Over 40,000 therapists worldwide have learned the NAT protocol for treating frozen shoulder since Simeon Asher first published his technique in 1999
What is Frozen Shoulder?
Frozen Shoulder Syndrome (FSS) is among the most severe, painful and debilitating shoulder conditions. It is fairly common and rarely the result of an underlying illness or pathology. Frozen Shoulder affects as many as 2-5% of the population.
Experts define frozen shoulder as "a stiff shoulder with less than 50% of normal range of active and passive motion in any direction". Although it is fairly common, one of the main problems is that frozen shoulder is often misdiagnosed.
The causes of frozen shoulder syndrome are still poorly understood. About 50% seem to stem from an injury to the shoulder (such as a fall on an outstretched arm) and these are called secondary frozen shoulders.
But 50% of the time they appear for no apparent reason, and these are called primary frozen shoulders.
The natural history of this condition is well documented. Over the course of (typically) 30 months the frozen shoulder passes through three phases: freezing, frozen and thawing.
Phase 1 - Freezing
The freezing (painful) phase lasts between three and eight months. Severe night pain is a common feature of this phase. Clients often complain that they are unable to sleep on the affected side. If they do manage to drift off, they are soon awoken in agony.
Many clients find that they are re-arranging pillows to support the arm and that they must ‘steal’ sleep where they can.
The pain itself can be quite horrendous. Clients usually describe three types of pain:1. A constant ‘internal’ dull burning
2. Pain down the outside of the upper arm
3. Severe sharp catching pain after certain innocuous movements lasting up to two minutes
Clients usually report pain when brushing the hair, doing up the bra, or reaching behind themselves.
Along with this there can often be rapid stiffening of the whole shoulder.
Phase 2 - Frozen
This is followed by the frozen (stiff) phase, which lasts between four and 12 months. There may still be night pain but this usually diminishes as shoulder mobility decreases. Here patients are usually able to sleep but find it increasingly difficult to perform daily chores.
This is especially so for those poor people who are affected on both sides. So many of the menial tasks we thoughtlessly perform become titanic achievements. I have had several female clients who have taken to wearing wigs, as they are unable to do their hair.
During this second phase, pain can often radiate into the forearm or hand, and in some cases the hand can become swollen and painful. In some cases this may be due to the onset of a condition called reflex sympathetic dystrophy (RSD).
In other cases the pain may also start at the back of the shoulder in the region of the triceps muscle. This is typically due to a triceps tendonitis.
Phase 3 - Thawing
Spontaneous recovery of mobility (thawing) follows over the next four to 12 months, although full recovery is commonly protracted.
Occasionally clients may awake after 18 months to find they are fully better, but in my experience this is rare. Without treatment, even after the thawing phase a restriction of mobility may often persist for several years.
It is worth noting that some experts talk of a ‘pre- adhesive’ stage, before the freezing phase begins. Here patients present with signs and symptoms of what is commonly termed ‘impingement syndrome’.
This is where there is still movement but there is a catching in certain positions. The only signs that there is a frozen shoulder would be if a camera were placed within the joint (arthroscopy). This often reveals some reddening of the synovial capsule and an increase in thickening of the capsule, indicating the onset of a frozen shoulder.
Who is Prone to Frozen Shoulder?
Frozen shoulder affects slightly more females than males typically between 40 and 60 years of age. The non-dominant arm (i.e. left arm in most people) is more likely to be involved, although about 12% of people are affected on both sides (bilaterally).
Frozen shoulder syndrome is much more common in diabetics, affecting between 10 and 20%. It lasts for an average of 30 months, although one recently published study showed that up to 60% of sufferers still had some symptoms after 10 years.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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When you purchase a "Printed" edition, you will also receive free access to the download edition.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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