What is Frozen Shoulder?

If we look closely and intellectually at frozen shoulder, formally known as adhesive capsulitis, we will come to learn that it is still to this day a phenomenon; occurring by an unknown cause, sometimes linked to injury or surgery but often coming on completely at random- or is it?

Like any diseases or disorders, we will find that there is usually an event that stimulates the inflammatory reaction (like falling on the arm or knocking into something), but nonetheless, health issues occur because of a predisposition each individual manifests for reasons personal to their constitution, thought processes, emotional capacity, relationship with their environment and stress, and ultimately, themselves.

I’m afraid to say that although disorders are unfair, painful and life altering, I do not believe they come from outside of us. And that being said, response-ability is how we choose to move forward, mediating what we at least can control, and instilling the art of acceptance in what we cannot control. 

Part of the journey for those with frozen shoulder is seeking support in the appropriate healthcare providers. This is the first step in admitting to needing aid and being with their pain.

The people I have treated over the years that commit to gentle rehab and regular manual therapies including massage, mobility and needling have seen the greatest results. The ones that maintain strength or resistance training within their window of tolerance, gently exploring their edges, embody the most willpower and optimism in recovering.

Those that have combined yoga nidra within their regime when pain comes on, especially when trying to sleep, have improved the most. By improving, I mean spending the least amount of time in the second/ frozen stage, gaining their range of motion back (entering the third/ thawing stage), having better sleep and experiencing less pain and sensitivity.

Another thing that comes up through conversational assessment is when the individual with frozen shoulder have ‘set backs’ or bad bouts of pain. Explaining to me that they occur due to having chosen to lift something at work or at home, or try and clean something or chop something up on their own. Pain episodes that are so excruciating that painkillers won’t take the edge off, only stillness and tears seem to ease the pain.

To be in such a world of pain, with such restricted use, and still force yourself to complete a task, is essentially a form of punishment. People with frozen shoulder don’t tend to be stubborn, it’s not that they are hyper independent and need to prove that they can do things all by themselves, it’s simply that they have trouble asking for help, asking for someone else to share the load, admitting to someone, even the people around them they love the most, that they simply ‘can’t do it’. There is an observable incongruence in their beliefs. “I can do hard things” is paramount, yet not acknowledging that they believe asking for help to be ‘hard’, thus never addressing their beliefs as the issue over the action itself.

I notice this when I ask what I can do for these particular clients in order to make them more comfortable. The rolled up towel under the arm to prop it up is fantastic and alleviates a lot of pain, but even accepting that as a form of assistance is a hard feat. As the weeks go by, there is a softening. As the individual accepts more help, their tissue softens too. Not clinging and grasping so much, not keeping them so protected. There is ease that follows a forced rest. One learns it’s actually easier to accept help than to push it away. Pushing things away takes force and effort, along with contraction born out of stress. Pushing others away doesn’t make humans more capable, it makes us lonelier. 

Loneliness causes a lot of inflammation in the body, and if we don’t put up our hands and ask for help, the body learns to adapt. The body preserves resources under threat. Taking from one system in order to support another. 

It’s often not even the ability to ask for help where one is limited, it’s the stage before, having the recognition that one can’t do it all themselves, leaving us unable to ask for help because of shame.

Shame seems to be the underlying emotion in most disorders, be it psychological, emotional, physical or spiritual. It’s the secondary reaction or emotion experienced to the primary one or the event that leaves us in a freeze/ shut down state, irritated by our unmet expectations. And the longer we spend here, the more we become stuck; the second or ‘frozen’ stage of frozen shoulder.

I’ve never known the expression ‘if you don’t use it, you’ll lose it’ to hold so much meaning than it does with frozen shoulder. There is a lot to be said about energy and the mind- body connection when it comes to thoughts and action. If we proverbially cannot raise our hands and ask for help, we just may lose the physical ability to do so. Essentially, by having a need (like reaching out for help through communication), but telling ourselves, and shaming ourselves, usually subconsciously, we are communicating to our bodies exactly that- I can’t ask for help. To me, it’s not so far-fetched that the body will begin to lay down adhesive tissues to preserve the energy required for this action that is not going to take place. 

Fundamentally, it will not happen until we tell ourselves it will. It will not take place until we believe it will, until we allow ourselves to receive (help).  Altering our beliefs, especially limiting ones that we often don’t realise are negatively impacting our ability to relate and connect to others, takes conscious work to break down and resolve. Most of us will find it hard to stop, slow down and sit in hard spaces. Limiting beliefs are often harsh and cruel, why would we choose to stop and become confronted by them? Get to know them? Get to know their origins? Learn that it’s literally our minds against ourselves? Most of us won’t, until we are injured or sick. Until we are presented with the time, the forced rest, the deep- rest (or being depressed) for this insight to surface, to work on our weaknesses, to embrace our vulnerabilities, to transform pain into power.

Recently I treated a woman with chronic frozen shoulder. She had never sought treatment for it, ever. She had it in both arms and had been in the frozen stage (which usually passes after 4-8 months) for many years. 

This process is not linear. It’s not that she didn’t receive treatment therefore she didn’t heal, but it’s perhaps that she didn’t act on the meaning she found in her pain. When I told her what I thought about frozen shoulders she said ‘I think you’re exactly right’. We can ‘know’ something, that we have to do something, release certain emotions, sit with uncomfortable feelings, step outside our comfort zone, quit a job, etc, but if there’s no response-ability, no action is usually taken.

The first woman I ever treated with a frozen shoulder was going through a divorce. She opened up and told me her marriage story whilst on the table in the first few treatments, as I was working on her shoulder. 

She said she had felt stuck in her marriage for many years. Having an ‘aha’ moment two weeks after her wedding, ready to leave only to find out she was pregnant and chose to stay for another 8 years. She spent a lot of her time thinking about her situation, feeling unhappy, knowing that she wanted to leave but knew it wasn’t the right time for her and her children.

One day, shortly after she’d left her husband (a few months into her frozen stage with little to no shoulder mobility) she was having a shower and washing her hair. As she was washing (practically with one arm and the other elbow winged down doing the best she could) she had a moment where she realised she was free, she had finally done it, done the thing she had been wanting to do for years, and in that moment, realised her frozen arm was up at the same level as her other, healthy arm.

It was in that moment that she knew her frozen shoulder was a byproduct of her stuckness, of her ‘I can’t’ that turned into ‘I can’ and ‘I did it’.

I don’t know why some people who struggle to ask for help get frozen shoulders and some don’t.

All I know is there is a link between the two. Perhaps, it’s a wound born out of trauma for some, and not for others- wounds require fresh tissue lay down, also known as scar tissue or adhesions that bind the body back together.

Perhaps when some people have the urge to ask for help it evokes a stress response throughout their bodies, and in others it doesn’t.

Perhaps some people have been struggling with the emotional response for a really long time and others it’s only come up more recently. It’s hard to say. 

Nonetheless, if you find yourself with a frozen shoulder or two, and you resonate with this information, perhaps it’s time to look into the resistances you may have towards asking for help, your relationship to your life, where you feel stuck and how to move forward and make healthy changes. Frozen shoulder will resolve itself in time, and hopefully you can resolve much more from the experience too.