Rapid Healing for Frozen Shoulder: Four Free Classes

1^st Free Class: Why is your shoulder frozen?

Introduction: That is the $64,000 question, and the short answer is you probably have adhesive capsulitis. In this video I will explain what that actually means, how to diagnose it, and explore possible causes.  I’m Dr. Larry Burk, and the MD after my name means that I have been a musculoskeletal radiologist for the past 35 years. I was section head of musculoskeletal radiology at Duke University Medical Center in the 1990s, and I still work there part-time a couple mornings a week.

However, I am actually a holistic radiologist, which many people think must be an oxymoron. The CEHP after my name stands for Certified Energy Health Practitioner, and I am also a mind-body coach. This stems from the early days of MRI when I was a member of the National MRI Safety Committee, and we were concerned with getting claustrophobic patients in the scanner. I learned hypnosis as an alternative to drug sedation which led me into the field of integrative medicine.

In 1998, I trained in acupuncture and co-founded Duke Integrative Medicine.  I was education director and practiced acupuncture and hypnosis in the clinics there until 2004. During that time, I learned an ideal mind-body approach that combined acupuncture and hypnosis known as Emotional Freedom Techniques (EFT) or tapping.  It is also referred to as acupressure for the emotions. EFT is considered a form of Energy Psychology.

In 2010, I got my CEHP credentials and started my part-time coaching practice. In 2017, I started teaching EFT courses for the public at Duke Integrative Medicine and shifted my coaching practice to mostly online via Skype or Zoom. These changes inspired these online classes.

Reasons I am Teaching:  I was one of the original researchers for shoulder MRI back in the 1980s, and I’ve read 1000s of shoulder MRI scans since then, including numerous with frozen shoulder. I’ve also worked with many orthopedic shoulder specialists, so I know what they are looking for on the scans and what surgical methods they use. I’ve also treated frozen shoulder patients successfully starting in integrative medicine and now in my coaching practice. In most cases they can shorten their recovery from months to weeks using the approaches I will outline in the next classes. I had my own frozen shoulder in 2006 and using all the self-healing approaches I’ve learned I was able to heal quickly in a matter of weeks rather than months and months. My hope for these classes is that you will be able to obtain similar amazing results from what you learn here.

History:  Frozen shoulder is considered an idiopathic disease of unknown cause occurring in 5% of the population between the ages of 40 and 70. It is more common in women, diabetics and prediabetics. It is called adhesive capsulitis as the synovial lining of the joint is angry red with inflammation at surgery and is stuck to the humeral head.

Clinical stages: There are three stages of adhesive capsulitis beginning in the first few weeks with severe pain in the freezing inflammatory stage, progressing to the fibrotic frozen stage with marked restriction of the range of motion which may last for many months, and finally recovering movement with gradual decrease in pain during the thawing stage. The process may last 1-2 years, and unfortunately it may recur in the other shoulder, more commonly in diabetics.

Physical exam: The most important finding is loss of internal rotation using the Apley scratch test where the hand is placed behind the back with the thumb between the shoulder blades. When the range of motion is restricted the thumb elevation will be limited to below the beltline with inability to unbutton a bra strap. Forward range of motion will also be limited to shoulder height, so combing hair and brushing teeth are not possible. The condition has been jokingly referred to by the afflicted as T. Rex disease due to the similarity between the restricted hand position and the small arms of the terrifying predator. 

X-rays:  Radiographs of frozen shoulder are usually normal and are used to exclude other diseases such as calcific tendinitis.

MRI:  Scans show inflammation and thickening of the capsule during the freezing stage in the axillary recess and rotator cuff interval becoming more fibrotic in the frozen stage. MRI is also useful for ruling out other problems with the tendons and muscles such as rotator cuff tears and Parson Turner Syndrome. For actual imaging examples please see the pdf opt-in gift for these classes: Do You have Frozen Shoulder or Another Cause of Chronic Shoulder Pain? See slide of MRI scan for frozen shoulder explaining the appearance of inflammatory fibrotic scarring in adhesive capsulitis.

Ultrasound:  Scans may show thickening of the coracohumeral ligament and an abnormal rotator cuff interval near the bicipital tendon. Ultrasound is also be useful for ruling out bursitis and rotator cuff tears although the muscles cannot be evaluated.

CT:  Scans are not useful for evaluating frozen shoulder due to limited sensitivity for soft tissue problems. CT is valuable in assessing fractures and osteoarthrosis for preoperative planning.

Triggering events:  The onset of frozen shoulder can be triggered by minor trauma or mild exercise and can also be preceded by an emotionally upsetting event. Other co-existing conditions can be present such as osteoarthrosis or prior rotator cuff surgery, although often there is no previous history of shoulder problems. When you’ve been frozen for months emotional triggers in the week or so before your pain started may be difficult to recall in retrospect. Reviewing prior diaries may be useful in remembering what was going on in your life at the time. Mine started with pain during minor stretching exercises that rapidly worsened over the next couple weeks. However, since I was already familiar with frozen shoulder, I recognized that I was dealing with considerable anger at that time in my life that was stuck in my shoulder.  Identifying such an emotional trigger can be quite important in facilitating the self-healing process that I will be describing in following classes.

Case report:  I treated my first patient for frozen shoulder in the Duke Sports Medicine Clinic in 2002 after completing the UCLA Acupuncture Course for Physicians and interning with Dr. Michael Greenwood. I combined both of these approaches with Emotional Freedom Techniques (EFT) Tapping. 

Linda was a 54-year old hospital pharmacist who got no relief from joint injection and other drugs in 6 months. Physical therapy was discontinued due being extremely painful.  She got constipation due to NSAIDs, so none of the conventional approaches were working for her. Her orthopedic surgeon referred her for acupuncture.

At the time of the initial acupuncture treatment she could not recall any emotional trigger that occurred right before her shoulder pain began. However, on the second treatment she remembered that her best friend had abandoned her without explanation by moving out of town abruptly. She admitted to still being angry about it. We did EFT on the anger stuck in her shoulder, and she felt some relief from the pain.  During the next acupuncture-bodywork session she did some deep rapid breathing with needles in her hands and feet. Her arm began to vibrate and shake as the blocked qi was released. Her range of motion increased, and she made a rapid recovery after a couple more treatments. She later described it as a turning point in her life.

“I very quickly regained full range of motion of my shoulder.  I don’t recall the actual time span but it was only weeks.  Compared to the months of physical therapy, injected steroids, oral steroids, and NSAIDs that I had endured, it was a miracle!  I have had no other problems with that shoulder.” - L. H.

Next class: What professional treatments are available to you? I will review all the possible options including pros and cons, advantages and disadvantages. The different approaches include drugs or injections, manual methods such as PT, massage and chiropractic, and more aggressive and painful treatment requiring sedation/anesthesia such as OAT, MUA and arthroscopic surgery.  Integrative medicine methods will also be discussed in the next couple classes including Chinese medicine featuring acupuncture and herbs, anti-inflammatory nutrition with diet and supplements, and even homeopathy, so you will have many options to choose from to accelerate your healing process.

Private Facebook group:  Please click on the link to join, so you can post comments and questions to which I will respond either online or in the next video classes.  I look forward to your feedback. See you in a couple days on the next video. Thanks, Larry