• Eric Lau

Frozen Shoulder: Early Signs, Treatments, and Exercises

Frozen shoulder, also known as adhesive capsulitis, is a condition that affects your shoulder joint. In many cases it involves pain and stiffness that gradually develops, tends to get worse, and then slowly recovers. The overall course and recovery of frozen shoulder can generally take 1 year. The bones, ligaments, and tendons that make up the shoulder joint are encased in connective tissue. Frozen shoulder occurs when this connective tissue thickens and tightens around the shoulder joint, and thus restricts its movement.

Doctors aren’t exactly sure why frozen shoulders happen, although it has been found to occur in people who have diabetes or those who recently had an injury that immobilized the shoulder for a long period of time, such as an arm fracture or surgery. Let’s take a deeper look at frozen shoulders in the next section.

Women placing cold compress onto sore shoulder

What is it?


Frozen shoulder is known to typically develop slowly, and progress through 3 stages over time. Each of these stages can last for many months. The first is called the “Freezing Stage”, where any movement of your shoulder causes pain, and your range of motion will start to decrease. Some people will experience pain at night, and can disrupt sleep if not careful. The second is called the “Frozen Stage”, and the pain will start to subside in this stage. However, your shoulder will become stiffer, and using it will become moderately difficult. Finally, the last part is the “Thawing stage”, where the range of motions begins to improve and you can move your arm around with ease. Now let’s take a look at some of the signs and symptoms you may have with frozen shoulders.

What are the signs and symptoms?


  • Pain and stiffness that makes it difficult to impossible to move it

  • Dull or achy pain in one shoulder

  • Pain in shoulder muscles around top of arm

  • Pain worsens at night making it difficult to sleep

How is it treated?


During your initial assessment your physiotherapist will determine which stage of frozen shoulder you are in. The stage of frozen shoulder you are in will then determine the types of treatment you will receive.


Freezing Stage


During this stage your shoulder will be very sore and stiff. Patients will often say that their shoulder is quite sore at night which interrupts their sleep. Their shoulder mobility will be quite limited. Your physiotherapist will work with you to focus on pain control. Your physiotherapist will use massage, gentle mobilizations, and gentle stretching to keep the shoulder moving. For pain management, your doctor may prescribe an oral pain medication. Your doctor may even recommend a cortisone injection into the shoulder to help with your shoulder pain during this stage.


Frozen Stage

At this stage your shoulder stiffness continues however the pain will more stable. You will experience less pain at night. Your physiotherapist will continue to massage, mobilize, and stretch your shoulder. Your physiotherapist will prescribe shoulder isometrics exercises to help you strengthen your shoulder even though your mobility is still limited in this stage. At this point your doctor will not recommend a cortisone injection since your pain will be more manageable.


Thawing Stage

Your shoulder range of motion will start improving at this stage. Your shoulder pain will be more mild and now you are able to sleep comfortably. Your physiotherapist will progress to more aggressive joint mobilizations and stretching. You will also be prescribed more challenging shoulder stretches. As your shoulder mobility improves your physiotherapist will prescribed you customized exercises to help you reach your goals or return to your sport.

Common Home Exercises

Shoulder pendulums


Bend over slightly. Keep your arm relaxed and allow gravity to gently traction your shoulder. Gently move your upper body to provide some momentum as your shoulder swings side to side or in a circle. Perform 10-20 repetition for 3 sets.


Physiotherapist standing slightly bent over performing shoulder pendulum exercise

Shoulder flexion stretch


Lye on your back. Clasp your hands together. Use your healthy arm to lift the effected arm as high as you feel comfortable. Perform 10 repetition for 3 sets.

Shoulder abduction isometrics


Standing beside a wall with your elbow bent. Push your elbow gently into the wall and hold the contraction for 5 seconds. Be careful not to lean your body into the wall and stand up straight. Perform 5-10 repetitions for 3 sets.


Physiotherapist standing by a wall performing shoulder abduction exercise


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