Frozen Shoulder

Did a little research to see why hydrodilation isn't commonly performed in the USA but wasn't able to come to a conclusion. I understand it will not be effective if there is a capsular tear as the tear will not allow for sufficient back pressure and the fluid will leak out. An informative article I found http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2051310/pdf/aco121-025d.pdf supports hydrodilation. I'll have to ask the orthopaedic surgeon we work with next time I see him to get his thoughts.

Hi Kris, Did you undergo the procedure? Talked to the orthopaedic shoulder surgeon today and he stated he doesn't perform the hydrodilation procedure because he has not found that a substantial amount of pressure can be generated to break up the adhesions in the capsule. He stated alot more surgeons would be performing the hydrodilation procedure if there were more evidence which supports it.

So I had my first visit with the Doctor this week, at the 5-week point since he injected the saline. With the great help of a very hands-on Physical Therapist (insisted upon by the Doctor), lifting my arm straight outward and upward has gone from about a very painful 95 degrees pre-procedure and 110 post-procedure, to approaching 180 degrees 5 weeks later. That is what we have been working on. Now for the next 5 weeks, we will be working on sideward-upward movement of the arm and also behind the back. Pain is virtually non-existent in daily activities. Just stiffness remains, in those sideways and behind the back motions. The Doctor feels that full ROM will be attained by June, after another 5 weeks of PT and home exercises of another 6-8 weeks. He has been right on the money so far. The exercise he insists upon every day is pulling the arm across the chest while lying down. He has increased the time frame from 2 minutes to 5 minutes. The Physical Therapist has given me about a half-dozen (and building) other exercises to do daily, now really working on internal and external rotation. Most entail varieties of stretching for longer and longer periods, now up to 3-5 minutes per exercise. He is also introducing a few strength exercises now that I am capable. Once again, I can not state enough how happy I am that I opted for capsular distension (hydrodilation, shoulder lavage, etc.) via saline injection rather than the risks, pain and hassle of surgery. Surgery would have also meant the risk of a buildup of scar tissue, reducing post-surgical ROM. The saline procedure still entails discipline in faithfully going twice a week for Physical Therapy, plus doing the recommended daily exercises (a good half hour per day), but offered an almost immediate ease in doing everyday things with little to no pain post-procedure.
I will try to answer any questions you may have as to my experience.

The Doctor who performed the saline injection procedure is not a surgeon.  He is a Physiatrist, who specializes in non-surgical, minimally invasive approaches to back, shoulder, knee problems, etc.  

Just wanted to update the log since it has been a year since I was suffering almost unimaginably from frozen shoulder.  As mentioned in my earlier posts, I had success with the injection of saline solution into the shoulder capsule early February, 2010.  Since I last posted in the Spring of 2010, my Range of Motion reached just about 100% of what it was pre-frozen shoulder within a few months of the procedure, also thanks to fairly aggressive PT.    There has been no recurrence, and I am able to do all of the strength building exercises recommended to me by the PT during my rehab.  I finished rehab late May of 2010, and have been doing resistance training with elastic bands to continue build strength with no problem.  I once again can not stress enough how happy I was to have done that procedure in lieu of the option of risky and painful surgery.