Imagine waking up and realizing you can’t lift your arm to put on a shirt or grab a cup from the shelf. At first, you ignore it. Then the stiffness sets in. Before long, even small movements send sharp pain through your shoulder.
If this sounds familiar, you might be dealing with frozen shoulder (adhesive capsulitis), a painful condition that severely limits shoulder movement. It doesn’t just affect your workouts—it impacts your sleep, daily activities, and overall quality of life. But the good news is, with the right treatment, recovery is possible.
At Adaptive Physiotherapy & Massage in Booragoon, we specialize in evidence-based physiotherapy for frozen shoulder, using manual therapy, stretching, and progressive exercise rehabilitation to restore mobility and function.
What is Frozen Shoulder?
Frozen shoulder is a self-limiting condition that progresses through distinct stages, lasting anywhere from several months to a few years. It primarily affects the glenohumeral (shoulder) joint capsule, which becomes inflamed and contracts, significantly limiting movement.
Common Causes and Risk Factors
✔ Primary Frozen Shoulder – No clear cause, often linked to autoimmune responses and inflammation.
✔ Secondary Frozen Shoulder – Develops after trauma, surgery, prolonged immobilization, or medical conditions like diabetes, stroke, or thyroid disorders.
Symptoms of Frozen Shoulder
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Gradual onset of stiffness and pain, worsening over time.
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Pain at rest and during movement, especially at night.
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Limited ability to perform overhead and rotational movements.
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Muscle guarding and compensatory movement patterns.
Categories of Frozen Shoulder
Frozen shoulder is categorized into two types based on its cause:
✔ Primary Frozen Shoulder (Idiopathic Adhesive Capsulitis)
- Develops without a known injury or underlying cause.
- Associated with systemic conditions like diabetes or thyroid dysfunction.
- More common in individuals aged 40-60 years and women.
✔ Secondary Frozen Shoulder
- Develops after an injury, surgery, or prolonged shoulder immobility.
- Common after rotator cuff injuries, fractures, or post-stroke patients.
- Can also result from inflammatory conditions like rheumatoid arthritis.
The Three Stages of Frozen Shoulder
Understanding the stages of frozen shoulder is key to knowing what to expect and how to treat it effectively.
Stage 1: Freezing Stage (Painful Stage – Lasts 2-9 months)
✔ Gradual onset of persistent shoulder pain, worsening over time.
✔ Severe pain at night, disrupting sleep.
✔ Progressive stiffness begins to set in, reducing mobility.
Treatment Focus:
✔ Pain management, gentle mobility exercises, and reducing inflammation.
✔ Avoid aggressive stretching, which can worsen symptoms.
Stage 2: Frozen Stage (Stiffness Stage – Lasts 4-12 months)
✔ Pain begins to subside, but stiffness remains.
✔ Shoulder movements become significantly restricted, affecting daily activities.
Treatment Focus:
✔ Manual therapy and stretching to maintain mobility.
✔ Strengthening exercises to support the joint.
Stage 3: Thawing Stage (Recovery Stage – Lasts 6 months-2 years)
✔ Gradual improvement in mobility.
✔ Pain significantly decreases.
✔ Function slowly returns, but mild stiffness may persist.
Treatment Focus:
✔ More aggressive stretching and strengthening to fully restore function.
✔ Functional retraining to prevent compensatory movement patterns.
What Works? Evidence-Based Treatment for Frozen Shoulder
1. Manual Therapy for Frozen Shoulder
Manual therapy plays a crucial role in improving joint mobility, reducing muscle tightness, and restoring movement.
✔ Gentle Joint Mobilizations
- Improves capsular flexibility and shoulder movement.
- Reduces pain and stiffness in the glenohumeral joint.
✔ Soft Tissue Release for Shoulder Muscles
- Myofascial release for the deltoid, rotator cuff, and pectoral muscles relieves tension.
- Trigger point therapy addresses muscle guarding and compensatory tightness.
✔ Scapular Mobilization
- Improves shoulder blade positioning and movement, reducing strain on the frozen shoulder.
At Adaptive Physiotherapy & Massage in Booragoon, our hands-on therapy techniques help patients regain mobility, function, and comfort.
2. Exercise Rehabilitation & Stretching for Frozen Shoulder
A structured exercise program is critical for recovering from frozen shoulder, helping to gradually restore range of motion and strength.
Phase 1: Pain Management & Gentle Mobility Exercises
✔ Pendulum Exercises – Uses gravity to gently mobilize the shoulder joint.
✔ Table Slides – Encourages gentle forward movement without excessive strain.
✔ Isometric Rotator Cuff Strengthening – Builds shoulder stability without aggravating pain.
Phase 2: Progressive Stretching & Strengthening
✔ Cross-Body Shoulder Stretch – Improves capsular flexibility.
✔ External Rotation with Resistance Band – Strengthens rotator cuff stabilizers.
✔ Wall Walks & Overhead Reaches – Gradually restores functional range of motion.
Phase 3: Advanced Strengthening & Functional Retraining
✔ Pulleys & Assisted Range of Motion Exercises – Expands mobility in all planes.
✔ Scapular Retraction & Shoulder Blade Control Drills – Improves posture and movement efficiency.
✔ Weight-Bearing & Resistance Training – Reintroduces functional strength for daily activities.
At Adaptive Physiotherapy & Massage in Booragoon, our tailored rehabilitation programs ensure safe and effective recovery, progressing at the patient’s tolerance and ability.
What Else Can Help? Additional Considerations for Recovery
✔ Pain Management Strategies
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Heat therapy to promote circulation and relaxation.
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NSAIDs or corticosteroid injections for early-stage inflammation.
✔ Patient Education & Self-Management
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Move within pain limits to prevent worsening stiffness.
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Avoid excessive rest to ensure progress.
✔ Long-Term Prevention
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Maintaining shoulder flexibility and strength reduces recurrence.
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Proper mechanics and posture prevent further issues.
Real-Life Recovery: What to Expect
Recovery from frozen shoulder is a slow process—there are no overnight solutions. But the right combination of physiotherapy, movement, and patience leads to success.
Many of our patients regain full range of motion and function, allowing them to return to sports, work, and daily life without pain. The key is consistency and the right treatment approach.
Take the First Step Toward Recovery
Frozen shoulder can be frustrating and painful, but you don’t have to go through it alone. At Adaptive Physiotherapy & Massage in Booragoon, we specialize in helping people regain movement and return to an active lifestyle.
📞 Book an appointment today and start your journey toward pain-free movement!
References
- Page, M. J., et al. (2019). “Manual therapy and exercise for adhesive capsulitis: A systematic review.” British Journal of Sports Medicine, 53(2), 149-158.
- Kelley, M. J., et al. (2021). “Rehabilitation strategies for frozen shoulder: Evidence-based clinical guidelines.” Journal of Orthopaedic & Sports Physical Therapy, 51(3), 225-240.
- Wong, C. K., et al. (2018). “Effectiveness of stretching and strengthening exercises for frozen shoulder.” Clinical Rehabilitation, 32(10), 1362-1373.
- Neviaser, A. S., et al. (2017). “Adhesive capsulitis: Pathophysiology and evidence-based treatment.” Journal of Shoulder and Elbow Surgery, 26(7), 1150-1160.
- Zuckerman, J. D., et al. (2016). “The natural history and treatment of frozen shoulder.” Journal of Bone and Joint Surgery, 98(7), 587-595.
