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Frozen Shoulder, medically known as Adhesive Capsulitis, is one of the most painful and psychologically draining conditions we treat. It typically begins innocuously with a mild ache in the shoulder. Over weeks or months, this ache evolves into a severe, relentless pain that keeps you awake at night. Then, the stiffness sets in. You reach for a seatbelt, or try to fasten a bra, and find that your arm simply stops. It feels like the joint has been welded shut.
For the patient, Frozen Shoulder is a living nightmare. The pain during the “freezing” phase is often described as a 10/10 agony, sharp and sickening, brought on by the slightest sudden movement. The disability affects every aspect of life, from dressing and washing to driving and sleeping.
The standard medical narrative offers little comfort. You are often told it will “burn itself out” in 18 months to 3 years. You might be offered a steroid injection or painful physiotherapy that involves forcing the arm to move. In severe cases, surgery (manipulation under anaesthetic) is suggested.
At Breakthrough Pain & Performance, we do not believe you should have to wait three years to get your life back. We understand that Frozen Shoulder is not just a stiff joint; it is a Neuro-Immune Event. It involves a complex interaction between the immune system, the autonomic nervous system, and the brain’s threat matrix. By targeting these systems directly, we can significantly shorten the duration of the condition and reduce the suffering involved.
Frozen shoulder typically follows a three-stage pattern. Understanding where you are is vital because the treatment for each stage is different.
1. The Freezing Phase (Pain Dominant) This is the inflammatory phase. The capsule (the sock-like ligament surrounding the joint) becomes inflamed and thickens. The pain is severe, constant, and worse at night. Range of motion starts to decrease because of Neurological Guarding (muscle spasm) rather than true structural stiffness.
• Our Focus: Pain reduction and inflammation management. We do not force movement here. We calm the nervous system.
2. The Frozen Phase (Stiffness Dominant) The acute pain settles into a dull ache, but the joint becomes rigid. The capsule has physically contracted and adhered to itself. Movement is severely restricted in all directions, particularly rotation.
• Our Focus: Remodelling. We use specific neurological inputs to encourage the brain to let go of the residual muscle guarding, allowing us to work on the capsule itself.
3. The Thawing Phase (Recovery) The stiffness slowly resolves, and movement returns.
• Our Focus: Restoration. We rebuild strength and motor control to ensure the shoulder returns to full function without compensatory habits.
Why does Frozen Shoulder happen? Often, there is no obvious injury. However, there is a strong link to systemic health. It is much more common in people with diabetes, thyroid issues, or hormonal changes (menopause).
This suggests that Frozen Shoulder is a Systemic Inflammatory Condition. The body’s immune system attacks the shoulder capsule, causing it to undergo fibrosis (scarring).
Crucially, this immune response is regulated by the nervous system, specifically the Sympathetic Nervous System (Fight or Flight). High stress levels or “sympathetic dominance” can drive the inflammation. The nerves that supply the shoulder become hypersensitive, releasing chemicals (neuropeptides) that increase the swelling and pain.
Our treatment targets this neuro-immune loop. We use Vagus Nerve Stimulation to activate the parasympathetic nervous system (Rest and Digest). This activates the “Cholinergic Anti-Inflammatory Pathway,” a biological reflex that dampens the immune attack on the shoulder. By calming the autonomic nervous system, we reduce the fuel for the fire.
In the early stages of Frozen Shoulder, a significant portion of the stiffness is not the capsule itself (the glue) but the muscles reacting to pain (the guard).
The brain senses the inflammation and screams “DANGER.” It commands the rotator cuff, pecs, and lats to clamp down to prevent movement. This Reflexive Guarding can make the shoulder seem completely frozen when, in reality, it still has some available range.
Standard physio tries to push through this guard. This is excruciating and counter-productive. It confirms to the brain that movement is dangerous, so the brain tightens the guard further.
We use P-DTR (Proprioceptive – Deep Tendon Reflex) to negotiate with the guard. We find the sensory receptors driving the threat signal. By resetting these receptors, we lower the threat level. The brain voluntarily releases the muscular component of the stiffness. We often see an immediate improvement of 10-20 degrees of movement in a single session, simply by removing the neurological brake.
Frozen Shoulder takes a heavy mental toll. The constant pain and sleep deprivation lead to anxiety and depression. This emotional distress feeds back into the pain system, increasing sensitivity.
Patients develop Fear-Avoidance. You stop moving the arm even within the safe range because you are terrified of the “zing” of pain. This lack of movement accelerates the adhesion process.
We provide a safe environment to explore movement. We use Graded Exposure. We support your arm fully so the muscles can relax, and we gently guide it through the painless range. We show the brain that some movement is still safe. This preserves the cortical map of the shoulder in the brain, making the final recovery much faster.
Aggressive stretching in the Freezing phase is dangerous. It tears the inflamed tissue, causing bleeding and more scar tissue formation. It is like picking a scab; the wound never heals.
Our approach is Pain-Free Mobility. We use the “path of least resistance.” If lifting the arm forward hurts, we don’t do it. We might work on the shoulder blade, the thoracic spine, or the elbow. By keeping the rest of the arm healthy and mobile, we maintain circulation and lymphatic drainage without aggravating the angry capsule.
Recovery from Frozen Shoulder is a marathon, not a sprint, but we can significantly improve your time.
1. The Diagnosis: We confirm it is Frozen Shoulder and not arthritis or a locked dislocation.
2. The Autonomic Reset: We treat the stress response to lower inflammation and improve sleep quality.
3. The Neurological Unlock: We use P-DTR to release the protective muscle guarding, revealing the true range of the joint.
4. The Capsule Remodelling: In the Frozen phase, we use specific, gentle joint mobilisations to stretch the capsule without triggering a pain response.
This clinic is for you if:
We provide a compassionate, scientific, and effective pathway through this difficult condition.
