HEAVY METAL PROTOCOL RE-DONE 5-23-2013 John W. Brimhall, DC (ONLY FOR REFERENCE)

Adjusting Equipment Lasers PEMF Machines Foot Baths

May 28, 2013 Puzzle Piece HEAVY METAL PROTOCOL RE-DONE 5-23-2013 John W. Brimhall, DC (ONLY FOR REFERENCE) Testing for Heavy Metals Test each patient first for a XYMOGEN Homeopathic heavy metal after you make sure they are testable by using MaX Adrenal or MaX Adrenal Herbal and the multipolar magnet. Now, test a strong muscle and further test to see if any of the homeopathic metals make the patient weak when placed in the patient's energy field. If a homeopathic metal is needed, you will give them one to three drops under the tongue of that homeopathic heavy metal that challenged at this time. The patient will now be testable, even if locked up before. They will not be switched on challenge if they were before. Now therapy localize (TL) EACH LOBE of the brain, starting with the right and left cerebellum. The brain will not usually TL in the clear or before a homeopathic metal or halogen is administered. It will always show specific weaknesses after the homeopathic. Each lobe that causes weakness to a previous strong muscle when touched (therapy localized), now needs to be lasered 30 to 60 seconds OR UNTIL THE WEAK MUSCLE STRENGTHENS. We most commonly use the Quantum laser with its 40 mw's of red laser diode power and 40 mw's of infra red laser diode wavelength and its 20 five mw violet LED's. This gives us THREE WAVELENGTHS OF INFORMATION. Therefore it sends THREE DISTINCT MESSAGES AND EACH WAVE LENGTH PENETRATES DIFFERENT DEPTHS as well. Go to www.brimhall.com or call 866-338-4883 if you have any questions or need clarifications on the Quantum laser. Training DVD's are available. We very commonly also use the LZR7 4.5 WATT, CLASS IV LASER. This works very rapidly and 3-4 seconds is usually sufficient. To repeat, 4, 5000 mw from the LZR7 works very rapidly. 3-4 seconds is usually sufficient. Do not over treat, as it may cause a headache. If you stopped at this point, you have created major improvements in the patient most of the time, including increased ranges of motion, balancing leg checks, strengthening previous weak muscles etc. If this is the first visit you want to test for nutrition or the monthly check-up, this is the time to do a MaX Scan. After the scan is completed, we challenge the patient by putting iodine on the tongue or body and test to see if this makes a previously strong muscle weak. IF THE PATIENT WEAKENS, WE SEE WHICH OF THE HALOGEN HOMEOPATHIC REMEDIES STRENGTHENS THAT WEAKNESS (or you could remove the iodine and one of the halogen homeopathic remedies would now weaken them from the choices of MaX Fluorine, Chlorine or Bromine). Most often the patient will weaken to one of the halogen homeopathic remedies. Most patients have BIO-ACCUMULATED ALL THREE. Therefore we send them home with all three remedies. WE HAVE THEM TAKE ONE TO THREE DROPS EACH MORNING (of one remedy only) before they take ONE MAX IODINE. We have them rotate one halogen remedy each day through each of the three homeopathic remedies. We have them take the three remedies long term do to the continual high exposure rate of CHLORINE, FLUORINE and BROMINE in our environment. If they can self-test, they can see which remedy the body chooses for that day. If not, we have them rotate them at one remedy per day as stated. It is best if an iodine-Challenge Test could be accomplished through, for example, LABRIX LABORATORIES at this point, if iodine weakened them on muscle testing. CURRENT LAB FINDINGS ARE THAT OVER 90% OF AMERICANS DEMONSTRATE IODINE DEFICIENCY. The patient should excrete 90 % of the 50 mg's administered over the next 24 hour period. Rarely is that accomplished according to Jay Mead, MD of Labrix Labs and David Brownstein, MD and Guy Abraham, MD in the book Iodine, Why You Need It, Why You Can't Live Without It. The brain will now show areas that need to be lasered after the administration of the halogen homeopathic remedy that tested. Treat as you did with the first heavy metal procedure. If you choose to move rapidly with the patient, a SECOND METAL can be identified with muscle response testing and balance their brain with laser as before. Different areas of the brain demonstrate the need for treatment with each halogen and heavy metal. You must test to see which area of the brain needs balancing with each remedy, starting with the cerebellum. When toxins are released in the body, they deposit frequently in the fatty tissue, including the nervous system, since it is made up primarily of fatty tissue. We have found it effective to use specific nutrition to help remove the toxins from the body such as Chelex, and possibly XenoProtX from Xymogen. We always recommend adding a good quality fatty acid such as fish, flax or Creel oil. My favorite is LipiChol, which is very high grade creel oil. Since we teach there are Six Interferences and six corrections to create optimal function in the body, we then evaluate and correct structural, visceral, craniosacral and neuromuscular imbalances. In our office we use the VibroCussor and the ArthroStim for structural and fascial correction, as well as visceral manipulation. Please go to www.brimhall.com for answers to any questions concerning the equipment or techniques mentioned. We send the patient home with the homeopathic metal that first challenged and have them take one to three drops each time, up to a maximum of three times per day, according to muscle response testing. To restate our position, we also have each patient take one to three of the nutrient CheleX to help the body release the heavy metal from the body that tested and the other metals that release do to unlocking of this heavy metal cascade. We have them take the essential fatty acid that tested, which is usually LipiChol, at two to three per day. You may uncover hidden weakness after exposing the toxic metal/s and or halogens. Depending on your practice, you can do this procedure and the muscle response testing scan on the first to third visit for a new patient. We do a muscle response testing Health Scan and send them home with the appropriate XYMOGEN nutrition on the first to second visit because we have a reputation for doing nutrition. Your procedure may vary with your circumstances. We retest each patient every thirty days and adjust their nutrition according to this new evaluation. If needed, we do a comprehensive blood profile and often a hair analysis at the same time we do the muscle response testing and compare this to our physical findings. Often we do a salivary test through Labrix Lab for our patients as well looking at adrenal function and hormone levels. Concerning the Heavy Metals and Halogen Homeopathics: What has given us the most dramatic results is to test each patient, each time they come in and give them that day, one to three drops of the homeopathic metal that tests positive. This evaluation continues to demonstrate hidden weaknesses and amplifies our treatment results. We do not send them home with a different homeopathic metal each visit. They continue on their previous nutritional support, along with only one heavy metal homeopathic until their 30 day re-test. This is usually the one metal that tested on the original exam. It is important to do all of the things you normally do for detoxification such as nutrition, lymphatic drainage, liver detox (MaX Liver Detox), foot baths, far infra-red saunas, Epsom salt and baking soda baths etc. Another consideration is do we begin this technique of heavy metal/toxic halogen challenge and treatment on really sick people, especially with a leaky gut, before I get them strong enough to detox? Should I get the gut healed first with MaX GI, MedCaps GI, L-Glutamine, ProbioMax DF, and XymoZyme before I release the heavy metals? Our experience, on the worst of cases, shows us the homeopathic heavy metals and halogens; with the above nutrition is the place to start altogether. The gut is the second brain and you need to heal both the brain and gut simultaneously. I personally think that is the key to discover and release the heavy metals and toxic halogens to create the wellness the patient needs to overcome many limiting dis-eases and their symptomatic expressions. Yours in Health and Wellness, John W. Brimhall, BA, BS, DC, FIAMA, DIBAK Dr. John Brimhall e-mail: drjohn@brimhallwellness.com Cell:  (602) 538-0976 Brandy Brimhall e-mail: brandy_tpr@yahoo.com Office:  (303) 242-8901 Cell:      (719) 349-0220 Jason Matuszewski e-mail: jason@brimhallwellness.com Office:  866-338-4883 Solitaire Parke e-mail: solitaire@brimhallwellness.com Office:  866-338-4883   UPCOMING SEMINARS (To Be Announced) 2013 ICAK USA Meeting Los Angeles, CA June 6-9 2 Day 6 Steps To Wellness Phoenix, AZ Sept 7-8 Dr. Brimhall's Health Puzzle Piece is a weekly email newsletter distribution that has been brought to you by the collaborative efforts of the Brimhall Wellness Team. All newsletters are published and available at www.Brimhall.com a division of Health Path Products, LLC. The above statements have not been evaluated by the FDA. The nutritional information, suggestions, and research provided are not intended to diagnose, treat, cure, or prevent disease and should not be used as a substitute for sound medical advice. Please see your health care professional in all matters pertaining to your physical health.

Awakening into the Sun ~ Healthy Lifestyles Festival June 1st & 2nd 2013

Come by and check out our fabulous Artists and Designers and Gifted Healers View this email in your browser Relax into Wellness First Unity St Petersburg Fl. 33703 Come Join the Fun!                  June 1st & 2nd First Unity St Petersburg, Fl. 33703. We will be Hosting ; Access Consciousness the Bars Relax into Wellness Massage #67004 The Artist Way ~ Fabulous Artists Moonflower Designs from the Woodlands ~ Jewelry, Herbs, Essential oils, Colloidal Silver, and much more! Lookingood creations.com LolaMoonflower.com Copyright © 2013 Relax into Wellness / Access Consciousness The BARS, All rights reserved. unsubscribe from this list    update subscription preferences

MONEY SPELL TO MEET EXISTING NEEDS

MONEY SPELL TO MEET EXISTING NEEDS

This spell helps bring money to meet existing needs.
You need to be precise as to how much money you need, and for what reason you want it for.
At the start of your day, print, type, or typeset with your computer, how much money you need,
and what you want it for. Draw a line around that statement.
Example: I need $500 to pay the bills Or: I want $1,000 to buy a new or used car.
Fold the paper in half, and in half again, and carry it with you during the day, for at least 12 hours.
Reread the paper, several times, during the day.
When the night comes, go into your bedroom, or ritual room, and light a new white candle.
Open the paper you have been carrying, and reread the message that you wrote, one more time.
Say these words, three times:
From beyond this candle light,
The powers that rule over money come,
To bring to me this needed sum,
Aided by a cosmic name,
Because I burn this sacred flame...
Tear up the paper, and discard it in a wastebasket. Repeat, each night, for seven days,
or until the money comes. This spell is very powerful, and effective, when you correctly
follow the instructions. If it is meant to be, you will get your money.

The Health Benefits of Dancing -- Including Specific Benefits of Different Dances

Anatomy In Motion

 

 

The Health Benefits of Dancing -- Including Specific Benefits of Different Dances

If you secretly sashay across your living room when you're home alone or long to cha-cha with your significant other, you're in luck. Not only is dancing an exceptional way to let loose and have fun, but it also provides some terrific benefits for your health.

In fact, Mayo Clinic researchers reported that social dancing helps to:
• Reduce stress
• Increase energy
• Improve strength
• Increase muscle tone and coordination

Dancing the night away can burn more calories per hour than riding a bike or swimming.

And whether you like to kick up your heals to hip hop, classical or country, the National Heart, Lung and Blood Institute (NHLBI) says that dancing can:
• Lower your risk of coronary heart disease
• Decrease blood pressure
• Help you manage your weight
• Strengthen the bones of your legs and hips

Dancing is a unique form of exercise because it provides the heart-healthy benefits of an aerobic exercise while also allowing you to engage in a social activity. This is especially stimulating to the mind, and one 21-year study published in the New England Journal of Medicine even found dancing can reduce the risk of Alzheimer's disease and other forms of dementia in the elderly.

In the study, participants over the age of 75 who engaged in reading, dancing and playing musical instruments and board games once a week had a 7 percent lower risk of dementia compared to those who did not. Those who engaged in these activities at least 11 days a month had a 63 percent lower risk!

Interestingly, dancing was the only physical activity out of 11 in the study that was associated with a lower risk of dementia. Said Joe Verghese, a neurologist at Albert Einstein College of Medicine and a lead researcher of the study, "This is perhaps because dance music engages the dancer's mind."

Verghese says dancing may be a triple benefit for the brain. Not only does the physical aspect of dancing increase blood flow to the brain, but also the social aspect of the activity leads to less stress, depression and loneliness. Further, dancing requires memorizing steps and working with a partner, both of which provide mental challenges that are crucial for brain health.

How Good of a Workout is Dancing, Really?
The amount of benefit you get from dancing depends on, like most exercises, the type of dancing you're doing, how strenuous it is, the duration and your skill level.

Says exercise physiologist Catherine Cram, MS, of Comprehensive Fitness Consulting in Middleton, Wisconsin, "Once someone gets to the point where they're getting their heart rate up, they're actually getting a terrific workout. Dance is a weight-bearing activity, which builds bones. It's also "wonderful" for your upper body and strength."

Most people agree that social dancing gives them a more positive outlook on life.

Plus, dancing requires using muscles that you may not even know you had.
"If you're dancing the foxtrot, you're taking long, sweeping steps backwards. That's very different than walking forward on a treadmill or taking a jog around the neighborhood ... Ballroom dancing works the backs of the thighs and buttock muscles differently from many other types of exercise," says Ken Richards, professional dancer and spokesman for USA Dance, the national governing body of DanceSport (competitive ballroom dancing).

Specific Benefits of Different Dances
If you're looking for specific health results, here's a breakdown of the benefits of some popular dances. Just remember that any type of dancing is better than no dancing at all!

Belly Dancing
• Improved posture and muscle toning
• Maintains flexibility
• Helps prevent lower back problems
• Tones and firms arms and shoulders
• Helps with weight loss
• Helps prepare women for childbirth
• Reduces stress

Ballroom Dancing
• Conditions the body
• Helps keep the heart in shape
• Builds and increases stamina
• Develops the circulatory system
• Strengthens and tones legs and body
• Increases flexibility and balance
• Helps with weight loss
• Relieves stress

Salsa Dancing
• Builds endurance and stamina
• Helps with weight loss
• Relieves stress
• Helps you release toxins via sweating
• May help lower blood pressure and improve cholesterol levels
• Can lead to a reduced heart rate over time

Square Dancing
• Provides cardiovascular conditioning
• May lead to a slower heart rate, lower blood pressure and an improved cholesterol profile
• Strengthens bones
• Helps you develop strong social ties
• Loosens and tones muscles

Physical benefits aside, dancing has a way of brightening up a person's day, says ballroom owner and operator Karen Tebeau.

"A lot of times, when people come into the studio, it's because there's been a change in their life: a divorce or they've been through a period of depression. They (continue) coming in, and you see a big change. After a while, they're walking in with a sunny expression. You know it's the dancing that's doing that," she says.

Article Here: http://bit.ly/111Za2v

Art by Lee Casbeer
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"OH, BE CAREFUL LITTLE TONGUE!"

"OH, BE CAREFUL LITTLE TONGUE!"

Ivie Powell

 

A favorite song of children teaches the importance

of

realizing that God sees everything we do, 

and

hears everything we say. 

 

Parents and friends look

with great joy

as the little folks enthusiastically sing:

 

Oh be careful little eyes what you see.

Oh be careful little ears what you hear.

Oh be careful little mouth what you say.

Oh be careful little hands what you do.

Oh be careful little feet where you go.

 

There's a God up above looking down in tender

love so be careful. ..

 

In all my years of preaching, I don't recall that s

one ever being sung during a regular worship

assembly. Why? 

 

Could it be we have the idea this is

a song only for

children? 

 

Do we as adults need to

take heed to the lyrics

of that particular song as well?

 

The Bible addresses all needs of man (2 Pet. 1:3)

including the use of the tongue. 

 

As a matter of

fact, the Holy Spirit had James to write eighteen

soul-penetrating passages concerning the tongue

(James 3).

 

 When is the last time you read those verses? 

 

Since sins of the tongue are so easily

committed, all of us need to be reminded of

taking heed to:

 

What we say!

What we hear!

What we repeat!

 

Sins of the tongue are numerous, and have far, far,

reaching consequences both in this life, and

eternity! Solomon wrote, "Death and life are in the

power of the

tongue..."(Prov.18:21). 

 

One of the ways

Satan has of

disrupting and destroying a congregation as well as

the brotherhood is through the improper

use of the tongue! 

 

Concerning this matter James writes:

"And the tongue is a fire, a world of iniquity;

so is the tongue among our members, that

it defileth the whole body, and setteth on fire

the course of nature; and it is set on fire of hell.

.(James 3:6)

 

Because of a deadly tongue, friendships have been

destroyed, marriages ended, reputations

tarnished, businesses shut down, jobs lost, fights,

killings, wars, law

suits, church splits and civil wars

have erupted within the brotherhood! 

 

The following

should cause all to take a

serious look at the use of the

tongue.

 

THE TONGUE IS GUILTY!

 

When it curses (James 3:10)

When it speaks evil (Eph.4:31)

When its speech is crooked (Prov.4:24)

When it harshly criticizes (Matt.5:22)

When it is backbiting (Rom.1:30)

When it is deceitful (Rom.3:13)

When it talks foolishly (Eph.5:4)

When it teaches falsely (Titus 1:10-1)

When it speaks idle words (Mat. 12:36)

When it sows discord (Prov.6:19)

When it flatters (Psa. 12:3)

When it lies (Rev.21:8)

7 Kinds of Kisses and What They Mean

7 Kinds of Kisses and What They Mean

What you can tell from even the simplest of kisses. From the book I Love You. Now What? by Mabel Iam
The moment you say “I love you,” it is essential to seal and affirm your statement with the most direct form of communication: the kiss. What can be said about a kiss that millions of poets, artists, and musicians have not already expressed? In actuality, kissing has its own language.
Kissing someone provokes a series of different reactions and allows us to express many emotions. With just a simple kiss, you may discover what your partner wants to communicate with you, turning that simple act into a means of fulfilling your partner’s desires.
Kisses are subject to a wide variety of circumstances, but certain types of kisses imply different things:
Kiss on the cheek: transmits affection, support and complicity, regardless of physical attraction.
Kiss on the lips: implies passion, may mean “I love you” or “I want to date you.” If it is carried out very quickly, just barely touching one another’s lips, it may mean simply friendship. This is why the intensity of the kiss is an important factor in interpreting its intention.
Kiss on the collarbone: implies intimacy and manifests a certain degree of erotic intention in the giver. It is a very effective seductive gesture.
Kiss on the ears: this gesture is charged with passionate sexual intention and power. It may be taken not too seriously, depending on the intensity with which the kiss is given. This kiss is imbued with the energy of play and mischief.
Kiss on the hands: either in women or men implies admiration, tenderness, or desire for love. Additionally, it expresses trust on the part of the giver.
Kiss accompanied by an embrace: when both bodies are in close contact, this is an expression of strong affection and surrender. Both are willing to give in to one another on both a sensual and a sexual level.
Kiss accompanied by an intense look of endearment: the person receiving the kiss feels tenderly loved, whether the kiss is on the face or the lips.

5 Things You Can Learn from a First Kiss (and One You Can’t)

5 Things You Can Learn from a First Kiss (and One You Can’t)

By Jack Murnighan
Co-author of Much Ado about Loving
First kisses can be some of the romantic, erotic, mind-jellying, and utterly terrifying moments of our lives. But how much (or how little) do they tell us about how the relationship would go as a whole? In fact, they can predict a lot more than you might guess, but maybe not everything you hoped.
Here’s a quick guide on what to take away from that first smooch:
1) Is he confident—or just cavalier?
Everyone knows confidence is sexy—as long as it’s not just blind cockiness used willy-nilly on anyone and everyone. The first kiss can help you separate the grounded and bold from the egomaniacs and braggadocios. How can you tell? Does he try to force the kiss on you like he’s giving you a gift that he just KNOWS you’ll love? Not good. Or does he ease into it the way you put your arm around an old friend—warm, embracing, strong? That’s the confident guy you’re looking for.
2) Does he rush things?
There are people who relish the sweet, simple joys of life, slowing to savor the lilies along the way, and then there are some who simply mow down those lilies en route to whatever it is they think they’re seeking. First kisses give you a good case study: Does he linger in the kiss, drawing out its full erotic and emotional potential, or does he start rushing off to put a tongue in your ear or try to slide a hand up your shirt? Guys who are still thinking of sexuality as “bases” and want to try to get home as soon as possible do not make up the world’s great lovers. You can weed them out with just one smooch.
3) Does he react to the signals you’re sending?
Good kisses don’t follow a formula; they’re an impromptu and evolving dialogue, like an unrehearsed mambo between two professionals, pressed close together. In the act of each kiss, we send dozens of micro-signs, alerting the person to how strongly to push or pull back, how to tilt and turn his head, how much tongue to share (if any), whether the rest of the body becomes part of the kiss, and on and on. These signals are your body’s way of showing what it likes, but only some kissers will be able to notice and respond. What types of guys are those? Probably the kind who will notice your other preferences in life as well. But the guy who just keeps kissing his way, no matter what you do? Red light! Red light!
4) Is he a full-body type (or just a one-point-of-contact guy)?
I’ve always believed that if the only point of contact in a kiss is the lips, then you’re only getting the tip of the iceberg of pleasure. In my mind, kisses can become transcendent by going 3-D, involving hands touching, bodies leaning, legs intertwining—creating co-efficients of pressure that are little dialogues or dances in themselves, both supportive to and part of the main dance of the kiss. My belief is that when you kiss someone who engages his whole body, it means he’s likely to engage it (and yours) in your horizontal exchanges as well. If he doesn’t, you risk having a one-point-of-contact man on your hands, and I think you know what that means…
5) Was he appreciative?
I know there are a lot of women out there who secretly like guys who remain a little aloof, somehow thinking that if the guy isn’t into it, he must be really special. But to me that’s a false premise; often the guy isn’t that into it because he’s simply emotionally closed or playing the field or even just trying to see how little effort he can get away with providing. Instead, I think you should try to find guys who you respect and who turn you on, but who are also really pumped up to be with you—and show it. So when you do end up making out with a guy for the first time, if he looks up starry-eyed, smiling, and maybe a little tongue-tied, you know he’s excited to be right there, right then—with you. And that’s a very good sign.
Finally the One Thing You Can’t (Necessarily) Tell: Will he be good in bed?
Yes, it’s commonly thought that the first kiss tells you what you need to know about how a man will be in the sack, and, yes, all of of the indicators above (confidence, appreciation, attention-paying, not rushing, using the whole body) should convert to some degree, but sex is still a wild card, and you really never know for sure. What you can find out is whether he’s likely to be terrible, because, obviously, if he’s flunking any of the 5 tests above, he’s not likely to be an A-student in bed. The reverse, though, is the problem: Just because he passed the kiss with flying colors, I don’t think you can conclude he’ll be a great lay. He might be, but he might also get nervous, have issues, like different things than you do, etc. So while the kiss can be a good way to weed out probable losers, it’s not quite a surefire way to pick winners. If only!

French Kiss

"Holding her face firmly but gently while you slip your tongue inside her mouth and suck on her lips will definitely make her toes curl."

Virtually everyone remembers their first French kiss. It was a great experience for some and more like a tongue-war for others. But since then, we've all learned that French kissing is a very personal and sensual experience.

Since women's lips are their No. 1 erogenous zone, it's very important for men to leave a lasting, eroticized impression with women. Remember that if you French kiss her like no other, you'll probably get to kiss something else soon afterward.

The skill of kissing does not simply consist of knowing how to maneuver your tongue inside a woman's mouth without hitting her tonsils. Rather, it involves the entire mouth -- the lips, tongue, teeth, and the rest of the body.

Give the lady a hand

Positioning your hands on her body while kissing her is especially important too. Holding her face firmly but gently while you slip your tongue inside her mouth and suck on her lips will definitely make her toes curl.

As well, pulling her hair back from the back roots or slightly squeezing the part of her body that is located right under her breasts (her ribs) could make for some very tantalizing kissing sessions.

slip of the tongue

Since kissing your partner is probably one of the most important parts of lovemaking altogether, here are some fail-safe ways to ensure that your woman will want to French kiss you for life.

Since people often give out what they would like to receive, pay attention to the way she kisses you -- that's probably the way she wants you to kiss her. Does she bite on your lips or try to gently suck all the saliva off your tongue? Well there's nothing in the world like the gift of reciprocity.

the tricks of the trade

Does your loved one kiss you like she's trying to suck the life out of your body? Or does she kiss too fast, too slow or without tongue, period? First off, don't tell her what you don't like, but rather what you do like. That way you won't hurt her feelings at all.

Control her mouth

The next time you're kissing her, hold her face with your hands and kiss her the way you'd like to be kissed. If the fact that you're taking control doesn't turn her on, then your sensual tongue will surely do the trick.

Play a little game

Tell her that kissing her gets you so excited; then suggest that you guys switch roles and ask her to kiss you the way you kiss her, because you want to know what it feels like. She'll be more than happy to cater to your request.

Make it last

There is almost nothing in this world that beats those long, slow, juicy, and very enticing kisses. Your woman will definitely feel your passion through one of those prolonged succulent kissing moments. French kiss her hard and deep.

Read more: http://www.askmen.com/dating/love_tip/35_love_tip.html#ixzz2TZ1yXyYZ

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.

Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more often than men.

Anatomy
Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

The head of the upper arm bone fits into a shallow socket in your shoulder blade. Strong connective tissue, called the shoulder capsule, surrounds the joint.

To help your shoulder move more easily, synovial fluid lubricates the shoulder capsule and the joint.

Description
In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.

The hallmark sign of this condition is being unable to move your shoulder - either on your own or with the help of someone else. It develops in three stages:

Freezing
In the"freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.

Frozen
Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.

Thawing
Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
In frozen shoulder, the smooth tissues of the shoulder capsule become thick, stiff, and inflamed.

Cause
The causes of frozen shoulder are not fully understood. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.

Diabetes. Frozen shoulder occurs much more often in people with diabetes, affecting 10% to 20% of these individuals. The reason for this is not known.

Other diseases. Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.

Immobilization. Frozen shoulder can develop after a shoulder has been immobilized for a period of time due to surgery, a fracture, or other
injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.

Symptoms
Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm.

Doctor Examination
Physical Examination
After discussing your symptoms and medical history, your doctor will examine your shoulder. Your doctor will move your shoulder carefully in all directions to see if movement is limited and if pain occurs with the motion. The range of motion when someone else moves your shoulder is called "passive range of motion." Your doctor will compare this to the range of motion you display when you move your shoulder on your own ("active range of motion"). People with frozen shoulder have limited range of motion both actively and passively.

Imaging Tests
Other tests that may help your doctor rule out other causes of stiffness and pain include:

X-rays. Dense structures, such as bone, show up clearly on x-rays. X-rays may show other problems in your shoulder, such as arthritis.

Magnetic resonance imaging (MRI) and ultrasound. These studies can create better images of problems with soft tissues, such as a torn rotator cuff.
Treatment

Frozen shoulder generally gets better over time, although it may take up to 3 years.

The focus of treatment is to control pain and restore motion and strength through physical therapy.

Nonsurgical Treatment
More than 90% of patients improve with relatively simple treatments to control pain and restore motion.

Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.

Steroid injections. Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder joint.

Physical Therapy and Massage Therapy: Specific exercises will help restore motion. These may be under the supervision of a physical therapist or via a home program. Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before the stretching exercises. Below are examples of some of the exercises that might be recommended.

• External rotation — passive stretch. Stand in a doorway and bend your affected arm 90 degrees to reach the doorjamb. Keep your hand in place and rotate your body away from your hand. Hold for 30 seconds. Relax and repeat.

• Forward flexion — supine position. Lie on your back with your legs straight. Use your unaffected arm to lift your affected arm overhead until you feel a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat.

• Crossover arm stretch. Gently pull one arm across your chest just below your chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat.

Surgical Treatment
If your symptoms are not relieved by therapy and anti-inflammatory medicines, you and your doctor may discuss surgery. It is important to talk with your doctor about your potential for recovery continuing with simple treatments, and the risks involved with surgery.

The goal of surgery for frozen shoulder is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anesthesia and shoulder arthroscopy.

Manipulation under anesthesia. During this procedure, you are put to sleep. Your doctor will force your shoulder to move which causes the capsule and scar tissue to stretch or tear. This releases the tightening and increases range of motion.

Shoulder arthroscopy.
In this procedure, your doctor will cut through tight portions of the joint capsule. This is done using pencil-sized instruments inserted through small incisions around your shoulder.
In many cases, manipulation and arthroscopy are used in combination to obtain maximum results. Most patients have very good outcomes with these procedures.

Recovery.
After surgery, physical therapy is necessary to maintain the motion that was achieved with surgery. Recovery times vary, from 6 weeks to three months. Although it is a slow process, your commitment to therapy is the most important factor in returning to all the activities you enjoy.
Long-term outcomes after surgery are generally good, with most patients having reduced or no pain and greatly improved range of motion. In some cases, however, even after several years, the motion does not return completely and a small amount of stiffness remains.

Although uncommon, frozen shoulder can recur, especially if a contributing factor like diabetes is still present.

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— with Sheila C. Fragoso Castro.