Surgical Treatments
for Frozen Shoulder
Surgery is only used for severe cases of frozen shoulder in which all other treatments have failed. The aim of frozen shoulder surgery is to stretch or release the contracted, tight shoulder joint capsule. This can be accomplished through 2 methods - your surgeon will determine the best procedure for you.
Manipulation under Anesthesia (MUA)
Manipulation under Anesthesia (MUA) is a day procedure that involves the surgeon manipulating your shoulder (forcing your shoulder to move through full range of motion) to stretch and break up tight scar tissue around your shoulder joint while you are asleep.
This is supposed to free the shoulder and increase range of motion. It is often performed in stage 1 or stage 2 of frozen shoulder.
There are some complications with this procedure that include but are not limited to, stretching and possibly tearing of the soft tissues in your shoulder (rotator cuff muscles and tendons, ligaments, cartilage, joint capsule), increasing inflammation and scarring in the shoulder joint, dislocating or fracturing your arm bone, neurovascular injury to your brachial plexus or other nerves, and severe osteopenia (reduction in bone mass or density). This procedure requires aggressive rehabilitation.
Arthroscopic Capsular Release
Occasionally an arthroscopic exam or open surgical procedure is required to release a tight shoulder joint capsule, especially when you have a very frozen shoulder after an injury, trauma or fracture (often used with diabetics as well).
Arthroscopic surgery involves making tiny incisions around your shoulder joint and inserting a pencil-thin, fiber optic camera with a small lens and lighting system in one hole, and small surgical instruments in the other holes. The surgeon will take a look inside your joint to investigate all the soft tissues and bones.
These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the frozen shoulder surgery under video control. At the end of surgery, your incisions are closed, and a dressing is applied.
Arthroscopic capsular release involves cutting the tight portions of your joint capsule, scar tissue and your coracohumeral ligament. This frees your joint which alleviates pain and returns your full range of motion.
Results are seen faster with this surgery than with MUA, and this surgery can be repeated a few times if inflammation and scar tissue persist. However, if shoulder movement isn't regained, open surgery may be required (a larger incision is made to have better access to the shoulder). Complications with this surgery involve persistent stiffness and pain.
Sometimes both surgeries will be used to get the best results. Generally recovery ranges from 6 weeks to a year after surgery. Your doctor will provide you with a rigorous, customized rehabilitation plan based on the treatments noted previously.
Keep in mind the longer you have your frozen shoulder symptoms prior to surgery, the longer it will take to recuperate. If you return to your activities too soon, you could cause permanent damage. You want to ensure the strength, flexibility and stability of your shoulder muscles before taking on too much.
Treating Adhesive Capsulitis
The trick to treating adhesive capsulitis, improving your range of motion, and getting your shoulder back in the best possible condition you can is removing the scar tissue in and around the shoulder joint capsule - something ultrasound therapy is great at!
If you heal adhesive capsulitis properly and treat scar tissue build up, your chance of recurrance or chronic shoulder conditions later on is greatly reduced. Therapeutic Ultrasound and Blood Flow Stimulation Therapy™ will treat scar tissue and promote blood flow to heal your labrum, ligaments, and tendons in the rotator cuff and glenohumeral joint faster and more completely than any other methods available.
Freezie Wrap® Cold Compression Therapy
To decrease inflammation and relieve the pain of adhesive capsulitis doctor's recommend cold compression therapy. Treating your shoulder pain with cold compression as needed will relieve pain and will reduce, or even eliminate, the need for pain medication that affects your entire body and can cause problems is used for a long period of time.
The Shoulder Freezie Wrap® is the cold compression tool you need to treat your adhesive capsulitis pain in an effective and convenient way.
The deep cooling effect provided by the Shoulder Freezie Wrap® gently numbs your nerves to reduce pain naturally!
The Shoulder Freezie Wrap® uses a supercharged cooling gel pack, that chills in the fridge, not in the freezer like ice or other freezer packs, giving you deep cold therapy without the risk of 'cold burns' or cryoburn. The medical-grade wrap keeps the cold directly off your skin preventing cryoburn while delivering cold right where you need it.
Once the pain of adhesive capsulitis has been reduced it is important to begin ultrasound and BFST® to soften scar tissue and begin to loosen up the area. BFST® will improve blood flow and relax muscles that have become stiff and tense because you are not using your shoulder properly.
Ultrasound Therapy
Ultrasound therapy is a great therapeutic option to soften scar tissue, decrease inflammation, reduce pain, and improve the tissue healing process. Therapeutic ultrasonic waves increase tissue elasticity while increasing blood flow to your glenoid cavity. This cleans the joint by getting rid of damaged tissue and reducing the inflammation while opening up the blood vessels to begin healing.
Ultrasound therapy is safe, easy, and convenient and generally requires between 10-15 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). By treating your rotator cuff and glenoid cavity with ultrasound these sound waves bounce against the scar tissue. The tough, fibrous tissue causing your shoulder to stiffen and/or no longer move becomes softer and the labrum, ligaments and tendon tissues become stronger reducing the risk of chronic problems in the future.
Ultrasound waves penetrate deep to relax your muscles, decrease inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible. Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.
With phonophoresis, MendMeShop® Ultrasound System sends micro vibrations into your body and carries medicated molecules within the ultrasound gel deep into your soft tissue to enhance the ultrasound therapy, resulting in even healthier tissue.
Using MendMeShop® Lavender Infusion Ultrasound Gel during your ultrasound therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the labrum, coracohumeral and glenohumeral ligaments, tendons and other soft tissue where it is most effective. 1 FREE bottle of MendMeShop® Lavender Infusion Ultrasound Gel comes with every MendMeShop® Ultrasound System and it contains the therapeutic essential oils of natural Bulgarian lavender, peppermint, eucalyptus, and menthol.
 Complimenting your ultrasound therapy with Blood Flow Stimulation Therapy™ BFST® nourishes and strengthenes your shoulder joint tissue and surrounding area. Using BFST® will speed your recovery and heal your rotator cuff more completely preparing it for strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.
Inferno Wrap® Blood Flow Stimulation Therapy™
The shoulder joint naturally receives a limited blood supply. When it's stiff and difficult to move the blood flow is reduced even further, limiting your body's natural ability to heal itself.
By treating your rotator cuff with BFST® you can increase your body's blood supply to the shoulder and increase your body's natural healing power.
An Inferno Wrap® for your shoulder is the tool you need to treat your sore shoulder because it speeds healing and relaxes the surrounding muscles. With BFST®, tissues are safely and gently stimulated. Your body responds with a rapid increase in blood flow to the area, increasing the supply of oxygen and nutrients to injured tissue to promote healing. Our Inferno Wrap® gives you the most effective, non-invasive, non-addictive, pain relief and healing with no side effect.
In addition, the improved blood flow whisks away dead cells and toxins that have built up from injury, scar tissue, and lack of blood flow. When you stop moving your arm and shoulder, your muscles and other tissue can become weak and dead cells and toxins in the area can cause further tissue deterioration - this can lead to atrophy (muscle weakness and/or deterioration). By clearing the area of toxins and increasing the amount of oxygen and nutrients to your muscle and other tissue, the risk of atrophy is greatly reduced. Keeping your upper arm, shoulder and rotator cuff tissue as healthy as possible throughout the healing process will allow you to improve shoulder strength again once your pain has gone and your tear has healed.
With these 3 easy therapies, cold compression, ultrasound and BFST®, you will notice significantly reduced pain, faster healing, and an incredible improvement in your rotator cuff range of motion.
We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.
During your recovery, you may have to modify and/or eliminate any activities that cause pain or discomfort in your rotator cuff area until your pain and inflammation settle, and you gain more mobility and strength in your shoulder. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!
Surgical Procedures for Adhesive Capsulitis
Manipulation Under Anesthesia
In rare cases, if the usual treatment options have been unsuccessful, manipulation under anesthesia may be required. Athough this procedure requires anesthesia, no actual surgery involved, meaning incisions are not made when a manipulation is performed. The doctor moves the arm to break up the scar tissue within and surrounding the joint. This is a painful procedure as it requires tearing of the scar tissue, but you will be able to move your shoulder joint more after the manipulation.
 Follow up the manipulation with cold compression therapy immediately. Continue with cold compression until the pain and inflammation has been reduced. Use ultrasound therapy as well to reduce the amount of scar tisue that will reform as the torn tissue heals. This will help prevent your shoulder from becoming frozen again. Once inflammation, swelling, and bruising has been calmed you can begin BFST® treatments to maintain healthy tissue in your arm and shoulder, reduce the risk of atrophy, and improve the health of the tendons and ligaments that have been damaged during the manipulation procedure.
Arthroscopic Capsular Release
Alternatively, or in conjunction with a manipulation, an arthroscope can be inserted into the joint to cut through the scar tissue. This procedure is called an arthroscopic capsular release. Surgical capsular release of a frozen shoulder is rarely necessary, but it is extremely useful in cases of adhesive capsulitis that do not respond to physical therapy or regular exercises done at home. If surgery is performed, immediate physical therapy following the capsular release is of utmost importance. If rehabilitation does not begin soon after arthroscopic capsular release, the chance of the adhesive capsulitis returning is quite high.
Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition.
| 
