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Frozen shoulder (adhesive capsulitis)

What is it?

A gradual onset of pain and stiffness which progressively causes difficulty moving your arm up or out in different directions. You may notice things difficulty with activities such as, reaching up to a high shelf, doing up your bra, getting a wallet out of the back of your pants or reaching to grab your phone.

Frozen shoulder can occur after shoulder or heart surgery, trauma, immobilisation in a sling or other shoulder injuries. Sometimes there is no cause for frozen shoulder. Risk factors include diabetes, stroke, Parkinson’s disease, or other genetic factors. It most commonly occurs in the non-dominant arm of females of menopausal age, but also occurs in males.

It has 4 phases:

1. First phase—pain phase

  • High levels of pain and there seems to be no position where your arm feels comfortable. Finding a comfortable sleeping position is particularly difficult.

2. Second phase—stiffening phase

  • The soft tissues around your shoulder joint become stiff so you struggle to move your shoulder partly due to pain, but also due to it ‘freezing.’

3. Third phase—frozen phase

  • The pain reduces, but the stiffness remains.

4. Final phase—thawing phase

  • The soft tissues around your shoulder loosen and your shoulder is easier to move.

How is it diagnosed?

Scans are often not able to see the changes happening in your shoulder. Frozen shoulder can be diagnosed by a physiotherapist by asking you questions about your symptoms and completing an assessment in clinic to look at your movement and function.

How can physiotherapy help?

Advice about how to support your arm for sleeping, managing or reducing pain or changes to your work or home environment to allow you to continue doing what you need to

You may find heat, cold or taping is helpful in decreasing your pain.

Your physiotherapist can prescribe you gentle exercises. However, all of these activities must be in the pain-free range, not provoking your pain.

How long until I feel better?

Frozen shoulder is one of the longest musculoskeletal recoveries. The pain stage can last anywhere from 3–6 months. It can take 2–3 years before your arm feels normal again. It is, however, progressively improving across that time and you are able to participate in higher level exercises and activities in the 2nd to 4th stages.

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