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About frozen shoulder
Frozen shoulder (also known as adhesive capsulitis) is a condition where there is significant stiffness and pain in the shoulder.
The shoulder joint consists of the upper arm bone (called the humerus) and the shoulder blade (the scapula). This joint is surrounded by a capsule of connective tissue. Frozen shoulder happens when this capsule thickens and becomes tight. This restricts the shoulder from moving and can cause pain. It is common to suffer from night pain, which can disrupt your sleep.
Three stages
Frozen shoulder is described in three stages. Each stage can last months.
Typically, symptoms begin gradually and worsen over time. It can take anything between 6 months and 3 years to recover.
| Freezing stage Lasts 6 to 9 weeks |
| During this stage, the range of movement in the shoulder will gradually reduce. Normally, any shoulder movement will be painful. |
| Frozen stage Lasts 4 to 6 months |
| During this stage, the shoulder continues to get stiffer. However, the pain may begin to ease. |
| Thawing stage Lasts 6 months to 2 years |
| During this phase, the movement in the shoulder begins to improve, although full recovery can take up to 3 years. It is in this phase that physiotherapy can be most helpful. |
Causes of frozen shoulder
It is not known exactly why this condition happens. However, it is more likely to happen for some of the following reasons.
Age and Gender
Being 40 or older, particularly for females, increases the risk of having a frozen shoulder.
Reduced shoulder movement
People who’ve had reduced movement of the shoulder for a while are at higher risk of developing frozen shoulder. This includes problems such as:
- rotator cuff injury
- broken arm
- stroke that causes reduced mobility of the shoulder
- surgery on or around the arm.
Underlying health conditions
People with certain health conditions are more likely to develop frozen shoulder. Conditions that may increase the risk include:
- diabetes
- overactive thyroid (hyperthyroidism)
- underactive thyroid (hypothyroidism)
- cardiovascular disease
- tuberculosis
- Parkinson’s disease.
Smoking
People who smoke are more likely to develop frozen shoulder. Smoking also slows down healing.
Exercises can help
The best way to improve your shoulder movement is by doing certain exercises. This will help you stretch the joint capsule in various ways.
Here are some examples of good exercises to help with your frozen shoulder. The Versus Arthritis Shoulder Pain online booklet has other, more challenging, exercises. Once recovered, you should continue with the exercises for 6 to 8 weeks to help prevent symptoms returning.
Shoulder pendulum
- Stand and lean forward supporting yourself with your other hand. Try to relax your injured arm and let it hang down.
- Swing your arm slowly and gently forwards and backwards.
- Swing your arm slowly and gently side to side.
- Swing your arm slowly and gently in circles, clockwise and anticlockwise.
- Continue for approximately 1 to 2 minutes in total provided there is no increase in symptoms.
- Remember: relax your arm!
Shoulder rotation
- Keep the elbow of your injured arm bent and tucked into your side.
- Hold onto a stick/umbrella/golf club or similar. If you don’t have a stick you could simply hold the injured arm at the wrist and guide it outwards.
- Use your unaffected arm to push your injured hand outwards. Remember to keep your elbow tucked in. Push until you feel the stretch.
- Hold for 5 seconds then return to the starting position.
- Repeat 10 times provided there is no increase in pain.
Shoulder flexing
- Use your other hand to lift your arm up in front of you, as shown in the pictures.
- Repeat 10 times provided there is no increase in symptoms.
Contact information
Physiotherapy