What is frozen shoulder?
Frozen shoulder, also known as adhesive capsulitis, is an extremely painful and debilitating condition of unknown cause. It is characterized by pain and stiffness of the shoulder joint and surrounding soft tissue structures.
Frozen shoulder facts
Frozen shoulder affects approximately 2-5% of the adult population
Commonly diagnosed in individuals between the ages of 40 and 70
60% of individuals affected by frozen shoulder are women.
Frozen shoulder is ten times more common in patients with Type 1 diabetes
Approximately 15% of patients develop bilateral frozen shoulder which usually occurs within five years of original diagnosis
The non dominant arm is more often affected
Frozen shoulder can last up to 30 months if left untreated.
Can occur after surgery
Frozen shoulder progresses through three distinct but overlapping clinical phases.
Phase One- The painful “freezing” phase
Marked by a gradual onset of diffuse pain
Night pain is a feature of this phase
Diagnosis of frozen shoulder at this stage may be uncertain
Generally a poor response to non steroidal anti inflammatory drugs.
1-8 months duration
Phase Two – The stiff “frozen” phase
Characterised by less constant pain but increased restriction in range of motion at the shoulder joint
The dysfunctional movement pattern of the shoulder known as the capsular pattern is most evident in this phase with external rotation most limited, abduction next with medial rotation least limited
Daily activities become increasingly difficult with sharp pain experienced at end ranges of movement
9-16 months duration
Phase Three- The resolving “thawing” phase
A gradual improvement in functional range of motion
A continuing reduction of pain
12-30 months duration
What is the Niel-Asher Technique?
Simeon Niel-Asher, Osteopath and founder of the Niel-Asher Technique
developed his frozen shoulder treatment protocol in 1998. There are now over 200 licensed Niel-Asher practitioners in the UK, Europe and the USA. For more information visit www.frozenshoulder.com
The Niel-Asher Technique involves the neuromuscular technique of trigger point therapy combined with a sequence of stretching and specific manipulations to the shoulder joint and soft tissues to combat pain and stiffness
The initial phase of the treatment is designed to significantly reduce the pain, by treating the swelling around the various shoulder tendons. The technique goes on to improve the shoulder range of motion by stimulating a sequence of reflexes hidden within the muscles.
The Niel-Asher technique can also be used and adapted to treat rotator cuff problems, biceps tendonitis, bursitis and arthritis.
Recommended frequency of treatments and expectations
Phase one “freezing” – approximately 12 sessions Once a week for 3 weeks, then fortnightly, then once every 3 weeks.
3-5 sessions to lessen the inflammation (measured by less or no night pain)
5-7 sessions to regain range of motion
Phase two “frozen” – approximately 8 sessions Once a week for 3 weeks, then fortnightly for 3 sessions, then monthly or more if required.
3 sessions to lessen the inflammation
3-5 sessions to regain range of motion
Phase three “thawing” – approximately 4-7 sessions Once a week for 4-7 sessions or more often (every 3-4 days) if required.
As a rule 85% of cases can usually be treated in less than 8-10 sessions.
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