Thawing the Mystery of the Frozen Shoulder

Whether originating from the press box at the ball park or second hand information from across the fence, there are two catch all tags that shoulder pain sufferers seem to have repeatedly tossed their way by the prognosticating layperson. To further frustrate, the sheer complexity of the joint and the frequent need for diagnostic testing to truly unravel the mystery, may leave the painfully bewildered even more confused after the first visit to the doctor. In this age of armchair orthopedists and speedy medical evaluations, the use of the terms “rotator cuff” and “frozen shoulder” are seemingly matched in proportional generality only by the multiple labels offered to the sufferers of influenza.

To quickly define, the rotator cuff is a group of four small muscles that envelope the shoulder joint, acting as a fine tuner in regard to the mechanical function. The supraspinatus is one of the four and is most commonly traumatized due to the fact that it passes across the top of the joint. Its vulnerable local allows adjacent bony structure to serve as a tethering device, slowly wearing through this frequently over utilized structure. The muscle can then be ruptured secondary to a pattern of overuse or trauma.

The supraspinatus functions both as a stabilizer in the rolling pattern of the ball and socket joints and initiates overhead motion. If injured, there is the classic compensatory pattern of raising the shoulder up toward the ear with attempts of lifting the arm overhead. Not all tears cause problems however, about 40% of the population that is 50 years and older have a viable tear, but most have no symptoms. Unlike the frozen shoulder, the precipitating factors causing the rotator cuff tear are, as a rule, easily recalled and symptoms are immediate.

This is far from the case with the frozen shoulder. The majority of sufferers cannot recall the origins or the time frame in which there has been actual impairment. There is an awareness that the shoulder is not functioning properly, but human nature dictates that these symptoms should resolve with immobilization and time. This mindset serves as an excellent fuel for the process to take control of the joint, leading the unsuspecting into a downward spiraling pattern of increased pain, mobility loss and weakness.