“Frozen shoulder” (F/S) describes a situation where so much pain is felt in the shoulder joint that the sufferer finds virtually any movement extremely painful and holds the arm as still as possible in the least painful position, which is often still quite painful.
The first thing to be aware of as a bodyworker is that a F/S, like all body problems, is not in any way a purely local phenomenon. The shoulder is not functioning separately from the rest of the body; as those of you who have taken our Advanced Tensegrity class or Patterns at WMTI are aware, the problem is not in the shoulder – the site of the pain is the symptom or effect of the problem.
Every frozen shoulder dynamic is unique, but there are aspects that will be, more than less, common.
Begin frozen shoulder work by putting the client in his or her most comfortable/least painful position. Pillows, body position, whatever it takes. Their least painful position may be sitting up, so you might be working in a massage chair. Or a kitchen chair – you never know.
The next steps are in the order I would follow, but they don’t have to be. Vary them according to how the client responds, seeking out the moves most acceptable to his/her body and proceeding from there.
My first exploration would be the opposite side of the neck to the frozen shoulder, focusing on the mid-neck. Much more than likely, there is severe hypertonicity centered there. I would combine that with occipiut/C1-2 on the same side as the F/S. I would look to get the hypertonicity to reduce somewhat – to any discernible degree. Combine pressure and movement to these areas simultaneously, play them off of each other, and, most importantly, follow the client’s tissue. It will always lead you to releases of hypertonicity.
Next I would look to the sacro-iliac joints, if the client’s body position allowed. I can find a way to work the SI joints from any position, really. Even if they are face up with pillows in the way, I should be able to hook my fingers into the SI joint cleft and mobilize a leg to get effective movement into the joint. My goal here is similar: improve movement in both joints to any discernible degree. I would also assess how balanced the movement is between the joints, looking of course to get them similar.
I would somewhere in here asses the action of the knees, ankles, and feet. If they are ‘players’ in the F/S dynamic, they will have functional issues – some type of hypo- or hyper- mobility. Address the situation.
Once I made progress on these fronts, I would almost certainly see how the shoulder responds to Floating Joint. Basically, if it responds and starts moving, I’d stick with that for a while. If it doesn’t, I know that the pattern is still too established in their structure and I’d go back to the above steps, maybe adding the rib cage, always looking for a way into the dynamic pattern behind the F/S. It will be there, I have to deconstruct it.
If you haven’t taken Floating Joint, Move the arm as slowly and gently as you can. If you are deconstructing the pattern behind the F/S, the shoulder’s range of motion will increase.
I would return often to the neck/occiput, as I feel it is the key. Float the head or move it slowly, working the myo-fascial structures, feel for joint movement. As the neck softens, so will the shoulder open. It probably has scar tissue/severe adhesions, and this work you would begin as the shoulder softens and gives you some access: any earlier would almost certainly be too painful for the client and only aggravate the situation. The arm itself probably only needs some thorough tune-up work.
I’d love to hear from you and what you think of this, and anything that is unclear please ask for more clarity. Grazie, ciao (thanks, later).