes deterioration of the acromioclavicular joint and what treatment options are available.

What is the AC Joint?

What we often refer to as our shoulder is actually a complex of four separate joints. The Acromioclavicular Joint or AC Joint is formed where the outer end of the collarbone or clavicle meets the acromion, a bony process on the scapula bone. The AC Joint attaches the scapula to the clavicle and is therefore the primary connection that suspends the upper limb from the trunk.

Several strong ligaments surround the AC Joint and work together to provide stability and maintain the alignment of the joint. The bony surfaces of the distal clavicle and the acromion are lined with joint cartilage and the joint capsule contains joint fluid to keep things moving smoothly. Some people have a small joint disc made up of fibrocartilage, similar to the meniscus found in the knee joint.

What is the function of the AC Joint?

The AC Joint is not as highly mobile as the Glenohumeral Joint (the ball and socket joint we often refer to as the shoulder) but it serves a few important functions:

1. It allows the scapula to rotate and tip on the thorax.
2. It allows for transmission of forces from the upper limb to the clavicle.

The AC Joint is hard at work whenever you move your upper limb through its range of motion, think of throwing, serving in tennis, push-ups and any other demanding movement of the arm and shoulder.

What causes AC joint degeneration?

The AC Joint is relatively small, but it still needs to deal with significant forces. In other words, we subject our AC Joints to large forces per unit area compared to our other joints. Unfortunately, this means that the AC Joint is extremely susceptible to trauma (often because of sporting injuries) and degenerative change. 

Primary osteoarthritis refers to joint degeneration that occurs with no underlying cause. It develops because of constant stress on the joint over a period of many years, often in people who perform repeated overhead lifting activities. Degenerative change refers to the gradual thinning and destruction of the joint cartilage to where the joint becomes osteoarthritic and painful. Degenerative change can occur as early as the 2nd decade but is very common and almost universal by the 6th decade.

Secondary osteoarthritis occurs because of a traumatic injury or an underlying inflammatory condition like rheumatoid arthritis. In a traumatic injury, a sudden abnormal force separates or dislocates the joint. Besides being extremely painful, these injuries raise the risk for later degenerative change. 

What are the symptoms of AC joint degeneration?

The primary symptom of AC Joint degeneration is pain. The pain is often felt at the top of the shoulder and provoked by overhead movements or sleeping on the affected shoulder. Sometimes there is some swelling or redness on top of the shoulder. Popping, clicking, or grinding sensations may be felt as the damaged cartilage surfaces move against one another. The AC Joint may be tender to the touch and even feel a little warmer than the surrounding area.

Your sports physician will make the diagnosis by performing a clinical examination and perhaps ordering imaging tests such as x-rays, ultrasound scans, or even an MRI.

How is AC joint degeneration treated?

Physiotherapy and activity modification

Physiotherapy is essential to manage pain, maintain the joint range of motion, strengthen stabilising muscles, and correct postural issues. Physiotherapy may include manual therapy, electro-modalities and exercise prescription.

Activity modification helps to avoid stressing the joint further and worsening the symptoms. Your physio will advise you to avoid push-ups, dips, flies, bench-press, and any repetitive overhead activities.

Oral analgesia

Pain-killing medications like non-steroidal anti-inflammatory drugs (NSAIDs) can diminish the pain from ACJ degeneration but have side-effects to consider.

Local corticosteroid injection

Your doctor will inject a mix of cortisone and local anaesthetic directly into the joint, usually under the guidance of an ultrasound scan. Corticosteroid injections can provide good pain relief but are ineffective in the long term. The pain usually comes back over a period of weeks to months.

Surgery

Surgical treatment is reserved for those severe cases that do not respond to at least six months of conservative treatment. Surgery can be done as an open or arthroscopic procedure (“keyhole surgery”). Arthroscopic procedures are generally associated with less pain and a faster return to function. 

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What is a TENS machine?

TENS functions with the application of a pulsed rectangular wave current via surface electrodes placed on the selected area of the skin. This current is often generated by small battery-operated machines in which circuits modify the battery’s output such that it will have a stimulatory effect on the nerves.

Usually, TENS is administered using either high- or low-frequency modes. Although many researchers employ frequencies at or above 100 Hz, high frequency can be defined as being larger than 50 Hz.

Intensity is believed to be important in maximising the effectiveness of the TENS. It should be enough to generate a strong but painless sensation and must be adjusted accordingly throughout the course of the treatment.

What does the TENs machine do?

The TENS machine works by the ‘Gate Control Theory of Pain.’ According to this theory, there exists a ‘gating’ mechanism in the spinal cord that regulates the amount of incoming painful stimuli. The pain stimuli come in through nerve fibres that have a small diameter. The sensory input of the TENS machine comes in via nerve fibres that have large diameters. Hence, it is thought that the larger nerves can block the sensations coming through the smaller ones; thereby, ‘closing the gate for pain’ and its perception. 

This may sound confusing, but humans use this mechanism to block pain unknowingly all the time. For example, rubbing your skin after hitting the edge of a table activates the large diameter nerve carrying the sensation of touch to block out the smaller pain-carrying nerve fibres. Thus, similarly, TENS electrically rubs pain away.

How does a TENS machine work?

The TENS machine can be used in the conventional mode or the acupuncture mode. During conventional TENS, low-intensity pulsed currents are administered at higher frequencies at the site of pain. This type of TENS activates large diameter non-noxious afferents (nerves with the incoming stimuli) and blocks the pain. It is more commonly used for acute episodes of pain.

The acupuncture type of TENS is less frequently used. At the site of pain, high-intensity currents are applied at lower frequencies. This is more often used in chronic cases of shoulder pain.

Now you may wonder if the ‘current’ given out by the TENS machine is anything remotely mimicking an actual electrical current that you get when you accidentally touch a wire. Well, it absolutely isn’t. The current experienced with this machine usually is a mild tingling sensation if you use conventional TENS. It can be slightly irritating in the beginning if you use acupuncture TENS as its main mechanism of action is irritation which counters the pain (counter-irritant effect). However, this does subside and does not cause prolonged discomfort.

Where to place the TENS machine pads for frozen shoulder

Before we answer the ‘where’, let’s focus on the how. How does one apply the electrodes of the TENS machine?

The first thing to do before using the machine is to test it and make sure that the machine along with its wires is intact. You can also test the current via the electrodes on the palm of your hand as a precautionary measure.

Before you do place the electrodes, ensure that you clean the skin over which you will be placing the electrodes.

Ideally, conductive rubber electrodes should be used with conductive gel to gain good skin contact. The electrodes can also be bandaged onto the skin or fixed with adhesive tape.

The electrodes should be placed over the area of pain. If it is a localised pin-point pain, both the electrodes can be placed adjacent to the area of pain. The rubber electrodes are quite malleable, so even if the rounded contour of the shoulder has pain, they can be comfortable stuck over it.

If the pain is a tingling type of pain, the electrodes can be placed in a straight line along the route of the nerve that causes the tingling.

How to use a TENS machine for frozen shoulder

There is some evidence to suggest that TENS may be helpful for frozen shoulder. In one study, TENS was found to be more effective than placebo for reducing pain and improving range of motion in people with a frozen shoulder.

Once the electrodes are stuck, the intensity must be very gradually increased. Higher intensity does not equate to better or faster healing. Thus, in order to avoid any electrical burns, optimal intensity should be chosen. After a while, you may feel that you are getting adapted to the pre-set intensity and the sensation of the machine has reduced, that is when you can gradually increase it.

There is no fixed duration for the application of the TENS machine but usually, about 20 to 25 minutes does suffice to induce pain relief. Using the TENS machine 3 times a week for around 4-5 weeks usually helps with shoulder pain. This may vary from patient to patient as all people have varied symptoms of frozen shoulder. Unlike pain-relief medications, the main advantage of a TENS machine is that it can be used multiple times a day depending on the intensity and severity of pain.

Patients with a frozen shoulder have adhesions in their shoulder joint capsule and muscular guarding due to pain. Muscular guarding is when muscles contract reflexively as a protective response to pain but remain in a contracted state, which increases the pain. 

Thus, they present with pain and a reduced range of movement of the affected shoulder joint. The TENS machine as mentioned does take care of the pain, thereby allowing the patient to move the joint more comfortably. 

Additionally, research has shown that the TENS machine can also reduce muscle hardness, thereby inducing flexibility in the muscle tissue. Therefore, after using a TENS machine, it would be beneficial to stretch the affected shoulder joint. However, this should be done gently and within the limits of pain. 

Will a TENS Machine help a frozen shoulder?

A TENS machine can provide short term and long term relief for frozen shoulder. If you are suffering from acute pain, which is typical in the freezing stage, a TENS machine electrically rubs the pain away. In the medium to long term, the TENS machine stimulates the muscles, helping to retain strength. This strength is needed as your shoulder range of motion returns.

Measure yourself

Download our app Reflex:Shoulder Mobility App to measure your range of motion and track pain over time. Reflex allows you to visualise your recovery by accurately measuring range of motion and tracking pain levels. 

Treatment will vary depending on what stage of frozen shoulder you are in. Your TENS machine can help you in all three stages of frozen shoulder. Below is an example of what your shoulder range of motion looks like in the Thawing Stage of frozen shoulder.

Click here to start plotting your frozen shoulder chart with Reflex

Best TENS Machines for Frozen Shoulder

The Best TENS machine for frozen shoulder may different for everyone. Based on budgets and availability, here are our top picks for the best TENS machine for you if you have symptoms of adhesive capsulitis.

HealthmateForever YK15AB TENS unit

Transcutaneous Electrical Nerve Stimulation unit with dedicated “Shoulder” Mode accessible by its own button

iReliev TENS + EMS Combination Unit

14 Modes including pain relief and muscle strengthening. Good all-rounder for different stages of frozen shoulder. Electrical Muscle Stimulation (EMS) also known as nueromuscular electrical stimulation (NMES) contract muscles using electric stimulation. EMS has the potential to serve as a strength training and rehab tool as well as offer post-exercise recovery benefits for athletes.

iSTIM EV-805 TENS EMS

High grade Japanese electrode pads designed for sensitive skin. High quality design, many people upgrade to this model after their entry level devices. 

TechCare Massager Touch X – TENS EMS Unit

Powerful and compact 

AUVON 4 Outputs TENS Unit EMS Muscle Stimulator Machine

Compact and powerful with a simplistic interface which means changing settings can be tiresome. Each of the 4 outputs connects to 2 pads, so total capacity is 8 pads.

Dangers and precautions of using a TENS Machine for frozen shoulder

1. Applying a high intensity of TENS alongside a high frequency for long durations can cause an electrolyte reaction under the electrodes.  
2. The TENS machine could cause a possible interference with a pacemaker’s functioning if applied too close to it and hence is inadvisable.
3. Application of TENS on an area with diminished or altered sensations should be strictly avoided.

The post Is a TENS Machine Good for Frozen Shoulder? appeared first on Siphox Health.

Shoulder bursitis is a condition that results in pain and inflammation in the shoulder joint. This condition is often caused by repetitive motions or injuries. There are many different shoulder bursitis exercises that can help to reduce inflammation and pain in the shoulder joint. These 13 exercises for shoulder bursitis can be performed at home with little to no equipment needed.

The type and intensity of the exercises depends on the underlying cause of the bursitis and the severity of inflammation. 

  

Why do Shoulder Bursitis Exercises?

To begin with, you will want to restore flexibility and range of motion, followed by strengthening exercises targeted at stabilising the rotator cuff muscles and muscles between the shoulder blades. Always use your symptoms and shoulder stability as a gauge for when you’re ready to progress with repetitions, resistance, and shoulder range. 

 

Stretching & Mobility exercises for Shoulder Bursitis

•     Stretching and mobility exercises help to stretch the shoulder muscles and help in reducing the tension. 
•     The exercises can be performed in standing or sitting position and performed twice or thrice a day. 
•     Hold the stretches until a comfortable position and do not push to a point of extreme pain or discomfort.

 

   1. Shoulder table slides

•     Sit next to a table and place the arm on the table (preferably place a towel underneath the arm to reduce friction).
•     Gently slide the arm forward while bending at the waist. 
•     Hold the position for 3-5 seconds and return to the initial position. 
•     Repeat 10 times.

  

  2. Active assisted shoulder flexion with cane

•       Stand comfortably in an upright posture and neck relaxed. Grab a dowel, wand, or a walking stick. Hold the stick in your hand at shoulder width down near your thighs.
•       Lift  up both hands towards the ceiling , as high as possible in a slow and controlled manner. Then, slowly return back to the starting position.
•       Repeat 10 times for 2-3 sets.

  3. Active assisted shoulder rotations with cane

•       Stand comfortably in an upright posture and neck relaxed. Grab a dowel, wand, or a walking stick. Hold the stick in your hand at shoulder width down near your thighs.
•       Keep your elbows close to your body and move the wand across your body toward the sore arm.
•       Hole for 10-15 seconds and repeat for 3 to 5 times.

 

 

4. Posterior capsule stretch or cross body stretch

•       Bring your arm across the body, placing your hand on the opposite shoulder. With the other hand , press over the elbow as if you are pushing the arm backwards. 
•       Hold this position for 10-15 seconds and then relax. 
•       Repeat this exercise 3-5 times.

 

5. Shoulder blade squeeze

•       Place your arms by your side. Pull your shoulder back as if the shoulder blades are touching each other. 
•       Hold the position for 10-15 seconds and then relax. 
•       Repeat this exercise 5-8 times. 

 

Strength Exercises for Shoulder Bursitis

Strength exercises help to improve the muscle strength around the shoulder joint. This can help to reduce the risk of further injury and provide support to the joint. These strength exercises for shoulder bursitis can be performed at home and require little to no equipment. It is important to perform these exercises with good technique to avoid further injury.

1. Isometric exercises for Shoulder Bursitis

Isometric exercises are a type of exercise that involves contracting your muscles without moving your joints. This type of exercise can help to improve joint stability and muscle strength. These Isometric exercises for the shoulder joint involve holding your arm in certain positions or resistance against an immovable object. These 6 exercises are the main isolated movements of the shoulder function.

Perform these exercises, using wall as the resistance. Apply light pressure.

Hold for 10 seconds and repeat for 5 times.

Flexion

Extension

Abduction

Adduction

External rotation

Internal rotation

 

2. Scapular wall push-ups

•       Stand facing the wall and place your hands on the wall at shoulder level.
•       Slowly bend your elbows and bring your face towards the wall. Keep your back and hips straight.
•       Push back to the initial position
•       Repeat 10 times

 

3. Scapular wall angles

•       Stand against the wall with feet 6-10 inches from the wall.
•       Position yourself so that the entire spine is aligned with the wall and the back of your head is touching the wall.
•       Bring your arms up, while keeping them flat against the wall, the shoulders should be abducted, and elbows bend to 90 degrees each.
•       Slide up and down the wall while keeping your neck relaxed.
•       Repeat 10 times , 3-5 times.

 

  

Activities to avoid with Shoulder Bursitis 

Activities to avoid depends on the severity of the bursitis, stage of recovery and your fitness level. Keep a watch on the symptoms and decide what activities increase and decreases  it. 

 

Some of the movements to avoid during shoulder bursitis include: 

•     Overhead throwing 
•     Triceps dip
•     Overhead reaching
•     Activities which involve heavy lifting
•     Avoid unnecessary shoulder impingement movements such as upright rows and arm exercise with thumb pointing downward
•     Any other painful movements

 

Other recommendations

•     Always start the exercises with a gentle warm up routine.
•     Stretching should be performed prior to strengthening to maximise the tolerance for range of motion.
•     Always focus on a good posture with daily activities and while exercising to reduce the impingement.

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What is the AC Joint?

The Acromion-Clavicular Joint (AC Joint) is the joint between the bony tip of the shoulder (acromion) and the collar bone (clavicle). The Acromion-clavicular joint is one of the synovial articulations of the shoulder complex which connects the axial to the appendicular skeleton.

The synovial joint is formed between the convex lateral clavicular and medial concave acromial ends.

A fibrocartilaginous disc similar to the knee’s meniscus sits between the articulating surfaces. Degeneration of this disc occurs with increasing age and activity and is thought to contribute to pain and disability in the elderly and overhead athletes.

The AC joint has four planes of movement: anterior-posterior and superior-inferior.

The capsule surrounding the joint,  the condensed acromioclavicular ligaments, and the coracoclavicular ligament complex is the restraint that keeps the joint in position and protects it from its dislocation.

AC joint injuries account for 9 to 12% of all shoulder injuries, both traumatic and degenerative injuries. 

Traumatic AC injuries are mostly seen in people aged in the twenties whereas Degenerative AC Injuries are more prevalent in people in their fifties. The AC joint sprains which can be due to direct or indirect force are high in collision and combat sports like hockey, American football, rugby, and karate.

How to find the AC Joint?

The joint can be found by running your fingers along the clavicle, also known as the collar bone, towards the shoulder. At the point where the clavicle ends, depression can be sensed between the clavicle and an overriding acromion. This joint space is the AC joint space. 

Can AC joint injury cause neck pain?

Yes, AC joint injuries can cause neck pain. The stability of the AC joint is provided by trapezius and deltoid muscles dynamically. They help in maintaining the joint position during movements of the arm. Hence any injury to the joint can cause a protective spasm in the upper trapezius and muscles surrounding the joint to guard the joint against further injury. Even some of the experimental pain studies have reproduced pain in the trapezius – supraspinatus, anterolateral neck region, and deltoid region by injecting saline in the AC joint. 

AC joint can cause referred pain in the neck region, for which the joint needs to be tested clinical-radiologically, with good attention given to the mechanism of injury.

How do you treat an injured AC joint?

An injured AC joint is treated according to the mechanism of injury. A degenerative or a micro traumatic AC joint is de-loaded by activity modification or restriction, icing, and taping. The scapular muscles are strengthened statically and dynamically and flexibility is restored to normal length.

An acutely sprained AC joint is generally treated with rest and immobilisation in a sling. Mobility, motor control, and strength are built gradually as the pain settles down and movement becomes easier.

How long does the AC joint take to heal?

The healing of the AC joint depends upon the number of structures injured, the mechanism of injury, the intensity of the traumatic force, the age of the patient, and his/her occupational demands. 

A degenerative joint disorder generally requires three to seven days of sling immobilisation with anti-inflammatories, physical therapy focuses on scapular control and flexibility, followed by activity modifications and strengthening. In some cases, intra-articular injections are also helpful in controlling inflammation. 

Acute AC joint sprains are classified according to Rockwood classification, depending upon the ligaments and trapezius – deltoid fascia involved. Type 1 and 2 injuries are mild sprains without any separation of the joint surfaces. These injuries are treated non-operatively with rest, immobilisation in a sling a gradual physiotherapy program focussing on building strength and scapular kinematics. Depending upon the extent of the injury and other comorbidities it might take 3 to 12 weeks of rehabilitation to heal an AC joint injury.

With respect to athletic injuries, especially in collision sports the player position, injury time compared to the athletic season, and throwing demands are taken into consideration to make treatment decisions. Athletes predisposed to further AC joint injuries are predominantly treated conservatively. Type 3 injuries can be treated both operatively and non-operatively depending upon the case and the structures involved.

Does AC joint separation need surgery?

Most AC joint separations are Types I- III and do not require surgery. Type IV – VI AC joint separations require surgery and can occur in high-impact traumas such as car crashes. These injuries have a high risk of instability of the shoulder joint and are treated surgically with one of  4 types of procedures as follows:

1. Primary repair of AC joint with pins, needles, or rods
2. Distal clavicle resection and reconstruction of soft tissues(Weaver Dunn Procedure).
3. Anatomic coracoclavicular reconstruction
4. Arthroscopic fixation with sutures

 The post-operative rehabilitation is gradual and might take 6 to 12 months for a full recovery and return to sport depending upon the structures involved and the surgical procedures used, with arthroscopic procedures requiring less time compared to the open ones.

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