Adhesive Capsulitis Treatment: What is a Myofibroblast?

By Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

adhesive capulitis treatment

Adhesive capsulitis is a problem also known as “frozen shoulder”. This is a difficult problem to fix, because it’s cause is poorly understood. All adhesive capsulitis treatment to date has been focused on the macro problem of a tight shoulder, however, recent research shows involvement at a cellular level by a strange cell called a myofibroblast.

A frozen shoulder is when the joint locks down causing almost no movement and often begins after shoulder surgery. It’s horrible for the patient, as things like getting dressed or reaching become almost impossible. It’s a serious issue, not only because the joint doesn’t move well and this limits function, but also because it places more wear and tear on certain parts of the joint, which can lead to arthritis.

The cause of this horrible problem has not been well understood. In fact, we only know a few things about the disease. First, it’s much more common in adult onset diabetics. It’s also more common in patients with poor blood sugar control who aren’t yet diabetics (metabolic syndrome). We also know that patients with diabetes don’t respond as well to traditional treatments. What is the number one adhesive capsulitis treatment? Yanking on the shoulder with force during surgery to break up the adhesions in the shoulder capsule. This is known as “Manipulation Under Anesthesia”.

This past decade has yielded some more information on what causes this shoulder problem, which is now widely thought to be due to chronic inflammation. This problem of too much whole body swelling is a huge problem in modern society. However, the real cause may be how the inflammation interacts with a very interesting and often ignored cell type called a myofibroblast. What’s that?

A myofibroblast is a cross between a muscle cell (myocyte) and a fibrous tissue (like ligament and tendon) cell. It’s a hybrid cell involved in healing because it can both anchor in the foundation material of cells (extra-cellular matrix) and contract. These myofibroblasts  manage a key job of healing torn tissue-contracting the two ends of the wound. This approximation part is necessary for big cuts or tears in ligaments to heal because repair cells can only bridge a small gap. Myofibroblasts are so important in healing, that stem cells can also turn into this cell type when there aren’t enough.

What does this cell have to do with a frozen shoulder? While these cells are critical for healing an injury, like many repair cells, they’re activated by inflammation. For an acute or recent injury, inflammation is what causes the dance of cells to spring into action and do their jobs. When the injury is healed, the inflammation stops and the various repair cells are deactivated. However, chronic inflammation is a low level signal that provides a constant “on” signal for many cells, including myofibroblasts. In adhesive capsulitis, this stimulation causes these cells inside the main shoulder lubricating sac to contract like a muscle. Since this portion of the shoulder allows free movement by allowing structures to freely and easily slide past one another, it’s tightening leads to a shoulder that doesn’t move.

The upshot? Adhesive capsulitis of the shoulder is what happens when chronic inflammation interacts with a cell type normally designed for contracting tissue tears to maximize healing. These cells are supposed to get a temporary chemical signal to contract from local inflammation caused by an acute injury. However, in the presence of chronic inflammation, they get a constant “on” signal that causes the shoulder bursa and capsule to contract. To prevent this horrible problem from happening to you, you’ve got to get on top of chronic inflammation. Read more here how you can help reduce chronic inflammation with supplements. To treat frozen shoulders, we’ve successfully used our third generation platelet lysate injected to expand these bound down myofibroblasts in the shoulder bursa and capsule.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.