The shoulder is the most mobile joint in the body, which also makes it vulnerable. Frozen shoulder (adhesive capsulitis), rotator cuff problems and bursitis are the most common complaints we see.
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Our treatment options
For frozen shoulder, we use a combination of Cyriax manual therapy and — in stubborn cases — a targeted injection into the capsule. For rotator cuff tendon problems, PRP (Platelet-Rich Plasma) can be an option: the body’s own healing factors are injected into the tendon area. Research shows mixed results.
The doctor treats bursitis with an ultrasound-guided corticosteroid injection, or with prolotherapy if you would rather not have that.
Your recovery journey
Every course of treatment is tailored, but this is what a typical course looks like — from the first intake to recovery; how quickly that goes differs from person to person. You are not tied to anything and always know where you stand.
Diagnostic intake
A Cyriax examination determines whether it is impingement (a trapped tendon), capsulitis, the rotator cuff or osteoarthritis. If needed, the doctor in Dordrecht performs an ultrasound.
Active treatment
Cyriax frictions on the painful tendon, and carefully loosening the joint capsule. With osteoarthritis: hyaluronic acid injection (Dordrecht, on Thursdays also Rotterdam). Shoulder blade control exercises.
Strength building
Strengthening the rotator cuff and the muscles around the shoulder blade: for the first four weeks with an elastic exercise band, then with light weights.
Free movement
Using your arm above your head again, with as little pain as possible. Treatment ends; you are welcome back if new complaints arise.
How the investigation is going
We examine the shoulder, but also the neck, upper back and ribs: shoulder pain can also come from the neck. You will always hear what we are investigating and why, and at the end what we have found.
Where you are treated
Examination and chiropractic care take place at our practice in Rotterdam. Injections are given by the doctors of our practice: PRP in Dordrecht; prolotherapy and hyaluronic acid in Dordrecht and on Thursdays also in Rotterdam. If a treatment in Dordrecht suits your condition better, we will discuss this with you.
Frequently asked questions
How long does frozen shoulder last?
Often one and a half to two years, in three phases: pain, stiffness and recovery. Treatment can improve pain and mobility; whether it shortens recovery has not been well studied.
Should I move through the pain?
Limited — moving to the limit of pain, not far beyond it. Complete rest makes the stiffness worse.
Does cortisone work?
Effective for short-term pain relief in bursitis, but repeated injections can cause tendon weakening.
When is surgery necessary?
With a complete rotator cuff tear, conservative treatment that has failed for 6 months, or a shoulder that keeps dislocating.
Does exercise help preventively?
Yes — strong rotator cuff and good shoulder blade control prevent many complaints.
Sources
Independent information from Thuisarts.nl, the patient website of the Dutch College of General Practitioners (in Dutch).
