Shoulder Workbook Foreword

The Frozen Shoulder Workbook

Foreword by David G. Simons, MD

Frozen shoulder is a very common musculoskeletal pain condition that is generally poorly identified and treated because the cause is usually myofascial trigger points that are overlooked in most practitioners’ initial education and training. In this book, Clair Davies presents a comprehensive and knowledgeable summary of shoulder problems caused by myofascial trigger points in twenty-four contributing muscles. His unprecedented methods are designed to fit the patient and are much needed.

In his candid introduction, Clair clearly describes the current darkness of inadequate understanding of myofascial trigger points (MFTPs) engulfing many health care professionals. He wisely notes the critical importance of improved attention to MFTPs by schools training those professionals. Fortunately, there is a trend developing to effectively illuminate this darkness. The Philadelphia College of Osteopathic Medicine, the Georgia State University Physical Therapy department, and a number of massage training institutions have effective programs in place.

This book brightly illuminates the shoulder region in this regard in a way that shows patients how to attack the problem for themselves, as Clair did. I hope you read his introduction that so eloquently describes the common plight of so many people suffering from musculoskeletal pain and how he conquered his own shoulder pain. His approach worked and it should be equally helpful to many readers who are afflicted with this problem.

Clair offers a simple manual method that readers can apply to themselves to consistently reduce the pain to fully acceptable levels. This puts you, the patient, in control. You make the decision when to take the time and make the effort to reduce or eliminate the pain. Now the one in charge of your life is you, not the pain. Many times, the loss of muscle coordination and strength are as distressing as the pain and are equally important and treatable.

Several points warrant special attention. This book not only presents in working detail the author’s massage technique, it also includes a comprehensive review of alternate manual treatments of MFTPs, including the original form of myotherapy introduced by Bonnie Prudden. The essence of Prudden’s technique was identified as ischemic compression in the first edition of Myofascial Pain & Dysfunction: The Trigger Point Manual, which I wrote with Janet Travell. The second edition of our book replaced that term and the method of treatment with a new concept: Trigger Point Pressure Release. The essence of this better method is described in Clair’s book under Myotherapy (p. 199); in this section he emphasizes the importance of repeated applications of moderate pressure. I would strongly recommend applying this pressure slowly and pausing where the tissue is especially tender. Muscle tissues need time to readjust toward normality—need coaxing, so to speak.

It is now becoming clear, based on yet-to-be-published surface electromyographic research studies, that, although latent (as opposed to active) MFTPs cause no clinical pain complaint, they can be a potent source of dysfunction of the same and associated muscles. These MFTPs commonly cause muscle weakness, incoordination, and substitute functioning by functionally related muscles. These effects can be disastrous in the shoulder and are a major reason for this needed workbook.

A recent research study by Jay Shah and associates at the National Institutes of Health [if possible, please cite year of study and add to references section] established unequivocally that there are many highly significant differences in the tissue substances of latent compared to active MFTPs that cause pain and inflammatory reactions. Latent MFTPs affect primarily the motor rather than the sensory nervous system.

The frontier of medicine treads on unexplored and often controversial territory. Under Energy Therapies (p. 202), Clair considers the energy features of acupuncture theory. Possibly related to this is a new treatment modality, frequency specific microcurrent (FSM), that produces unprecedented and remarkably effective results by increasing the energy state of specific tissue components. The many specific frequencies used by FSM energize specific tissues at the molecular level, requiring very low energy because they employ resonant effects. Frequency specific microcurrent has limited application for self-treatment because of the cost of the equipment and the need for some training on how to apply it. Fortunately, there are monthly three-day training programs given around the country that provide the necessary training needed for clinicians to use this novel modality and instrumentation effectively, so some well-trained practitioners are available.

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