Everything You Need to Know About a Frozen Shoulder

What is a Frozen Shoulder?

Frozen shoulder is a condition where the shoulder joint becomes stiff, painful, and loses its range of motion. It happens when the capsule of connective tissue surrounding the shoulder joint thickens and tightens, restricting movement. It often comes on gradually and progresses through three phases, freezing, frozen, and thawing, over several months to years.

An analogy…

Think of the shoulder joint like a ziplock bag filled with water, normally, the bag moves freely as the shoulder moves. In frozen shoulder, that bag shrinks and stiffens, making it harder and more painful to move the shoulder.

What are other names that a frozen shoulder can be referred to?

Adhesive Capsulitis, Frozen Shoulder Syndrome

What causes a frozen shoulder?

The shoulder joint is surrounded by a capsule of connective tissue that helps keep it stable. In frozen shoulder, this capsule becomes inflamed and thickened, causing it to stick to itself and restrict movement. The exact cause isn’t always clear, but it often follows a period of immobility, such as after surgery, injury, or prolonged rest. It’s also more common in people with diabetes, thyroid issues, or autoimmune conditions.

What are the signs and symptoms of a frozen shoulder?

Gradual onset of shoulder pain, especially at night
Progressive loss of shoulder movement
Stiffness in the joint, even with passive movement
Pain that can be dull or aching, and located deep in the shoulder

What tests are used to diagnose a frozen shoulder?

Apley Scratch Test: This test checks shoulder mobility and flexibility. The patient is asked to reach one hand over the shoulder and down the back, and then reach the other hand up behind the back to try and touch the fingertips together.

Physical Examination: During a physical exam for frozen shoulder, the practitioner will assess both active (your own movement) and passive (practitioner-assisted) range of motion. In frozen shoulder, both types of movement are limited, especially when lifting the arm or rotating it outward. The practitioner will also check for muscle tightness, pain points, and joint stiffness to rule out other causes.

How long does a frozen shoulder take to heal?

Frozen shoulder usually resolves over time, but it can take 12 to 24 months depending on the severity and phase. Early treatment helps reduce the time it takes to recover, but some people may take longer if it’s not managed well or if there are underlying conditions like diabetes.

How does a frozen shoulder happen?

Shoulder immobilisation
Conditions like diabetes, thyroid dysfunction, or autoimmune disorders
Poor shoulder posture and lack of mobility

What treatment can help a frozen shoulder?

Manual therapy to gently mobilise the joint
Stretching and mobility exercises
Dry needling or trigger point therapy for surrounding muscle tension
Corticosteroid injections

What exercises or stretches can I do for a frozen shoulder?

Pendulum swings
Wall climbs (flexion and abduction)
Sleeper stretch
Towel stretch behind the back
Scapular setting and posture drills

What products can help with a frozen shoulder?

Superior shoulder capsule stretch

Place a towel underneath the injured arm, in the armpit area.
Bring this arm across your chest and grab onto the wrist with your other hand.
Pull the arm across your body until you feel a stretch in the top aspect of your shoulder.
Hold this position, then relax and repeat.

Shoulder forward flexion stretch over table

Start in a seated position and put your arms on a table.
Steadily stretch your arms forwards as far as you can, dropping your head down between the shoulders.
Your arms should remain floppy and relaxed throughout and be careful not to tense your shoulders.
Hold this position.
Note this exercise can also be performed from a standing position over a higher surface.

Shoulder external rotation stretch supine with shoulder in neutral

Lie on your back with your symptomatic arm on a pillow by your side.
Hold a broom stick in both hands with both elbows at a right angle.
Use your good arm to push the stick across your body towards your symptomatic arm, turning the forearm outwards.
You should feel a stretch at the front of your shoulder.
Do not allow your upper arm to move away from your body.
Hold this position.

Hand behind back – Shoulder internal rotation stretch with towel

Take a towel and drape it over your good shoulder.
Reach behind your back with your symptomatic arm and hold the other end of the towel.
With your top hand pull the towel straight up so that your back hand comes up towards your shoulder blade.
You will feel this stretch in the front of your shoulder.

Shoulder external rotation stretch in supine

Lie on your back holding onto a broomstick or rod.
Place your symptomatic arm out to the side, about 90 degrees away from you.
Bend your elbow to a right angle.
The stick should lie vertically in the direction of your body.
Using your good arm, push the stick upwards, turning the forearm of the symptomatic arm upwards.
Do not allow your upper arm to move upwards.
You should feel a stretch at the front of your shoulder.
Hold this position.

Sleeper stretch

Lie on your affected side, with the arm out in front and elbow bent to 90 degrees.
Place your other hand on the back of your wrist, and push down to rotate the forearm.
Make sure you do not hunch your shoulder up.
You will feel a stretch over the back and top of the shoulder.