What is a Frozen Shoulder? Chiropractors in Southampton at The Avenue Clinic Explain

How do I know I have a frozen shoulder?


Frozen shoulder is a painful condition that affects the general mobility of the shoulder – see left how this sufferer cannot raise his arm above 90 degrees without raising the whole shoulder. It usually develops slowly and may follow on from an injury or may happen spontaneously. Frozen shoulder affects 2–5 per cent of the population, and 10–20 per cent of people with diabetes.

 Typically you feel restriction when you try to bring the arm away from your body to the side, when you rotate your shoulder to put your hand into your back pocket or do up your bra or reaching up and back.


This is called a capsular pattern of restriction as when you require the capsule to stretch, it doesn’t allow the stretch to occur as the capsule tissues shorten and tighten.

For this reason, frozen shoulder is also known as adhesive capsulitis or shoulder contracture.

What causes frozen shoulder?

Frozen shoulder is caused when the flexible tissue that surrounds the shoulder joint, known as the capsule, becomes inflamed and thickened.

It is not fully understood why this happens, although there are a number of things that make developing a frozen shoulder more likely. These include having:

  • a shoulder injury or shoulder surgery
  • Diabetes 
  • Dupuytren’s contracture a condition where small lumps of thickened tissue form in the hands and fingers
  • other health conditions, such as heart disease and stroke.

What can you do about it?

It is a good idea to have an x-ray of your shoulder to rule out any other cause of your pain and limited range of movement.

If there is no other problem then there is an effective treatment that the chiropractors in Southampton at the Avenue Clinic use to help prevent long-term pain and stiffness developing in your joint and to make you more comfortable.

We will assess how well your back moves in the mid thoracic area (between your shoulder blades); look at how your shoulder blades are positioned; look at how your humeral head is positioned (top of your arm as it inserts into your shoulder joint and move the shoulder to assess which of the movements cause the pain or lack of movement.

At the Avenue Clinic we use what is called the Spencer Technique, which was developed in 1915 by Charles H. Spencer, D.O. to increase the range of movement at the shoulder. It has been modified and personalized by many physicians through the years.

The technique helps to

  •  Improve shoulder mechanics and range of motion
  • Stretch local tissues, improving lymphatic and circulatory flow
  • Relieve adhesive capsulitis, post-operative or post-injury myofascial restriction, bursitis/tendonitis
  • May be performed while you are lying on your side or sitting

Research by Knebl et al in 2002 looked at twenty-nine elderly patients with pre-existing shoulder problems. Each subject had chronic pain, decreased range of motion and/or decreased functional ability in the shoulder before entering the study. Subjects were randomly assigned to either a treatment involving Spencer technique or a control group for 14 weeks. Over the course of treatment, both groups had significantly increased mobility and decreased perceived pain.

After treatment, those subjects who had received the Spencer Technique demonstrated continued improvement in their range of movement, while range of movement in the placebo group decreased.

Another technique has been developed by Dr Jeremy Lewis, physiotherapist and shoulder expert at the London Shoulder Clinic has found that the following treatments can also be very beneficial.

In “Phase-one” frozen shoulder, ultrasound guided injections can be helpful (a small volume of corticosteroid and analgesic). In many people this procedure powerfully reduces the pain associated with frozen shoulder.

Cortisone is a type of steroid which is naturally produced by the adrenal gland in your body.

Injectable cortisone is closely derived from the body’s own product and is synthetically produced. In contrast to the body’s method, the synthetic cortisone is injected directly into the area of inflammation and not into the blood stream, keeping side effects to a minimum.  Cortisone treats the inflammation and not the pain.

Having too many injections might cause damage to your shoulder. In some cases, it may only be possible to have this treatment 3 times, and you will need to wait between 3 and 4 weeks between injections.

In the later stages of the condition, when stiffness predominates, Dr.Lewis offers ultrasound guided hydro-distension procedures using sterile water (sodium chloride). This technique is used to stretch the joint capsule from the inside. Dr Lewis has discovered that this procedure can, in his experience quickly restore restricted movement.

More information on Dr Lewis and his techniques can be found at www.LondonShoulderClinic.com

Dr Lewis says “ I have found that hydro-distension techniques work best when embedded within a care pathway that involves hands-on techniques such as the Spencer Technique.

Some people with frozen shoulder may get better over a period of 18-24 months. In other cases, symptoms can persist for several years.

Studies suggest that about 50% of people with frozen shoulder continue to experience symptoms up to seven years after the condition starts. However, our  treatment can help to shorten the period of disability.

The aim of treatment is to keep your joint as mobile and pain free as possible while your shoulder heals. The type of treatment you receive will depend on how severe your frozen shoulder is and how far it has progressed.