CHAPTER 1
THE FROZEN SHOULDER
Also, all knowledge seems to be teachable,and what is known is learnable.
Aristotle
Frozen shoulder is also called adhesive capsulitis, capsulitis, and primary orsecondary frozen shoulder. It normally takes two years to heal. The termitis means inflammation; capsule is the name of the tissue involved—hencecapsul-itis. It can affect anyone and has no known cause. The armbecomes extremely painful, and then, often suddenly the movementsat the shoulder also begin to tighten, or "adhere." This affects yourability to move, turn your forearm, and lift your arm. Frozen shoulderis very debilitating; many physical therapists believe it is one of themost difficult conditions to fix. Few can stop the freezing stage once ithas commenced. Worse still is that you may additionally begin to havecapsulitis on the opposite shoulder after six to twelve months of theother one repairing itself. So keep reading!
The American Shoulder and Elbow Surgeons define frozen shoulderas "a condition of uncertain etiology characterized by significant restriction of bothactive and passive shoulder motion that occurs in the absence of a known intrinsicshoulder disorder."
The arm can ache, or twinge prior to really acute pain. Theremay be a hot spot in one area of the arm or a tender patches over thejoint area. There is usually no recollection of one specific injury thatcould result in this amount of pain. Tissue takes six weeks to heal, butthis injury goes on for months and months, even with appropriatetherapeutic interventions. When ignored it progresses to extreme lossof range of movement: the arm cannot be lifted sideways at all. Somewomen say it is more painful than having a baby, and we should know!Even the neck, shoulder, and back muscles begin to ache in their effortsto compensate for the lack of range. Sleeping is problematic and moodswings common.
Frozen shoulder is not linked specifically to any occupation orgenetic disposition. Statistics reported in medical journals indicate thatfrozen shoulder affects up to 5 percent of the population (higher indiabetic populations) and is more common in women over forty yearsof age. Frozen shoulder continues to baffle medical practitioners, whoconsistently report that frozen shoulder is of unknown etiology. Thismeans there is no known specific cause. Controversy surrounds theeffectiveness of various physical and medical treatments relating to thisshoulder condition. Time remains the single most efficient healer ofthe condition, and—sorry to say—it takes two to three years! Whetheror not other body systems remain in disbalance is a matter for longer-termstudy.
An intricate system is involved in frozen shoulder, and withinthis book I propose a new model for more successful healing andoutcomes. The condition is thought to start most commonly as avague, intermittent pulling sensation or discomfort, usually around theshoulder tendon areas. A gripping sensation precursors the stiffeningphase. It is often ignored or wrongly attributed to an injury of the rotatorcuff, the system of muscles and tendons that stabilize the shoulder. Theactual cause, however, is an underlying stress causing messenger andreceptor imbalances in the body. The balance inside your system hasbecome undone.
To date, this has only been alluded to in some journal articlesnoting the abnormally high incidence of frozen shoulder in people withdiabetes and thyroid dysfunctions (high and low). Within the bookreference is made to hormones, connective tissue, and the nervoussystem and unique exercises and tasks as fascinating as they are toughto perform. If you are game to read on and self-discover the cause, thenyour arm pain and frozen shoulder are not going to have the standardtwo-year recovery rate. Healing will be accomplished much faster,depending more on your own needs and the initiation of a self-careprogram.
A joint threatened will be braced. Pain will stop use of the arm whilethe body braces the shoulder back into itself. The capsular adhesionsrepresent a tightening in different areas, which unfortunately result ina loss of range of movement or freeze. All movements become extremelydifficult and are very painful.
The outline of care in this book is a result of my own experiencesand the fact that traditional therapies failed to heal my pain or rangeof movement. As a practicing physical therapist and Feldenkraispractitioner I disliked being on the receiving end of ineffective costlytherapy treatments. The program began after studying Metaphysics andre-learning meditation and affirmation variances. It was quite crazy toget in touch with inner knowledge or higher consciousness initially. Thefirst time you actually hear something you cannot possibly know, it isshocking; especially for someone trained in more traditional westernmedicine models. To be truthful I actually panicked, jarred my shoulder,and booked scans. And I certainly stopped meditating for a while, too.After some scans to eliminate the presence of a tumor, I discoveredI was being supplied with incredible information for frozen shouldersolutions, for a variety of conditions. So the approach contained hereincludes not only getting you to relate hormones, mood, and youremotional history to the shoulder, but also has some really different,weird-looking movements. (I use the term movements instead of exercisesas I am not into pain or drama.)
These movements are totally different to my previous knowledge;it can be hard to comprehend how getting into a froglike positionhas anything to do with frozen shoulder at all, but wait until yousee the results. While I initially assumed some exercises to be sometype of fascial stretching or nerve stretch, I continued to observe thatolder bodies could get into this position without the harm I wouldhave imagined. The expansion of this experience is the source ofthe knowledge presented in this book. It remains new and unused inclinical trials, like many techniques.
The release of hormones and related chemical messengers on thelimbic-hypothalamic-pituitary-adrenal axis (LHPA) deserves morestudy in relation to this shoulder condition. This complex system isa major player in linking emotions, mood, and energy reserves at acellular level. The affect from emotional causes is even more dramaticamongst those already challenged in this axis. This includes thosewith pituitary problems, diabetes, and hormone insufficiencies (e.g.,adrenocorticotropic hormone, or ACTH) and probably perimenopausalstates. Whether or not the menopause can be considered a pre-existingdeficiency is debatable. Perhaps the menopausal changes in needs,mood, and emotional reactions makes this group more vulnerable totissue changes by altered levels of cortisol, a catabolic hormone thatcan weaken tissue over a long term. (Catabolic means simply breakingdown complex molecules into simpler ones in order to release energy.)For me, especially in hindsight, it was a specific emotional stressorthat was catastrophic. Dealing with these deficiencies requires separateinterventions and transgresses from traditional approaches to thecondition of frozen shoulder.
Mental processes affect mood, and certain stressors can bereversed with cognition and physical hard work. Whether or notthe time associated with the healing of a frozen shoulder can beforeshortened depends on the release of hormones involved. Asbehaviors and reactions affect all hormones, fear has to beconsidered the prime cause of this condition. People (and someanimals) freeze when frightened. How can this relate to you, then?For example, the stress-related hormone ACTH discharged inextreme emotional circumstances can lead to tissue laxity throughthe overproduction of catabolic steroids. How that laxity affectssomeone is dependent also on preexisting muscular length and onthe joint surface condition. For example, in diabetes there are alreadycollagen changes that exist locally. This will naturally affect tissuetolerance and shoulder strength at the capsular level. Another personmay, however, experience a different physiological response, such asindigestion, emotional overeating, or high blood pressure.
In devising treatment one should consider the individual's social,emotional, and genetic disposition as part of a thorough medical history.Can one consultant do this? In fact, it is outside the scope of any onepractitioner to heal a shoulder injury of this type. Many people rely onexercise and mobilization with a physical therapist. It is important toconsider the reason for the freeze in the first place.
Surgical interventions are no different. Surgery can alter theperson's short-term shoulder outcomes. But is it better medical practiceto heal the signs or the cause? Could frozen shoulder be one of manyprecursors to an ongoing limbic-hypothalamic-pituitary-adrenal axis(LHPA) system in disbalance? Perhaps the physical body can return toa new functioning homeostasis (balance); with or without surgical ortherapeutic interventions. Noting, any stress of a similar nature mayheighten a similar component in the LHPA system and lead to moreor other stress-related disorders (e.g., digestive disorders, chest pain, bloodpressure).
Assume an open-minded approach to this condition. Testingimbalances in hormones is difficult, with results variable even over atwenty-four hour period. Support your medical practitioners with thefollowing:
• Write up a full and thorough history of any emotionally chargedevents as well as presence or absence of any physical harm,injury, repetitious movements, sports, or jobs you hate
• When no physical indicator is present explore logically anyemotionally charged reasons or events that keep you in anonresolved state.
• Check if any of the following prewarning signs were present(try to recall to the best of your ability).
* sensations of being overwhelmed (six months prior)strong sensations or feelings of rejection or hopelessnessrelated to recollection of retrenchment, financial loss, orseparation [it is the authors opinion that feelings of rejection leftunchecked alter hormonal pathways in a narrow band somehowinfluencing this particular shoulder condition]
* feeling morose or hopeless or unusually sad, etc. (six to ninemonths prior)
* dull ache prior to pain and before night pain
* squeezing of upper arm automatically (around the deltoid)in attempt to give pain relief (limbic system response beforethe freeze)
* intermittent local tendon pain or pulling or tugging orother random sensations in the shoulder area well beforethe acute pain phase (disbalance sign)
* stress (emotional disbalance)
* reacting to any event in a hyperactive or hypersensitive way(emotional disbalance)
* sensations of fatigue unrelated to physical events (physicaldisbalance)
* hate, laughter, and overwhelming sensations of sadnessatypical to your personality (emotional disbalance)
Using these criteria as a diagnostic guide is helpful but insufficient;further study on the mix of emotional and physical signs needs to beundertaken with an expert. Each person has a chance to reverse his orher own emotional traumas through altering reactions or perceptions.Where the trauma is addressed professionally with physical therapyalone, ensure a program of self-help is implemented to cover any residueLHPA system involvement.
While the limbic-hypothalamic-pituitary-adrenal axis(LHPA) access is proposed as the key, there are other brainareas and neuro anatomical links that disbalance for emotionalreasons. These are the upstream complications referred to in theparable. For example fear or anxiety are said to upset balance in thecentral amygdala altering neuropeptides, glutamate and many otherneuromodulators (Panksepp, 2001, pp147). This book deals withshoulders that are reversible in their injury status. Most are able toreverse receptor sensitivity with training and time. The use of biofieldtherapies can add a new treatment dimension for emotional factorsrelating to neural receptor chains, research is emerging in this area tooslowly due to skepticism.
Can you imagine there is an emotional layer around and within youcommunicating with your physical body and able to alter all hormonesand potentiate new neural balance. I need you to understand that as truthto believe in your own body, as often after the emotional turmoil you aregoing through the body develops a system of coping without hearing.The emotional needs are a system available to the hormone whisperer.The emotions are not necessarily comprehended in logic. They neednot be. The emotion you are accessing here is only the one affecting thearm pain. If the arm pain were not part of the emotional system then itwill be better in 5-8 working weeks, ok? I am going to call this layer ofenergy emotional SEL.
CHAPTER 2
INTRODUCING THE TERM SEL
Spontaneous healings, psychic phenomena, amazing feats of strength andendurance, the ability to walk across hot coals without getting burned,acupuncture's ability to diminish pain by moving chi around the body,and many other paranormal phenomena defy Newtonian biology.
Bruce Lipton
The book contains a new word: SEL. SEL is not to be confused withcell. The human body, for example, has 100 trillion cells varying in sizeand complexity. SEL is a cluster of energy substances around and in the humanbeing. It is capitalized to emphasize that it is a newly coined term and toeliminate spelling confusions. SEL is contained by energy fields aroundyou. SEL should not be confused with auras or auric fields; it is thecontent layers and frequency thereof.
SEL is a group of atoms of information, or banding waves, thatform in around the body. SEL responds to stimuli and reacts verysimilarly to a single cell but does not contain the organelles foundwithin cells. SEL attracts energy, disperses, and can be stagnant in timeand space (this is complex but apparently very helpful in understandingintergenerational traumas in the future). SEL is not visible nor to datescientifically acknowledged; it is considered by some to be the aura andthe linking energy, or etheric layer. One may expand it into band wavesor frequencies or even more formal groupings related to its action,such as spiritual SEL, physical SEL, emotional SEL, and the eternalsoul SEL.
For the course of this book, SEL groupings are assumed to havereceptors and feedback mechanisms and operate in a transitionaryplane. There is, for example, a body of emotional SEL that incorporatesall your feelings and locked memories. Emotional SEL can be seen onlyif acted out through the physical SEL affecting the physical body, e.g.,stress, crying, or even running away or freezing in fear. Spiritual and soulSEL is all about God or the I am, and as important as that is, it will notbe covered in this book. It affects pain too; ask someone who has beenmistreated in the name of God. This book will focus on an innovativeway of resolving a hard-to-diagnose-and-treat shoulder condition thatremains at the boundary of understanding.
The foundation of this new book on shoulder pain is that it offersthree possible gateways to relate healing and injury mechanisms, eachrelating to SEL:
1. Natural weakening of shoulder tissue and a new "abnormal"position of the ball-and-socket joint, leading to micro-trauma.This is naturally physical SEL related and will require exercise,joint compression and self-evaluation of posture and motion.
2. Being rejected or continually not believed/acknowledged/honored by those you love, resulting in a negative attitudeto one's own self over a long period of time, depression, andaltered hormones. You exceed your own SEL tolerance.
3. Problems in, within, or preexisting in the limbic-hypothalamic-pituitary-adrenalaxis.
The theory implied is that any trauma or distress of significancewill impact the chemical messengers linking the emotional and physicalSELs. This includes the belief that emotional SEL is able to alter thepeptides and chemical messengers, thus potentially altering physicalSEL from standard operations. I am proposing emotion as outsideenergy.
I have to take the liberty to assume you believe that your bodyextends outside its layer of skin in the form of frequency emissions.An odd way of confirming this is to allow someone you dislike tostand too close to you; even though they are not touching, what do yousense? Is it only an encroachment into your space? Some people even getgoose-bump warning of bad SEL. Another way is to be near someoneyou really love and sense a connection.
