Frozen Shoulder Syndrome

This Frozen Shoulder Syndrome DVD was written, instructed and directed by Elaine Calenda, AOS, NCTMB, a massage therapy educator for over 28 years. She has successfully applied the techniques demonstrated on this  DVD seminar on real clients experiencing real shoulder issues. She also filmed this DVD with one of her own clients in Boulder, Colorado who suffered from Frozen Shoulder Syndrome.

During her 25+ year career as a massage therapist and instructor, Elaine has learned firsthand that people who receive regular therapeutic massage for Frozen Shoulder Syndrome recover a lot faster, develop far fewer adhesive formations and scar tissue and are much less predisposed to strong holding patterns that can develop as a result.

This DVD will also be helpful to you if you treat clients with active lifestyles who suffer shoulder problems, stiffness and restricted range of motion related to everyday repetitive motions. This DVD is recommended for practicing massage professionals, chiropractors and physical therapists who have completed at least 500 hours of accredited education that includes massage, physiology, pathology and anatomy.

INNOVATIVE AND SUPERLATIVE

Elaine Calenda is an innovative and superlative healing arts educator. I strongly recommend her Frozen Shoulder Syndrome DVD as an excellent way to enhance your palpation and clinical skills. For three decades Elaine has set the standard for massage therapy training. She is a passionate, articulate and humorous educator. Her style reflects her holistic values and top-notch expertise.

- Robert King, Co-Founder and former Owner, Chicago School of Massage Therapy

A DVD YOU WILL WANT IN YOUR LIBRARY
On this DVD seminar, Elaine demonstrates techniques for the shoulder with an actual client who had suffered with frozen shoulder syndrome. FSS is clinically known as adhesive capsulitis, a condition for which there is little known in conventional medicine regarding causative factors and prognosis. Anecdotally, we know massage can help with FSS. Calenda shows how to perform an assessment for FSS, how to palpate the muscles involved, and apply proven techniques, including three-dimensional side-lying shoulder mobilization.  Calenda also demonstrates how shoulder rehabilitation includes working with subconscious holding patterns, and she uses resistance exercises that can help the body process its own healing more freely.  The DVD was shot using a massage table with a see-through surface Calenda designed so you don't miss anything her hands are showing you, even underneath the body, you can see her hands' movements on the posterior neck with the client supine.  "Frozen Shoulder Syndrome" is a DVD you will want in your library so you can refer to it over and over.
Lisa Mertz, PhD, LMT. Massage Therapy Journal February 2008

GUIDES VIEWERS THROUGH TECHNIQUES

Elaine Calenda's new DVD teaches practitioners how to assess and treat Adhesive Capsulitis, or Frozen Shoulder Syndrome, beginning at the client interview, and followed by developing a treatment plan and evaluating the client's progress. Calenda, the academic dean at Boulder College of Massage Therapy, guides viewers through techniques such as shoulder mobilization, traction for the shoulder joint, fascial release for the shoulder girdle, and breaking down holding patterns.

Massage and Bodywork Magazine July 2008

How to assess and treat this condition including:

• Interviewing your client for the facts about the condition.
• Recording information that you have collected.
• Developing a treatment plan with an expected outcome.
• Evaluating progress with your client.

Visually learning a variety of valuable and novel techniques including:

• Shoulder Mobilization
• Traction for the shoulder joint
• Fascial release for the shoulder girdle
• Breaking down holding patterns
• Breaking up adhesions using “pincement”
• Mobilizing the glenohumeral joint
• Releasing the scapula, and more.

This DVD features exceptionally good up-close views of Elaine’s instruction utilizing her “Through-Touch” massage table. This feature enables you to see her hands working underneath her client’s head, neck and shoulders.

DVD Contents

1 Introduction

2 Through-touch table

3 Case History

4 Intake and SOAP Chart

5 Neck and Chest Massage

6 Back Massage

7 Side-lying Massage

8 Abdominal Massage

9 Studio B

10 Scapula Movement

11 Closing Comments

Running Time: 65 mins

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Author Clair Davies’s success in treating his own frozen shoulder led him to undertake an extensive study of trigger points and referred pain that eventually resulted in his runaway best-seller, The Trigger Point Therapy Workbook. Now this renowned bodywork expert and educator revisits the subject of frozen shoulder, offering the most detailed and comprehensive manual yet available about this painful and debilitating condition —a useful resource for self-care and for bodywork practitioners looking to expand their treatment repertoire. 

Frozen shoulder, the syndrome name for several muscle, joint, and tendon-related symptoms, is experienced as pain and a loss of motion in the shoulder and upper arm. Frozen shoulder is most often observed in women between the ages of forty and sixty and in individuals with type-two diabetes, although a man or woman of any age may be afflicted. Traditional medical treatments for frozen shoulder, which rely on painkillers, steroid injections, surgery, manipulation under anesthesia, and physical therapy, often do little to moderate symptoms or speed recovery. Include: New Techniques: Self-Treatment —fix your own shoulder! Partner Treatment —friends and family can help . Clinical Treatment —for doctors and therapists.

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Through collaborations with worldwide medical practitioners, and an intense self study of anatomy and pathology, James was able to discover the missing link for immediate release of complicated frozen shoulders. After being challenged with many clients with difficult frozen shoulders, James observed that at the articulating cartilage of ball and socket joints was a thick layer of fascia. Due to repetitive movements in the shoulder  joints certain muscle groups become strong and short while opposing muscle groups become overstretched and weak. This eventually leads not only to joint degeneration and resulting arthritis as the cartilage wears down, but also limits range of motion causing a formation of adhesions in the joint capsule itself. The articulating fascia acts as superglue and literally glues the humerus to the scapula. The deep fascial adhesions however can be melted, in almost a miraculous discovery James was able to use the head of the humerus in the shoulder to melt the fascia using very gentle movements. This technique has been able to release thousands of complicated frozen shoulders in literally one session.

This DVD addresses scalenes, pectoralis minor, subscapularis problems, and deep adhesions in the joint capsule. It also addresses emotional components of pain stored in the tissue and the psychological guarding patterns.

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“Elaine Calenda brings state of the art educational standards to her commitment to integrity-based education. She has my highest professional recommendation.” - Robert King

Elaine Calenda has been a massage therapy educator for over 28 years. She graduated from the Swedish Institute in 1979 with her CMT and gained clinical work experience with Dr. Richard Bachrach at the Center of Osteopathic & Sports Medicine in New York City. Elaine was an instructor at the Swedish Institute for six years. She is the Academic Dean at the Boulder College of Massage Therapy where she teaches Sports, Orthopedic, and Medical Massage.

Elaine contributed to the development of the AOS Medical Massage course and she has participated in multiple research projects including: “The Effects of Massage for Carpal Tunnel Syndrome” and “Chronic Tension Headache.”

Elaine is dedicated to the advancement of the massage profession and she is a member of the Massage Therapy Research Consortium. She writes for massage and CAM publications, she designs anatomical charts and she is frequently quoted as a massage expert by various health-related media venues. She is a member of the teaching team in the Orthopedic and Sports Massage Certificate Program and she teaches Structural Kinesiology, Anatomy & Physiology, Pathophysiology, and Medical Massage.

Interview with Elaine

Tell us a little about the Frozen Shoulder Syndrome DVD instructional program and how you decided to do it.

I started working with frozen shoulder in my early 20s, in an osteopath office, with doctor Richard Bachrach. Since then, there have been many times when I have been frustrated with frozen shoulder and other stiff joints in the traditional way. One day I asked a client to turn over onto her side, and that’s where the side shoulder mobilization techniques came in. It was the first day that I felt like I had made some real progress, in working with the shoulder because the next time that she came in she was able to raise her arm for the first time in months above 90 degrees.

Your Frozen Shoulder Syndrome DVD program demonstrates how to position clients to work on the shoulder most effectively. Does this produce better recovery?

Yes, clients regain mobility a lot quicker than with the standard pro-pine position. Seeing this gave me the confidence to move out of two-dimensional ways of treating people and really get into three dimensional rotation techniques. That’s what gave it the edge that it really needed.

And you feature a real frozen shoulder client in the DVD?

I think it’s important to have a live model to demonstrate with, someone who can tell their story to make it real. She fell off a ski lift that was coming in and fractured her shoulder so she had a pretty bad stiff joint. Also then to give people hope that no matter where they are in their life, they can get better through massage therapy.

The clinical name for Frozen Shoulder Syndrome is Adhesive Capsulitis? Is that scar tissue?

Scar tissue is created from a fracture swelling that hardens. It also comes from fear that’s locked into the muscle. We demonstrate resistance exercises on the DVD. Doing those over and over helps the body to understand that it is no longer in trouble.

A big part of frozen shoulder rehabilitation involves taking something called the shrug mechanism that locks the shoulder up and in to the socket AND splinting which holds a part of the body close to the center. Shrugging and splinting are the hardest things to treat. The fracture heals, the person becomes more mobile but what often remains is a holding pattern that sinks way down into the sub-conscious. That’s the hard part to treat because you’ve got to convince the body that it’s okay. And it takes a lot of convincing. That’s another reason why this Frozen Shoulder DVD instructional program is a good idea, not just for massage therapists but also for physical therapists and chiropractors.

Can viewers of this Frozen Shoulder Syndrome DVD use your techniques to deal with other ailments or problems that clients may have?

The instructional program includes neck work that helps to work the deeper layer of muscles on both the front and side of the neck. We also include some upper back tension techniques. We do a 16-17 minute back routine that covers not just how to work on loosening the shoulder blade, but also how to get rid of deep seated upper back tension, which enables the client to regain normal breathing patterns.

Researchers are finding that many musculo-skeletal problems originate from or are exacerbated by the fact that we don’t breathe properly. It’s important for massage therapists to help people by not only asking clients to take deep breaths but also to make it possible for them to do so. Helping clients relax their accessory breathing muscles -- which is what causes us to breathe shallowly -- to relieve restrictions on the diaphragm enables them to breathe deeply and more normally, more healthfully.

So what’s the usual medical protocol for clients with frozen shoulder syndrome?

Many patients go directly to orthopedic surgeons who in many cases will crack you open and do surgery to see if they can clean up the joint but sometimes there’s nothing to clean up. That’s one of the things that makes frozen shoulder syndrome mysterious. So massage provides a non-invasive alternative to surgery. Is there any way you can help massage therapists zero in on clients who have frozen shoulder syndrome or may be getting close to it? It’s great if you can catch them early but a lot of times people come to see us as their last resort. If they are lucky, they may already be working with a massage therapist trained to recognize these limitations because they are so obvious.

People suffering from frozen shoulder syndrome are so obviously different than someone who is just stiff. This is somebody who has a pathological immobility in the shoulder and the scapula and a restriction in what is called the scapula-humeral rhythm, which is how your shoulder blade slides on the ribs as you lift your arm. If that can’t happen and your shoulder blade is stuck to your ribs, no matter how great your ball and socket are doing, your arm won’t be able to go past 90 degrees because that is the point where the scapula starts to slide. If your shoulder blade is stuck, you’re going to be stuck right there.

Do you think some people live with Frozen Shoulder Syndrome and just think, ‘well, I’m getting older, so I guess it’s normal to have aches and pains?’

They do. The category of people we are talking about will mysteriously get well again about a year and a half later. Eventually, they are going to get better and they are going to have more natural range of motion restored. But it’s not like you can’t treat them, just because they will get better in a year and half. In fact using the massage techniques on this Frozen Shoulder Syndrome DVD, will enable clients to get better a lot faster with a lot less pain AND have more of their movement restored AND feel a lot better sooner.

So it sounds like this DVD helps massage therapists diagnose and pin point problems and provide some preventive massage therapy to their clientele.

They’ll be able to recognize the condition and more readily assess it since we really don’t do diagnosis. A massage therapist will say ‘I can help you, but I really need to know what is not going on in your joint.’ They have to rule out any calcium deposits or other things that will show up on an X-ray or MRI. Get those ruled out first and seek out a doctor’s referral.

Tell us about the touch table that you use to better demonstrate your technique on the DVD?

My partner and I created and used a special touch table with a see-through surface during the filming of this DVD so that practitioners can see what the teacher’s hands are doing underneath the body.

This means that people can see what I’m doing underneath a person’s neck, when they are lying face up which is something that you can’t see in a normal classroom. It also provides a better view underneath the shoulder blade because there is a lot of work; a lot of technique that takes place while the client is lying on their back. With the touch table, you see how my hands go up underneath the shoulder blade, mobilize it against the rib cage and break up those adhesions. That provides a real learning enhancement for viewers, a distinctive feature of your program. It does help to relieve a lot of the frustration. And I mean students had a lot of ‘Ahs’ when it came out.

Tell us about the client you treat in the Frozen Shoulder DVD.

She’s a real person who had Frozen Shoulder Syndrome. We had Sandra, who was our model describe her full injury, her surgery and her medical treatment. This is an important thing because massage therapists have to be very good listeners and then have to document all that. In chapter 4 we talk about all that.

She had gone through the standard medical procedures and she was looking at another several months of just slow rehabilitation because it’s a pretty slow process. And then she ran into me at a clinic I was supervising here. She was going to our student clinic.

I walked into her room and I saw that limitation which is just classic and started working on her and she was just “You know lady, I think you can help me out.”  I said to her, “Well I’m looking for someone just like you to star in our video would you be a volunteer?” She totally just allowed herself to be part of this project, and was very open so that was a good thing.

Did you reduce her rehabilitation time?

Yeah, by about six months. These techniques help people get better much quicker. It takes at least two thirds of the time off of that healing time and I do expand the range of mobility a lot. Plus my techniques improve the mobility in their neck, their breathing, their general comfort in their body and it prevents them from injuring it again.

I also help clients develop good body awareness which most people don’t have, unless you’re an athlete or runner, they’re very tuned in. Day to day people like you and me have to learn how to pay attention. We’re born with an innate sense of where we are in space and it gets compromised by sitting still, driving cars and being in these positions that are not natural. Sitting in front of a computer all day is not natural and we lose our body sense.