Collagen deficiency with diabetes

I am 63 and have a frozen shoulder (9 months). I recently read diabetics are 5 times more likely to have frozen shoulders than non-diabetics because higher blood sugars deplete your collagen. Plus type 1’s are more prone over type 2’s to get a frozen shoulder. My endo has never recommended I take collagen supplements. I was diagnosed type 1 at 55. My A1c is 6.9. I am curious what others are doing? Has anyone done plasma therapy and been successful unfreezing their shoulder? An xray did not show arthritis. A MRI will be next. I am doing PT stretches.

I have had frozen shoulder 4 times. There are definitely discussions about collagen but I don’t know that it is collagen depletion. Frankly they don’t really know what causes frozen shoulder. I have always felt that it is some sort of disease/inflammatory process with a beginning, middle, and an end. But people with diabetes are less likely to have a full recovery compared to others. I wrote a blogpost many years ago with links to to some interesting articles. My frozen shoulders have definitely not been related to A1c since my last FS happened when my A1c was 4.9.

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I think it has to do with a witches curse.

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I had both shoulders freeze at the same time. It lasted the better part of a year,and it took a lot of pt to heal.

I think it comes from inflammation and a sore is created in the joint which causes scar tissue and impedes movement.

I’ve never heard of lack of collagen a side effect of high glucose levels.
But it could be witches. If maybe you smited one recently

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Well, even if frozen shoulder is caused by lack of collagen your Dr. wouldn’t recommend collagen supplementation because eating collagen (or putting it on your skin) hasn’t been proven to actually increase collagen. Instead you might consider eating foods high in vitamin A such as liver or desiccated liver pills , or orange veggies as vitamin A does increase collagen.

Yikes both at the same time.

Marguerite Truttman

Thank you Firenza

Marguerite Truttman

I also had frozen shoulder years ago. It is considered a repetative motion injury, like repeatedly putting things overhead.
I have never heard of depletion of collagen as a cause, and I think it would affect something like the knee if so.
It is caused by autogycosylation of the collagen sub-unit, causing cross links of the collagen, or making it sticky. When this occurs the tendons, made of collagen, cannot glide with movement. Consider that collagen is also a component of blood vessel structure, and they also become autoglycosylated. The vessels then narrow restricting blood flow, and oxygen is less able to diffuse across.

So, frozen shoulder is a slow progressive problem. I don’t think eating supplements would help; but, if you want to consume collagen supplements, then save your money and eat plenty of Jello! It took me 4-5 years to get full mobility back, and it has not recurred.

Mike

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Thanks Laddie. Definitely a good read.

@MikeR1 Repetitive motion doesn’t explain it for all. I constantly played softball up to early teenage years, and I used to swim 75 laps daily in a gym swimming pool for years. I’ve done plenty of damage but never frozen shoulder! Knock on wood as both my sisters have had it.

@Laddie That was a great article you wrote about it.

@Maggie4 Hyaluronic acid is a better source if you want collagen, it’s what helps make collagen in the body and was considered superior to taking actual collagen. Collagen absorbed some but not well. But the cheap hyaluronic acid doesn’t absorb that well either, you need to take the more absorbable forms like the fermented one KAL had. I have no idea if it helps with frozen shoulder, but it sure helped my skin and knees!

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I stand by what I said. Not everyone will have frozen shoulder as a result, but being diabetic is a predisposition. Unless you are doing the same motion day after day it would not be considered repetitive. It could be repetitive injury as an initiator, causing inflammation and not healing.
Mike

Frozen shoulder is not a complication of diabetes (i.e., result of high blood sugars), it is a co-morbidity (i.e., commonly co-occurring disorder), and is co-morbid also with autoimmune thyroid disorder. That leads many to suspect it is an autoimmune condition, triggered for many by initial injury/damage to the area (whether repetitive or sudden) and then the immune response results in the capsule inflammation process, which typically resolves even without treatment in two years for most, but can linger (and co-morbid diabetes is a risk factor for worse outcomes, as mentioned above, and that might be due to either worse autoimmunity and/or impaired healing). Also once it happens in one shoulder, it seems like for many it takes much less strain/injury to provoke in the other shoulder (even just compensatory use can do it), so not uncommon to have the other shoulder freeze soon after the first.

I have had it in both; neither shoulder ever fully regained its premorbid range of motion, but as someone who previously had extreme hypermobility in both due to an actual genetic collagen disorder unrelated to diabetes, my PTs and I were hoping not to fully regain mobility. PT helped to an extent, as did ultrasound guided cortisone shots. I never got an MRI, because to my understanding, even if they show some underlying damage like a tear, it’s impossible to know whether that is a factor in impairment until the frozen shoulder resolves, so that needs to happen first. Many people have entirely non-impairing tears, so be wary of anyone who suggests surgery for that prior to resolution of your frozen shoulder…

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Interesting. I had first bout of frozen shoulder before diagnosed with LADA. Had PT but still had some pain in arm. My non diabetic daughter developed double frozen shoulder last year. Had a lot of PT. In the middle of her treatment I got it in my opposite arm. So not sure if hereditary or some other reason. Not one ever mentioned collagen to me. It’s not fun. First time was the worst and my daughter had a lot of pain.

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It’s caused by inflammation and a small sore caused by straining it or pulling it. Then with inflammation it swells and moving the joint makes it worse. Then healing causes scar tissue which keeps you from being able to move the joint.

Diabetes often causes a stronger inflammatory reaction so it makes us more likely to suffer frozen shoulder.

I got it in both shoulders but I also dislocated both shoulders in high school at different times. Once playing basketball and once playing Ice hockey.

When they froze and I had pain, I figured it was from those injuries, but later I learned it is common in diabetics.

There could be a genetic component, it’s likely that it’s a confluence of a few different factors.

Again, autoimmunity is likely what is producing the full syndrome and degree of inflammation, and autoimmunity tends to roughly be a combo of some degree of genetic vulnerability and then a trigger. For some autoimmune conditions, that’s an infection of some sort. For frozen shoulder, it’s typically some degree of injury/initial inflammation.

I would not be surprised if risk for developing frozen shoulder is hereditary to an extent—my father, who does not have diabetes, also developed it, which makes me suspect I also inherited some of my broader autoimmunity risk from him (no one in my family has T1D or much in the way of obvious autoimmune disorders).

Furthermore, I would hypothesize that a.) people with current or past frozen shoulder but no diabetes dx are at greater risk than the general population of developing LADA; b) people with T1D and frozen shoulder are at higher risk of developing (or already having) additional autoimmune disorders than those with T1D and no frozen shoulder (with the caveat that frozen shoulder only tends to emerge close to age 40 or later); and c) people with T1D and additional autoimmune conditions/symptoms are at greater risk of developing frozen shoulder compared to people with only T1D.

Several years ago after impingement surgery on my right shoulder I woke up one morning with frozen shoulder. I was warned about this prior to surgery. When I realized what was going on I took measures into my own hands and with my left hand, forced my right shoulder to move. I nearly passed out from the pain. In the end it was worth the immediate pain as within a week or two the pain was gone and my shoulder moved as it always has.

The event reminded me of living with T1D. It’s up to me to control what is in my control.

I’m glad that worked for you. But I had PT where someone manually moved my shoulder to the point where I was in intense pain (with consent and communication about it, but it was NOT fun) 2x a week for a year with only gradual improvement. I even fell on one of my frozen shoulders at one point, which was excruciating (like… screaming/crying pain for hours), and had clearly ripped up some of the frozen capsule bc I had like 10° improvement in range of motion the next week, but that was it. Apparently they used to more often offer basically doing that to you under sedation, but the risk of damage is high enough that it’s not offered typically anymore. So I would say, like with excellent T1D diabetes control, please do not discount the extent to which luck and health in other domains plays into it, because some people’s bodies will not respond the same way, just like some people’s bodies have blood sugars that are inherently less reliable and harder to control (as someone with a connective tissue disorder, multiple autoimmune disorders causing inflammatory flares, and menstrual cycles, I’ve learned unfortunately both are true for me and to temper my expectations of how far I can get with effort).

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When I was in my 30’s, I had a frozen shoulder and went to PT for months. The therapist and I finally talked to an orthopedic surgeon about my shoulder, and he shot my back with anesthetic, climbed on top of me and tore my shoulder loose. It was slightly traumatizing both to me and my physical therapist, but it was wonderful! I left his office finally able to move my arm and the pain was gone. I continued with PT for a little while longer to make sure I kept almost full movement in my shoulder.

A few years later the other shoulder froze. I went to a different orthopedic surgeon to have my shoulder torn apart. This doctor was horrified that my first frozen shoulder had been ripped apart. He said the 1st doctor could have broken my shoulder. I ended up not doing anything for my second frozen shoulder, and eventually it regained movement.

I have close to full movement in both of my shoulders at 71.

I started feeling frozen shoulder symptoms in the fall of 2017 and started physical therapy sessions in early 2018 to treat it. After a few months with absolutely no progress to report, I had a steroid shot in the shoulder and enjoyed immediate and sustained relief. Here’s my post of that event.

Thank you Terry. So how long after the shot were you able to move your arm freely?