Don McCann, founder of Structural Energetic Therapy, describes how he treated three of his clients who had frozen shoulder.

In order to be able to effectively treat all of the above clients, it was necessary to evaluate the structural distortion that each client had, and to determine whether the shoulder was internally rotated. I found that all three had a significant internal rotation of their problem shoulders. This in essence left not only the shoulder, but the entire arm, severely weakened and susceptible to strain and injury with light activities. These clients had used their arms with a decrease of at least 50% of normal strength due to the strain pattern, and consequently had damaged soft tissue. As the tissue damage was worsening through regular activities, the inflammation and swelling was also increasing. This ultimately led to their frozen shoulder conditions.

It was apparent that the internal rotation of the shoulders in these three clients had to be addressed in order to effectively treat and rehabilitate their frozen shoulders. This required evaluating what muscle tension and myofascial holding pattern were responsible for the internal rotation of the shoulders. The obvious culprits were the pectoralis groups along with serratus anterior and subscapularis. Palpation showed that all of these muscle groups were very tight and rigid with very active trigger points. In addition, the fascia associated with these muscle groups was tightened and fibrous indicating that splinting was taking place further limiting the range of motion of the shoulder. The splinting had become part of the cause of the frozen shoulder by reinforcing and limiting the range of motion.

There was other not so obvious soft tissue that was also involved. This soft tissue was located on the inside of the upper arm and included the biceps brachii, coracobrachialis, and anterior deltoid fibers. As with the pectoralis groups these tissues were tightened, shortened, and inflamed. The fascia associated with these muscles was also contributing to the frozen shoulder by being rigid, fibrous and shortened.

At this point, it was also necessary to view the relationship of the forearm to the upper arm and the pronation of the hand as contributors to the internal rotation of the shoulder. It was obvious that the entire arm down to the pronated hand were all either supporting or helping to cause the internal rotation of the shoulder. In addition, upon kinesiological testing the strain pattern that existed in the shoulder manifested all the way through the hand. The muscles of the forearm and the hand were also contracted and in a strain pattern with inflammation and weakness. The clients were not aware of what had been happening in their arms or hands because the most severe pain was in the shoulder. The muscles used in pronation were the ones I found that were the shortest and most distressed. The fascia was similar to what I had found in the shoulder and upper arm. It was fibrous and shortened, and splinting was found even in the hand and forearm which contributed to the limited range of motion of the shoulder.

After addressing the specific musculature involved with the frozen shoulders, it was now important to bring the rest of the body into structural balance to support the remobilization and rehabilitation of the shoulder. Each client had fallen into a structural collapse through different life activities, yet this collapse appeared to be the major player in the development of their frozen shoulders due to the internal rotation of the shoulders.

Now for the therapeutic challenges. All three clients had swelling and inflammation in the tissue that needed to be treated to rehabilitate the shoulder. This swelling and inflammation were two of the principle reasons for the degree of pain that each client was experiencing. Each client also had tightened, fibrous fascia that was pulling the arm into internal rotation and splinting the area which greatly contributed to the lack of range of motion. Finally, each client had significant adhesions that had developed from being in the strain pattern while using the arm. Some of these adhesions were deep and were compressing nerves next to bony prominences resulting in significant pain when their arms were moved. The tightened fascia was also in and around the muscle fibers which added to the limitation of range of motion.

The protocol I designed to treat these shoulders would first and foremost release the internal rotation of the shoulder and arm; 2^nd reduce swelling and inflammation and the associated pain; 3^rd release the myofascial holding pattern that was helping to lock the internal rotation and restrict the range of motion; 4^th lengthen the fascial and muscle fibers that had become shortened and contracted locking the shoulder into internal rotation and restricting its range of motion; and 5^th release the adhesions and scar tissue that had formed which were compressing nerves and restricting the range of motion of the shoulder and arm.