What is frozen shoulder?

The Three Stages of Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis, is a painful and restrictive condition that limits shoulder movement over time. It often develops gradually and can take months or even years to resolve. Understanding the symptoms, stages, and treatment options can help you take the right steps toward recovery. In this guide, we’ll explain what frozen shoulder is, why it happens, and how exercises and physiotherapy can support your healing.

1. Freezing Stage: In this initial stage, patients experience increasing pain and a gradual loss of range of motion in the shoulder. This stage can last for several months, and the exact cause of frozen shoulder is not always clear, although it can be associated with inflammation and the formation of adhesions (scar tissue) in the shoulder joint capsule.

2. Frozen Stage: During this stage, the pain may begin to subside, but the shoulder becomes extremely stiff. It can be difficult to perform even simple tasks and movements like reaching overhead or behind the back. This stage can last for several months to a year or more.

3. Thawing Stage: In the final stage, the range of motion in the shoulder gradually improves, and the patient experiences a reduction in pain and stiffness. This stage can also take several months to a year or more.

Unfortunately, you are not guaranteed to achieve full function of the shoulder at the conclusion of this condition. Often patients can be left with residual stiffness and lack of shoulder mobility.

Possible Causes of Frozen Shoulder

The exact cause of frozen shoulder is not always known, but it can be associated with various factors, including:

• Injury or trauma to the shoulder

• Prolonged immobilisation of the shoulder, such as after surgery or an injury

• Certain medical conditions, such as diabetes

• Autoimmune diseases

• Hormonal imbalances

What are the symptoms of frozen shoulder

Common frozen shoulder symptoms include persistent shoulder pain, stiffness, and a limited range of motion. Pain may worsen at night and interfere with daily tasks such as dressing, reaching, or lifting. These symptoms typically appear gradually and change as you move through the three stages of the condition.

Frozen shoulder exercises will help increase your mobility

Physiotherapy-guided exercises are key to regaining shoulder movement. Gentle stretching and strengthening can ease stiffness and restore range of motion. Always work within your pain-free range and progress gradually with the help of your physiotherapist.

Pendulum stretch: Lean forward slightly and swing your affected arm in small circles to loosen the shoulder joint. Towel stretch: Hold a towel behind your back and use your good arm to lift the affected one upward for a gentle stretch.

Finger walk: “Walk” your fingers up a wall to gradually increase arm elevation.

Cross-body reach: Use your unaffected arm to bring the other across your body for a deep shoulder stretch.

Armpit stretch: Rest your arm on a surface and bend your knees gently to open the armpit area.

Outward rotation: With a resistance band, slowly rotate your affected arm outward.

Inward rotation: Pull the band toward your body to strengthen the shoulder’s internal rotators.

Treatment of Frozen Shoulder

Physiotherapy treatment is typically an integral part of managing frozen shoulder, combining with pain management and, when necessary, injections. In some cases, a doctor may recommend more invasive treatments, such as manipulation under anesthesia or surgical release of the joint capsule, to improve shoulder mobility.

Recovery from frozen shoulder can be slow and may take several months to years. It's essential to work closely with a healthcare professional to develop a personalised treatment plan and manage the symptoms effectively.

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