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Can the mind freeze shoulders? Five studies [member post]

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Luise Hollmann of the Sydney School of Medicine published one of the coolest papers I’ve cited in my frozen shoulder book, or anywhere else. In 2018, she and her co-authors reported some mind-blowing evidence that at least some frozen shoulder patients have way, way more shoulder mobility while anaesthetized.

That just isn’t possible if the joint capsule is truly stuck — mechanically seized up — the way we’ve always assumed it is. So maybe some frozen shoulders aren’t so “frozen” after all.

The paper is titled: “Does muscle guarding play a role in range of motion loss in patients with frozen shoulder?” My sensationalized version: “Has everyone been wrong about how frozen shoulder works? For decades? Seriously?!” If the shoulder can seize up spectacularly from muscle guarding… implications.

This is bigger than just frozen shoulder. There may be lessons here for the whole body, and many other conditions. (Hard not to think about vaginismus, just a week after Vaginismus Awareness Day. Talk about “guarding”…)

Muscle guarding may freeze shoulders. If so, we aren’t sure why the muscles do it. Is it a psychological thing?

There has not yet been any more research of this kind, alas, but today I will look at some new “circumstantial” evidence, five other studies that shed some light on the subject — the psychological side of the equation. If shoulders are frozen by muscle, does that mean we can think the stiffness away? Is that muscle-powered freezing sensitive to our psychology?

But I will explore that evidence today … with my premium subscribers only. Subscribe now, and get the latest on this fascinating topic. Or buy the frozen shoulder book, and it will turn up as a free update soon-ish.

Headings ahead, in the full post (which is about 2000 words, 10-min read):

  • Why would muscles guard? What exactly do they think they are doing?
  • Muscle guarding doesn’t mean you’re a coward, afraid to move…
  • …but you could still have an “emotional relationship” with your shoulder issues!
  • Shoulder physio goes a little better if you think it will
  • Smoke from the muscle guarding fire? Perceived stiffness is not related to structure
  • How frozen shoulders get linked to psychology
  • Not so fast: it could all be the other way around
  • What to make of all this