Condition guide
A condition in which the shoulder first becomes painful and then gradually seizes up. It usually gets better on its own, but this can take months or even years. With the right exercise and treatment, you can get through this period more comfortably.
The connective tissue that surrounds the shoulder joint, called the capsule, thickens, becomes inflamed and shrinks. The space for movement inside the joint narrows. The result: pain, and a clear restriction in lifting the arm, reaching behind you and turning the arm outwards.
Turning the arm outwards is usually the most restricted movement. Brushing your hair, putting on a jacket and fastening a clasp or belt behind your back become difficult. The pain is often worse at night, and lying on that side becomes difficult.
Some people who have had it in one shoulder may develop it in the other shoulder over the years.
How long each stage lasts varies from person to person; it is usually longer in people with diabetes.
Pain gradually increases, especially at night. Range of movement starts to decrease.
Pain may ease, but the shoulder becomes very stiff. Everyday tasks are hardest during this stage.
Movement slowly returns. Some people may be left with mild restriction for a long time.
The diagnosis is usually made from an examination: the shoulder is equally restricted whether you lift your arm yourself or someone else lifts it for you. An X-ray, ultrasound or MRI is not needed to make the diagnosis, but one may be requested to rule out other causes such as osteoarthritis or a tear.
Exercises at home
Do these exercises only until you feel a mild stretch; do not push into sharp pain. Keep the dose low in the painful stage. Work out with your physiotherapist which exercises suit your stage.
Before exercising, place a warm towel or a hot-water bottle on your shoulder for 10–15 minutes. This relaxes the muscles and makes the movements easier. Put a thin cloth in between to protect your skin.
1–2 times a day, 20 minutes at mostLean on a table with your good hand and bend forwards. Let your painful arm hang loosely and swing it in small circles. Move the arm by gently rocking your body, not by using the arm muscles.
10 circles clockwise, 10 anticlockwiseStand facing the wall, an arm's length away. Walk your fingers up the wall like a spider, pause for a few seconds where you feel tension, then slowly come back down.
10 reps, 1–2 times a dayHold a towel behind your back with both hands: your good arm on top, your painful arm below. Use your good arm to slowly pull the towel upwards, letting the painful arm slide up your back.
Hold for 10–20 seconds, 5 repsReach your painful arm across the front of your chest towards the opposite shoulder. With your other hand, press gently just above the elbow and draw the arm towards you.
Hold for 15–20 seconds, 5 repsLie on your back or stand. Keep the elbow of your painful arm tucked in at your side and bent to 90 degrees. Hold a stick with both hands; use your good arm to push the stick so that the forearm of your painful arm turns outwards.
Hold for 15–20 seconds, 5 repsVideo
Step-by-step exercise programmes for each stage of frozen shoulder, from the YouTube channel of US physical therapists Bob Schrupp and Brad Heineck.
Gentle exercises to keep the shoulder moving without increasing pain.
Stretching and mobilisation exercises to increase range of movement.
It usually gets better on its own, but this can take months or even years; the condition typically lasts 1–3 years. Some people may be left with mild restriction for a long time. With the right exercise and treatment, you can get through this period more comfortably.
Yes, but without forcing it. In the painful stage, the focus is on gentle movements within the pain-free range; in the stiffening stage, it moves to stretching and joint mobilisation. Do the exercises only until you feel a mild stretch; do not push into sharp pain.
The diagnosis is usually made from an examination: the shoulder is equally restricted whether you lift your arm yourself or someone else lifts it for you. An X-ray, ultrasound or MRI is not needed to make the diagnosis, but one may be requested to rule out other causes such as osteoarthritis or a tear.
A cortisone injection into the joint can clearly reduce pain within a few weeks, especially in the early, painful stage. Its effect is mostly short-term, and whether to have one is your doctor's decision. The foundation of treatment, however, is physiotherapy and regular exercise.
Shoulder pain is not always frozen shoulder. See a doctor without delay in these situations:
Sources
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