After taking small tendon biopsies, they looked at the health of the tenocytes (the cells that make up a tendon). First, the healing rotator cuff tendon samples showed what you would expect to see with healing – more cells and blood vessels. However, the shoulder steroid injection group had neither. Other indicators of healing (cell proliferation and HIF-1A) were present in the shoulder surgery group and not the shoulder steroid injection patients. In addition, an important cell receptor linked to cell death and poor cell health (NMDAR1) was more prevalent in the shoulder steroid injection group. This same receptor is also found to be increased in severe alcoholics whose cells are being poisoned by the alcohol. Finally, while evidence of painful inflammation was present in both patient groups (increase in the neuro excitation agent glutamate), the steroid injection patients weren’t expressing the off switch for that pain while the healing rotator cuff group was expressing this receptor (metabotropic glutamate receptor 7). This may help explain why tennis elbow patients who are injected with steroids have more pain in a few months – the switch for normal healing pain is left stuck in the “On” position by the steroids!
Diligent physical therapy is often essential for recovery of many conditions but not for adhesive capsulitis frozen shoulder. There is no evidence that physiotherapy helps frozen shoulder at all. Physical therapy targeting frozen shoulder adhesive capsulitis will take months to years of treatment for recovery, depending on the severity of the scarring of the tissues around the shoulder. Over aggressive physical therapy has also been shown to significantly worsen the frozen shoulder as the body responds to additional trauma by over-reacting and laying down more scar tissue around the shoulder capsule. All forms of physical therapy for adhesive capsulitis frozen shoulder are basically useless, can often be torturous and have sometimes been known to significantly worsen the condition. Frozen shoulder sufferers have notoriously spent thousands of dollars and countless hours attending for treatments over months and years which do nothing to help and sometimes worsen the condition. We believe you will find yourself wasting your time and money attending for physical therapy sessions to alleviate your adhesive capsulitis frozen shoulder. Before you attend for physical therapy, be sure to ask the physiotherapist if they have ever had much success with frozen shoulder. The only cases, they may site as being successful, would most likely have improved of their own accord during the timeframe of treatment.