Defrosting a Frozen Shoulder

Recently a local surfer came in to see me about an injury he had sustained while out on the waves. He told me that he had been surfing on a pretty big day back in May 2016, and got thrown off his board. During his constant tumbling in the whitewash, his hand got caught in the reef. His forward momentum had caused his arm and shoulder to get wrenched something awful. Being the true die hard surfer, he continued to surf after the heavy wipeout. On his very next wave, his foot slipped off his board, and he wrenched his knee. That was the end of his surf session, and he paddled limply to shore.

The weeks that followed were filled with pain and immobility. Although his knee slowly recovered from the wrenching, his shoulder did not. He found he could not lift his arm more than a couple of inches away from his body without tremendous pain. He had spent the next few months resting his shoulder and seeing doctors, getting x-rays and MRI’s. The diagnosis was that he had a SLAP tear. That is when the cartilage in his shoulder joint, called the labrum, becomes torn. The doctor’s recommendation was to perform surgery. The surgeon would go into his shoulder joint and remove the torn away tissue and, if possible, sew the tears together. After the surgery, he would need several weeks of physical therapy, and it would be months before he could even consider putting on a wetsuit.

Rather than following the advice of one doctor he decided to get a second opinion from another surgeon. What do you predict the second opinion was? If you guessed surgery, you would be correct. There is a quote, believed to be from Mark Twain that I simply love and often repeat, “If a hammer is your only tool then all your problems become nails.” If surgery is your only tool then why would we expect a different answer from the doctor? As strange as it may seem, doctors are not well educated in restorative exercise, how the body moves as an integrative unit or other modalities of treating joint pain. They may know all there is to know about joint surgery but not about other approaches to the problem.

The injured surfer was encouraged by a friend to make an appointment with me just to see if there was another approach to try before going in for surgery. In the months since his surf accident, he had been able to increase his range of motion, with the help of a physical therapist, to the point that he could lift his arm to shoulder height with minimal pain. When he attempted to reach higher, he found the pain increased and would not allow him to go any further. There was no more improvement after that.

When we met, to put it in very simple terms, I wanted to see what movements he could do and what movements were missing. What we discovered was that his shoulder blade moved quicker than it needed. His hips were not moving enough to assist in reaching the arm upward. His spine was not side bending or rotating enough to encourage proper motion either. In essence, his frame was on lock-down, pulling him in the direction of the fetal position. It was bracing to protect from further pain and injury.

So we began to ask his body questions. What would happen if we got the hips and spine to move a little more? What would it feel like if we were to slow down the motion of the shoulder blade? What positions can he move into that are pain-free? We let his body inform us as to how to move and how much. Some pretty cool things began to happen so that within a matter of minutes he could raise his arm over his head without pain. He had been unable to perform this action for over six months! By listening to what the body told us we were able to create a strategy of motion that unlocked areas that were in a constant, unyielding loop of fear and immobility.

A couple of weeks later he returned for another session, and his range of motion had continued to improve. However, there were still areas of pain or discomfort that occurred when his arm moved in certain directions. After listening to what the body was telling us, we did a few more movements and also began working with the Indian clubs. In just five minutes of swinging the clubs in certain patterns, his jaw dropped. He could feel how his shoulder had released its tension and the movements that caused pain no longer did. It really is almost like magic when you see how the body can improve and heal itself when you listen to what it has to tell you. Perhaps somewhere down the road, he might need to get surgical attention for the wear and tear his lifestyle creates. Or maybe not. He seems to be doing quite well on the waves without it.