General info
Summary

Data about the condition

People who have frozen shoulder often experience shoulder pain, stiffness, and decreased range of motion. Everyday activities—such as getting dressed or reaching for something in a cupboard—can be challenging.

Physical therapy is usually the first treatment recommended to people with frozen shoulder. Over 90% of people with frozen shoulder (adhesive capsulitis) get better with nonsurgical treatment.

Symptoms

Achy, spread bread. This pain is felt over the shoulder and occasionally on the upper arm. Pain begins gradually, and intensifies with shoulder movement. Pain is usually worse during the early phase of the condition and decreases in later phases of this condition.

Shoulder stiffness. A noticeable decrease in the shoulder’s range of motion occurs as the shoulder’s joint capsule tightens. People with frozen shoulder typically have pain with arm movement, so they try to avoid it. But avoiding arm movement can lead to more stiffness. Mobility improves and may be completely restored as the condition gets better.

Trouble sleeping. Sleeping on the affected side usually uncomfortable or even painful.

Frozen shoulder symptoms may be more severe in people who have diabetes.

Causes

Health issues increase the risk of developing frozen shoulder, including:

  • Thyroid problems (hypothyroidism and hyperthyroidism)
  • Depression
  • Cardiovascular disease
  • Lung disease
  • Breast cancer
  • Open heart surgery
  • Polymyalgia rheumatica (an inflammatory condition causing stiffness and muscle discomfort)
  • Parkinson’s disease

Shoulder stiffness may be one of the first indications of Parkinson’s. There have also been incidences of frozen shoulder in people who have had either lung or breast cancers.

Periods of inactivity. Long periods of inactivity—from an injury, surgery, stroke, or illness—can lead to frozen shoulder. People may be susceptible to inflammation or develop stiff tissue during these times. Completing physical therapy exercises following shoulder surgery can help prevent this condition.

Other shoulder issues. Frozen shoulder can occur alongside other shoulder problems, including:

Calcific tendonitis, or calcium deposits in the rotator cuff.

Rotator cuff tear, or injury to the large tendon in the shoulder comprised of four muscles.

Treatment

Without treatment, symptoms usually go away in about two years. More than 90% of people with frozen shoulder get better with nonsurgical treatment, such as physical therapy and anti-inflammatory medicines, such as ibuprofen. If symptoms do not diminish or resolve with time and nonsurgical treatments, surgery may be an option.

Physical therapy exercises and stretches designed to help increase shoulder motion. A person may be given an exercise program to complete at home or attend prescribed physical therapy appointments. Progress may be slow. It can take anywhere from weeks to months to see improvement.

People with frozen shoulder are advised to take an active role in their physical therapy, and remember:

  • Exercises and stretches are usually performed daily, sometimes multiple times each day.
  • Patience is key—it can take weeks to months to see improvement from physical therapy. Physical therapy exercises should be challenging but should not exacerbate pain.

The objectives of the Recovery Program

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The objectives of the Recovery Program

Experts advise warming the body up before starting physical therapy exercises. Apply a moist heating pad to the shoulder, for example, or take a warm shower.

Pendulum stretch

Stand next to a table or counter about waist-high. Place the hand of the healthy arm on the stationary object for support. Lean forward slightly without rounding the back. Let the affected arm dangle.

Swing the affected arm in small circle, about one foot in width, in one direction for about 10 revolutions. Then, reverse and swing the arm in circular movements in the opposite direction for 10 revolutions.

The diameter of the circle can increase as symptoms improve. This exercise can be made even more challenging by holding a small weight, about 3 to 5 pounds, in the hand of the affected arm while performing the same movements.

Finger walk

Stand facing a wall, about 15-20 cm away.

Using the hand of the affected arm, touch the wall just above waist level with the index and middle fingers. The elbow should be bent, making a “v” with the arm.

“Walk” the fingers up the wall, until the arm is raised as high as it can comfortably reach.

The healthy arm may need to help lower the affected one back to the starting position.

Inward rotation

This strengthening exercise involves a rubber exercise band tied at the ends to make a loop.

Put one end of the loop around the door handle.

Stand to the side of the door, with the affected arm closest to the door.

The hand of the affected arm holds the other end of the loop. The elbow is at a 90-degree angle and rests close to the body.

Pull the band inward to the body a few inches. Hold the position for about 5 seconds.

Sleeper stretch

This exercise may be suited to people who have relatively mild cases of frozen shoulder.

Lie down on the side of the affected arm, with the arm extended straight out. Bend the knees at an angle.

Bend the affected arm, so that the elbow forms a 90-degree angle. The forearm should be raised off the ground and the fingers pointed toward the ceiling.

Use the hand of the healthy arm to push the affected arm toward the ground (palm facing the ground).

Hold each stretch for 30 to 60 seconds. Perform the stretch 2 to 3 times each day.

Standing Extension

This is exercise uses a light bar or cane.

Stand and hold the bar or cane horizontally behind the body. The arms are about shoulder width apart. Position the hands so the knuckles face toward the ground.

Lift the arms in an upward movement until a stretch is felt.

Repeat each exercise about 10 times. Hold each repetition for approximately 1 to 5 seconds. Physicians typically recommend completing physical therapy exercises a couple of times each day.

People with more severe cases of frozen shoulder may also benefit from other treatments, such as electrical stimulation or application of heat to the affected area. A physician or physical therapist may also suggest alternatives to daily activities that may provide comfort and reduce tissue irritation.

Methodical Indications

You should use your affected arm
Resting the affected arm does not help the shoulder heal. In fact, medical professionals say that resting the shoulder may make the condition worse by allowing more adhesions to develop around the shoulder capsule. In addition, using the shoulder helps maintain muscle strength, which can prevent additional problems later on.

Did you know ?

About 2% of the population is affected by frozen shoulder.1 It often impacts adults aged 40 to 60,1 and is more common in women and people with certain medical conditions, such as diabetes.


You can also read about Knee osteoarthritis.

  • 1.Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008;1(3-4):180-9.<
  • 2.Frozen Shoulder. MedlinePlus website. https://www.nlm.nih.gov/medlineplus/ency/article/000455.htm. Last updated November 2014. Accessed May 29, 2016.
  • 3.Frozen Shoulder. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00071. Last reviewed January 2011. Accessed May 19, 2016.
  • Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1-31.
  • https://www.sports-health.com/treatment/shoulder-injury-treatment/exercises-moderate-severe-cases-frozen-shoulder

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