The Key to the “Cure” of Frozen Shoulder

Welcome Deb Fraine, Occupational Therapist!

Deb Specializes in Shoulder, Elbow, Wrist and Hand Therapy.  She provides hands-on individualized care

First of all, I would like to express my gratitude to Jessica Cavaco, Kim Pelletier and all of the
Mattapoisett Wellness Practitioners for welcoming me to the “Center for Mindful Medicine!”
Four years ago, it became my dream to start a private occupational therapy practice combined
with yoga instruction at this beautiful, cozy wellness center and studio. This opportunity finally is
coming to fruition in the midst of a pandemic as it provides a sanctuary for my clients where I
can safely share my 33 years of experience and skills to restore them to health in an
individualized, quiet, peaceful atmosphere.

I am not only a yoga instructor but also a certified “hand therapist.” This is a bit of a misnomer.
A certified hand therapist a specialist (PT or OT) in the evaluation and treatment of the shoulder,
elbow, wrist and hand. As an occupational therapist, I am trained to treat the “whole person,” –
body, mind and spirit. Many ask the difference between Occupational and Physical Therapy.
Occupational Therapists are trained similarly in the physical evaluation and treatment of the
upper extremity but our education also includes extensive training in psychology. The focus of
Occupational Therapy is always on the goal of returning a client to their “occupation”. This does
not just include their work but their independent participation in activities of daily living,
recreational activities, sports, family care and any activities that they wish to resume after
rehabilitation.

Shoulder conditions are one of the most common areas of treatment in my practice.
The shoulder is a complex, highly mobile ball and socket joint consisting of the shoulder girdle
which includes the shoulder blade or scapula, clavicle or collar bone, humerus and sternum or
breast bone. These bones and joints are surrounded by a bursa, ligaments, tendons and
muscles which move and stabilize the shoulder. The rotator cuff, most commonly injured,
consists of four tendons including the supraspinatus which moves the arm away from the body
in a reaching position, the infraspinatus and teres minor which externally rotate the arm and the
subscapularis which internally rotates the arm. Other muscles involved in shoulder movement
include the latissimus dorsi, trapezius, pectoralis major and minor, deltoid, coracobrachialis,
rhomboids and serratus anterior. In my practice, anatomical education is essential as the more
a client knows about their body, the more they will understand and appreciate how to prevent
injury.

One of the most painful shoulder conditions that I see is “frozen shoulder” or adhesive
capsulitis. This condition can be a result of overuse, trauma, holding the shoulder in a position
for a prolonged period of time or even an unknown origin. It is most commonly seen in adults
over 45 years of age, more often in women. It may come after a fracture or rotator cuff tear as a
result of favoring the arm. There are also studies that indicate that the decreased hormones in
menopause contribute to its onset. Symptoms of frozen shoulder include pain, restricted range
of motion, difficulty sleeping and inability to reach behind the back. Most usually the onset is
gradual but it may have a sudden onset.

In most cases a course of therapy with an experienced manual therapist is the best solution for
this problem. Steroid injections and anti-inflammatories may accompany therapy. Diagnostics
such as X-ray and MRI are helpful to determine if there is arthritis and/ or rotator cuff tears involved. I have found in my practice that the most common denominator in cases of frozen shoulder is lack of mobility at the scapula which can adhere at the scapulo-thoracic joint and
tightness in the axilla or armpit where the latissimus dorsi and pectoralis muscles attach to the
upper humerus from the torso. The key to recovery of range of motion and function and
decreased pain is to free these adhesions with manual therapy and stretching. In order for us to
reach our arm forward the scapula or shoulder blade must rotate in a counter clockwise
direction about 45 degrees. In the case of frozen shoulder, this “scapulo-humeral” rhythm is
lost. It is as if the muscles of the rotator cuff are pulling against a very tight shirt restricting
functional movement.

There may be other contributing factors to frozen shoulder may include stress, poor posture,
diabetes, joint hyper mobility, joint stiffness and/or a disconnection between the mind and body.
Treatment will include a focus on techniques to reduce stress, breathe deeply and improve body
awareness and techniques for self care so that reoccurrence of this condition will be prevented
in the future.

The treatment for this can take months but with the right experienced therapist who is able to
spend one on one time with you focusing on holistic hands on treatment, listening intently to
your problem and custom home programs- you will need to spend much less time in therapy.
My goal is always to empower you to take control of your body and return you to independent
participation in all of the activities that are important to you.

I am happy to report that several of my former shoulder patients now come to my yoga classes
and have remained pain free for years especially because of the mind-body connection that
they were able to establish as a result of their participation in Occupational Therapy.
Whether you are interested in integrating yoga into your recovery or not, I would be happy to
see you for any conditions of the shoulder, elbow, wrist and hand. Feel free to call 508-951-0908
for an appointment or free consultation today!

“Deb provided treatment for my shoulder impingement syndrome that resulted in increased
strength and mobility and much less discomfort. Yoga with Deb has been the key to continued
shoulder health.” – Jennifer P.

 

Contact Deb Fraine:

Monday  and  Friday: 9am – 6pm
Saturday: 9 am-12
Call for other appointment options.  Appointments will be scheduled within 72 hours

Deborah Fraine, MS, OTR/L, CHT, RYT-200

508.951.0908

Email: Info@debfraineot.com

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