Frozen shoulder, medically known as adhesive capsulitis, is a painful condition that causes stiffness and restricted movement of the shoulder. Simple activities such as dressing, reaching overhead, combing your hair, or putting your hand behind your back can become difficult.
The good news is that physiotherapy can play an important role in reducing pain, restoring shoulder movement, improving strength, and helping you return to daily activities.
What Is Frozen Shoulder?
Frozen shoulder occurs when the tissues surrounding the shoulder joint become irritated, thickened, and tight. This can gradually restrict the normal movement of the shoulder.
It usually develops slowly and may last for several months or longer. Recovery varies from person to person, so treatment should be based on the individual's symptoms, stage, and movement limitations.
Symptoms of Frozen Shoulder
Common symptoms include:
- Shoulder pain, particularly at night
- Increasing stiffness in the shoulder
- Difficulty raising the arm
- Difficulty reaching behind the back
- Trouble wearing or removing clothes
- Difficulty combing or washing your hair
- Pain when sleeping on the affected side
- Reduced ability to perform everyday activities
A characteristic feature is loss of both active and passive shoulder movement, especially external rotation.
The 3 Stages of Frozen Shoulder
Frozen shoulder is commonly described in three stages.
1. Freezing Stage
Typical duration: Around 2–9 months, although it varies.
Pain gradually increases and shoulder movement starts becoming restricted.
Patients may experience:
- Increasing shoulder pain
- Night pain
- Progressive stiffness
- Difficulty performing overhead activities
- Increasing difficulty reaching behind the back
During this stage, aggressive stretching may increase symptoms. Physiotherapy generally focuses on pain management and gentle movement within tolerance.
2. Frozen Stage
Typical duration: Around 4–12 months, with considerable individual variation.
Pain may become less intense, but stiffness is often significant.
You may have difficulty:
- Raising your arm
- Reaching overhead
- Reaching behind your back
- Performing household activities
- Dressing independently
Physiotherapy during this stage focuses on maintaining and gradually improving available range of motion and function.
3. Thawing Stage
Typical duration: Around 6–24 months, but recovery can vary.
Shoulder movement gradually improves and pain usually decreases.
Treatment can progressively focus on:
- Improving range of motion
- Strengthening shoulder muscles
- Improving functional movements
- Returning to normal daily activities
Important: These time frames are approximate. Not everyone follows exactly the same pattern.
Physiotherapy Treatment for Frozen Shoulder
A physiotherapist will first assess your pain, range of motion, strength, functional limitations, and overall shoulder condition.
Treatment may include:
1. Pain Management
Depending on the individual, treatment may include:
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