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Frozen shoulder self-management sequence

Frozen Shoulder Self-Management Sequence

A 12-step frozen shoulder self-management sequence, developed by Jonathan Reynolds, PT PhD, inventor of TolaPoint.

In considering whether you have frozen shoulder condition, you should consider the fact that the rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres minor) all attach to the capsule of the glenohumeral joint, in addition to the humerus itself. Therefore pain and/or dysfunction in any one of these muscles can have an effect on the tightness and pain experienced in the capsule of the glenohumeral joint.

Check with your health-professional or physical therapist before you attempt this self-management sequence.

Part 1: Releasing and stretching the rhomboid, levator scapulae, upper arm and posterior capsule

Step 1: Apply pressure to trigger points in your rhomboid and levator scapulae muscles

The details of the technique shown can be found here.

Other ways to reach these muscles with TolaPoint can be found here and here.

UT-TPR-FixedStrap

Step 2: Apply pressure to trigger points and fascia on the side of your upper arm

The details of this technique can be found here.

LateralArmTPR2

Step 3: Apply pressure to trigger points in your posterior capsule

The details of this technique can be found here.

A Point between a flat, vertical surface and the posterior capsule.

Step 4: Perform Codman’s pendular swing

Lean over and allow your shoulder to swing away from the body. Move your arm in small clockwise and counterclockwise circles – as if you were stirring paint in a bucket. Your movements should be loose. Do not keep your arm rigid.

Do this as often as you need to during the day to alleviate discomfort in your shoulder.

Codman

Step 5: Stretch your posterior capsule

Glenohumeral internal rotation stretch: lie on your affected side with your upper arm at 90° to your body and your elbow bent at 90°.

Place your unaffected side hand on your affected side wrist, and gently apply pressure with your unaffected side hand to rotate your affected hand down.

You should feel a stretching sensation at the back of your shoulder.

Any discomfort felt at the front of your shoulder could signify possible impingement and you should abandon the stretch.

Hold the stretch for 30 seconds or until release is felt at the back of your shoulder.

SleeperStretch1SleeperStretch2

Step 6: Stretch your rhomboid

Reach across your body with the affected side arm and cradle the weight of the arm in the opposite hand.

Gently pull your affected-side arm and shoulder across your body until a stretch is felt in the area of the shoulder blade or at the back of the shoulder.

Hold the stretch for 30 seconds or until you feel a release in the discomfort that is bothering you at the back of your shoulder.

Abandon the action if you feel any stretching at the front of your shoulder.

RhomboidStretch

Step 7: Stretch your levator scapulae stretch

Stretch your levator scapula by rotating your head 45° to the side and nodding forward.

You should feel the stretch down the back side of your neck to your shoulder blade.

Enhance the stretch by stretch by placing your arm up on a wall or a doorjamb.

LSStretchLSStretchComplete

Part 2: Releasing and stretching the long-head tendon, the insertion point of the subscapularis tendon and the infraspinatus muscle

Step 8: Apply deep pressure to your biceps long-head tendon at the anterior capsule

and

Step 9: Apply deep pressure to the humeral insertion of your subscapularis tendon

The details of the technique shown can be found here.

AC-TPR

Step 10: Apply pressure to trigger points in your infraspinatus muscle

The details of the technique shown can be found here.

Infraspin3

Step 11: Stretch your shoulder into external rotation

External rotation of the shoulder (glenohumeral) joint is a difficult stretch to perform correctly.

Secure your TolaStrap in a doorway at elbow height (with the buckle and Strap base on the other side of the door).

Form a loop in the Strap just large enough to fit your hand through.

With the Strap looped around your wrist, bend your elbow to 90 degrees.

With your elbow held snugly against the door by your side, slowly turn away from the Strap to feel the stretch in your shoulder.

Hold for at least 30-seconds then slowly return to the starting position.

ExtRotStrap1ExtRot1ExtRot3

Step 12: Stretch your shoulder into flexion

Stand with your affected side shoulder close to a door jamb.

With your opposite foot in front, reach your arm as high as possible by sliding your hand up the door-jamb.

Stop once you feel a stretch in the shoulder.

Try to keep your shoulder blade (scapula) from hiking up. Hold for 30-seconds and slowly return to neutral.

FlexionStretch