| Diabetics in India have an additional
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| | by this.History of frozen shoulder-Only
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| burden of joint problem in addition to
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| | in the last few years has the ideal
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| their systemic problems of nerves, eyes,
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| | treatment been suggested. It is a
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| blood vessels, kidneys etc.
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| | relatively rare disorder of the shoulder
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| Diabetics are prone to develop a
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| | and in a population of 20 shoulder
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| condition of the shoulders called primary
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| | patients there may be one or two with
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| frozen shoulder. It can affect both
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| | this condition.However many doctors and
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| shoulders in a small percentage of
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| | orthopaedic surgeons label any painful
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| people. It usually resolves over a period
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| | condition as a frozen shoulder and advice
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| of time but can leave behind a lasting
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| | physiotherapy. This can make the
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| deficit of certain movements.Middle aged
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| | condition worse.Recent advancesIt has
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| diabetics also develop tears of the
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| | been recently discovered that the answer
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| rotator cuff and this can lead to a
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| | to frozen shoulder lies in the genes.
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| secondary frozen shoulder. Rotator cuff
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| | These genes may also be associated with
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| is group of tendons on top of the
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| | Diabetes mellitus. The alterations in
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| shoulder which help to stabilize the
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| | these genes and chromosomes lead to a
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| joint.They can develop calcium deposition
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| | distorted response to wound healing and
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| in the rotator cuff tendons.They are
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| | scar tissue formation. Exuberant scar
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| prone to develop Gouty arthritis in their
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| | tissue forms in response to trauma. The
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| shoulders like in any other joints since
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| | remodeling of scar tissue collagen is
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| Gout has an association with diabetes.
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| | less. When more scar tissue forms in the
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| Gout is a condition due to consumption of
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| | capsule of the shoulder joint, the
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| uric acid which is a by product of the
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| | normally possible movements are grossly
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| digestion of red meat.In this article I
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| | reduced. Diabetics also develop nodules
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| shall discuss frozen
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| | in their palms and feet, another evidence
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| shoulder.Definition-Frozen shoulder
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| | of the exaggerated healing
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| (Adhesive capsulitis, periathritis) is a
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| | process.Standard treatment-This is a
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| condition characterized by a loss all
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| | combination of physiotherapy and steroid
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| movements at the true shoulder joint.
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| | injections when the condition is
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| There is pain initially. Pain settles
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| | initially painful. Physio can be done at
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| down and there remains stiffness which
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| | home. The standard Orthopaedic treatment
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| sets in over a short period of time.
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| | has been a manipulation under
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| Clever people may recall a traumatic
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| | anaesthesia. This carries a theoretical
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| incident. In others it may come on
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| | risk of fracture but has not been
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| slowly. Stiffness may be permanent. The
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| | validated in practice.A manipulation is
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| movement that is maximally affected is
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| | contraindicated when a x ray reveals that
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| external rotation (rotating the arm
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| | the bone is very osteoporotic. It is also
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| outwards away from the body). This
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| | contra indicated in diabetics as more
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| results in inability to reach behind the
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| | exuberant scar tissue will form in
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| head with the hand to tie the hair. When
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| | response to the crude method.Since I have
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| both shoulders are affected elderly women
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| | pointed out that sometimes rotator cuff
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| are in an embarrassing situation.
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| | tears can coexist with a frozen shoulder,
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| Overhead activities are also affected as
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| | the ideal management for a frozen
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| the degree of elevation of the arm is
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| | shoulder would be an arthroscopic release
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| reduced.AnatomyThe shoulder is the most
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| | of the contracted structures within the
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| mobile joint in the body. Its function is
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| | joint. An arthroscope is an instrument
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| to position the arm in space to reach out
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| | used to look into joints through tiny key
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| to objects and deliver them to the mouth
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| | hole incisions. The benefits are less
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| for eating and for other actions. The
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| | pain after surgery and faster
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| shoulder is a ball and socket joint
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| | rehabilitation. Since scar tissue
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| formed by the upper end of the humerus
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| | formation is minimized, chances of
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| (arm bone) and the socket formed by the
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| | recurrence are less and greater are the
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| glenoid of the shoulder blade. It is
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| | chance of retaining the full range of
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| lined by a bag like capsule. The capacity
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| | movement achieved during the procedure.
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| of this joint is about 15- 20 cc. In
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| | The range of movement achieved after the
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| frozen shoulder the capacity is reduced
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| | release has to be maintained with
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| to 2- 3 cc. The movements at the shoulder
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| | physiotherapy. In case there is some tear
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| joint occur synchronously with that at
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| | of the rotator cuff, repair can be done
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| joint between the shoulder blade and the
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| | at a later stage.Dr. A.K.
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| torso and are compensated to some extent
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