jen
20 posts
Nov 07, 2008
7:47 AM
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any body have any tried and true go to's for frozen shoulder? got 2 ladies right now (both right side frozen) have had almost complete alleviation of pain but ir behind back is crazy resistant for both pts.....gone thru fab 5 and few supersix-really havent combo'd or wow'd anything and still have some leg super six to try........they are both really pleased with everything else-but im not (crazy how much greedier ive gotten using tmr :)).......for both torso rotation left is easier, small differences in sit-stand (one is good same side shoulder, one is good opposite side shoulder) and both of these motions seem to be helpful, arm raise is only slightly helpful for both but leg raise (one same side shoulder, the other opposite again) also helps some wtih elevation of ribcage when reaching ovhd.......just looking to see if anyone has had any consistency with one or two motions in particular-thanks, jen
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ScottStrickland
Guest
Nov 07, 2008
3:50 PM
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Jen,
I have found leg raise and BKTR, sometimes I do passively, somtimes they do actively. Mostly combo's (leg raise and twist or twist and BKTR) have helped for those last degrees. Rena Luna, at R&R Physical Therapy gets great results with Frozen Shoulders. I'll see if I can get him to comment.Scott
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ktoncapecod
1 post
Nov 13, 2008
6:06 PM
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I have been finding the same thing. What I have tried with success is to have the patient on their good arm mimic the motion (eg reach behind your back to hook your bra-IR). Then I had resistance to try to "undo" their postion into this motion. It seems to increase the motion. Or I may have the person extend their arm backwards into extension and apply a forward flexion ROM. Reaching behind your back requires lots of motions put together, so maybe piece out where to restriction or challenge is and try it on the good side. I also have been finding that if I have a patient perform the UBE FWD only this seems to help almost every patient with shoulder pain (of any kind). I guess we should look at the way most people guard, with the shoulder protracted in a more fwd rounded position. So I theorized that I should listen to their body and instead of worrying about strengthening their posterior postural muscles and standing them upstraight as most good PTs are taught, but instead feeding their body's ability to heal, maybe it would help--and it does!
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DthuePT
5 posts
Mar 07, 2009
7:59 PM
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this blew me (and a PTA) away we both thought we were crazy!!!. pt#1 s/p rot. repair left. (symptoms like frozen). old PT brain said mobe + PROM L side and contract relax=little results. grabbed PTA to help with new idea. i did prom L side, she did contract relax on R side. I could feel L "trying" and it would relax when R relaxed. the most odd thing was when she pulled the R arm into resting position at the side, the L relaxed even more!. pt#2 same day slipped on ice L arm overhead "sprained shoulder". did my eval and did the same thing and her arm amazingly went overhead. she responded "it hasn't been that high in three months" WOW WOW WOW RESULTS BY MOBING THE OTHER SIDE WITH CONTRACT RELAX!!!!!
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jen
30 posts
Mar 10, 2009
7:28 AM
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so sorry so long in reporting results-had 2 ladies at one time both with 'frozen shoulder' right side..one lady overall loosey goosey (her 'frozen shoulder' was better than the tight ladies nonaffected shoulder) and one lady tight overall actaully tested tmr quadrant motions (get to tmr 3)and found one really helpful for loosey goosey lady (she had been havin a persistant small lag when moving into her full flexion and her ir behind back was about 3 inches lower than her left arm could reach)i tried this left arm motion with a-end range pushes, b-repetitions, anc c-gentle ballistic reps allowing her hold body to react in what i call a 'rocking chair' fashion-simply amazing-ir only about 1in lower than left with no difficulty moving into that position and no lag at all into full flexion.....it consistently has helped her (she knows if it stops-to return to fab 5 and figure it out)and she likes the 'rocking chair' motions-feels good overall second lady (tight lady)-leg raise had been most helpful to right ar flex/abd and ir behind back but even after she wasted herself with end range holds and reps it was still just not fully improved-let her do the 'rocking chair' (gentle ballistic leg raise letting the body move with it) and wa-la....super quick and much more complete resolution of tightness...same as other lady (she knows if it dont work-go to fab 5 and figure it out) thanks for suggestions-i usually stick with fab 5 motions to make sure i dont get too messy with pts-and instead of moving to different motions i will trial allowing the pt to use 1-end range pushing, 2-reps, or my new favorite 3-'rocking chair' reps (they really do feel good and that gentle coil-recoil action is really relaxing thruout i think.....i cont to enjoy working with people to help them figure out and realize their physical potential and watch them regain a sense of control over it-that's why i got into PT to begin with-NOT to fix people and wait for them to come back, jen
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AKPT
4 posts
Mar 11, 2009
8:03 AM
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Great idea with the "rocking chair". I haven't been able to quite clean up a smidge of pain in my left shld with flx or abd combined with IR/ER. I've tried the standard Fab 5 mods (chunking, extreme end ROM, combos, etc), quadrant and even my usual ace card, "windshield wiper" (slow IR/ER combined w/ extreme end ROM)... but nothing really got rid of it until your cool technique. It's quick and easy. Can't wait to try it out with my patients. You go girl!
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MaryanninTN
13 posts
Mar 11, 2009
10:51 AM
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3 things I use---I do a Mulligan Mobilization with Movement (MWM) technique on the "good" arm or Maitland grade 3 "fish flop" mob on the good arm for ER or IR limitations that linger with frozen shoulders or status post any shoulder surgery. So far has worked everytime. Recently started using Quadrant stuff that I learned in TMR 3 with increases in ROM too.
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GRobPT
3 posts
Mar 17, 2009
8:08 AM
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Jen, could you explain/describe the "rocking chair" motions you used and mentioned earlier in these posts. I have a shoudler patient that i am struggling with getting last 5-10 degrees of ER/IR. Have tried FAB 5 motions and have been doing prone ER, Horizontal ABD with ER and that seems to help but doesn't last to next appointment. Overall pain levels are good and functional range is good but he wished to be able to pull his bow back and can't quite get it all the way back. Have tried just doing that motion on the left which helps a little but not complete. Thanks in advance. Gerad
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mauijim
4 posts
Apr 02, 2009
8:31 AM
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This is off the TMR path a bit. I have spoken with other P.T's who have seen frozen shoulders especially with women, improve or completely resolve with the supplementation of B-12 pill under the tongue. Mauijim
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Tom Dalonzo-Baker
106 posts
Apr 02, 2009
3:43 PM
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Dag - this is a good string of posts. Love reading about how people are being creative with TMR. Jen - it is so funny you are using the "rocking tmr". I think you may have been the only one I have ever shown this too. Glad it worked. I have not used it since I showed it to you. Go ahead and explain it, when you get a chance,to everyone on the list. Interesting about B-12. I'll have to recommend it and see what happens. Is there a certain amount that should be taken?
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jen
35 posts
Apr 02, 2009
5:18 PM
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ok-rocking chair....picture a leg raise, now do faster reps, now start letting the leg raise momentum rock you back as if you were rocking back and forth in a rocking chair (the other leg may come up too as it rocks with your body)....same for arm raise, twist and sit to stand-but you 'rock' differently-get in the zone with reps and then allow the whole body to participate in the 'coil-recoil' action....you cant rush the reps, you have to find the right rhythm to rock (same in a rocking chair-if you try to go too fast or too slow-the end ranges dont feel right and will be much more effortful to change directions of motion) im curious too about the b-12....do you just start takin it even if testing doesnt show a deficiency or would a deficiency need to be found? have had a chance to check up with both ladies in last week and one of them (ms loosey goosey) had returned to doing some strenthening ex on BOTH sides (even though the bad side was still a bit worse) and her pain and limited rom began to rear its ugly head-she backed up and did only good side and now pain back gone and only lil lag with liftin overhead (but she admittedly doesnt do her HEP more than about 1xday) the other is better better every day (i dare say she may not be so tight overall if she keeps going as she is)
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GRobPT
4 posts
Apr 06, 2009
3:11 PM
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Thanks for that description, that a lot more sense and i will try it. As for the B12, i have suggested it in cases of fatigue as well as chroic bursitis such as for trochanteric bursitis that has seems to help. I have never used it for adhesive capsulitis but it might make sense to look at that as a possible deficiency. From my understanding it is best taken sub-lingually (under tougue) unless you do it by injections which your doctor can do or i have had patients even gave themselves some ordered from dr. I'm not sure if there is any precautions with B12 and i am not sure if the tests are completely sensitive so it may be beneficial even if blood tests are still in the normal range (as with many test such as thyroid tests). Thansk to all for the input. Great dialogue. Gerad
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