Understanding Frozen Shoulder: Causes, Treatment and How to Regain Function
Why is my shoulder so stiff and sore?
Feeling like your shoulder is frozen in place? Struggling to move without discomfort? You might be dealing with frozen shoulder, also known as adhesive capsulitis. This condition causes pain, stiffness, and a frustratingly limited range of motion in your shoulder joint. While its exact cause is often unclear, the aim of physiotherapy is to keep the shoulder mobile and avoid further stiffness, whilst helping to ease that nagging discomfort.
Check out our blog for a guide on understanding frozen shoulder and tips on improving mobility and easing discomfort.
Why is my shoulder so stiff and sore?
Your comprehensive guide to understanding frozen shoulder
What Exactly Is Frozen Shoulder?
Frozen shoulder is a condition where the shoulder joint becomes increasingly stiff and painful, gradually reducing movement over time. It progresses through these overlapping stages:
Stage One: Painful Stage
Lasts several months with increasing stiffness and discomfort.Stage Two: Frozen Stage
The shoulder becomes very rigid, limiting movement.Stage Three: Thawing Stage
Movement starts to improve, but full recovery can take months or even years.
Anatomy of the Shoulder
FAQ: It’s the most flexible joint in the body!
Let’s break it down: the shoulder is a ball-and-socket joint where the upper arm bone (humerus) fits into a shallow socket in your shoulder blade (glenoid cavity). A capsule of connective tissue surrounds the joint, allowing the arm to move freely when healthy.
In a healthy shoulder, synovial fluid lubricates the joint, making movement smooth and easy. But with frozen shoulder, this capsule tightens and thickens, limiting motion. Sometimes scar tissue or adhesions form, restricting movement even further.
Common Symptoms of Frozen Shoulder
Frozen shoulder typically brings a mix of pain, stiffness, and a reduced range of motion. It often starts with a bit of discomfort that gradually intensifies over time. You might notice a dull ache that can get worse with movement or at night, sometimes making it tough to get a good night’s sleep.
As the condition progresses, your shoulder can feel increasingly stiff, making simple tasks like reaching overhead, getting dressed, or lifting objects more challenging. In the most severe cases, you might even find it difficult to move your shoulder at all.
Causes and Risk Factors
While the exact cause is unclear, however research has identified several factors that can increase your risk:
Shoulder Injury or Surgery: Long periods of immobility can trigger frozen shoulder, especially after an injury or surgery.
Inflammation: Conditions like tendinitis or bursitis can lead to shoulder inflammation, setting the stage for frozen shoulder.
Other Health Conditions: Diabetes, thyroid disorders, and Parkinson’s disease increase the likelihood of developing frozen shoulder.
Age and Gender: It commonly affects people aged 40 to 60 and is more prevalent in women.
How Is Frozen Shoulder Diagnosed?
Getting an early and accurate diagnosis is crucial!
Getting an early and accurate diagnosis is crucial. Even though it doesn’t immediately improve your symptoms — It helps shift your focus from searching for answers to starting your journey toward recovery. Knowing what’s going on allows you to move forward with a clear plan and begin your rehab with confidence.
At Kaylana, we offer a thorough and personalised approach to diagnosing frozen shoulder and creating a recovery plan:
Initial Consultation: We start with an in-depth discussion about your health, symptoms, family history, exercise routine, and recovery goals to understand your overall wellbeing.
Comprehensive Assessment: We evaluate your shoulder to identify frozen shoulder and rule out other issues like glenohumeral joint osteoarthritis, rotator cuff tears, fractures, or bone health concerns. If needed, we may refer you for an X-ray or consult your GP for additional tests.
Clear Diagnosis and Tailored Treatment Plan: Based on our findings, we provide a clear diagnosis and develop a customized treatment plan to address your specific needs and goals for the best possible outcome.
Treatment Options
Physiotherapy provides a proactive approach to recovery
Most frozen shoulder cases will improve on its own, with many patients making a full recovery. Physiotherapy offers a proactive approach to speed up this process by keeping you active within your pain limits and providing essential education. Avoiding immobilisation is crucial, as stopping movement can worsen the condition.
While home exercises are vital, supervised physiotherapy provides added support and can significantly enhance your recovery. Many of our patients benefit from our dynamic clinical exercise rehab classes, which complement your home program and keep you motivated.
Physiotherapy Treatment For Frozen Shoulder Includes:
Gentle Stretching Exercises:
Pendulum Stretch: Lean forward and let your affected arm swing in gentle circles.
Towel Stretch: Use a towel behind your back to lift the stiff shoulder upwards.
Cross-Body Reach: Use your unaffected arm to stretch the painful shoulder across your body.
Strengthening Exercises:
We use the Control–Chaos model, starting with low-grade movement and progressing to higher level strength and range of motion based exercises as your function improves.
Recent research also supports the use of eccentric exercises, which lengthen the muscle while under tension, helping to release muscle tightness and improve movement more effectively than traditional stretching.
Manual Therapy:
Although debated, some patients find relief with hands-on techniques like gentle joint mobilisation and soft tissue release. We tailor this approach to your needs.
Heat and Cold Therapy:
Heat before exercises relaxes tight muscles, while cold therapy afterward helps reduce inflammation and swelling.
Home Exercise Program:
A personalised, consistent home exercise program is crucial for maintaining progress and speeding up recovery, with exercises performed daily within pain limits.
A Note on Cortisone Injections
Importantly, physiotherapy has been shown to reduce the need for a second cortisone injection!
For those with severe and highly irritable symptoms, cortisone (steroid) injections into the shoulder joint may offer temporary relief, but they come with a risk of infection. We recommend discussing this with your healthcare provider. Importantly, physiotherapy has been shown to reduce the need for a second cortisone injection, making it a valuable part of your treatment plan.
Surgery is typically a last resort, with over 90% of people experiencing improvement through non-surgical methods. It's generally only considered if conservative treatments have not been effective for more than 12 months.
The Road to Recovery
At Kaylana, our goal is to keep you active and moving! Frozen shoulder is a highly frustrating condition, but with the right treatment, particularly clinical exercise, most people can regain full use of their shoulder. Early intervention, a combination of stretching and strengthening exercises, and consistent at-home care can shorten recovery time and restore mobility. If you’re experiencing symptoms of frozen shoulder, consulting a physiotherapist can help guide you through a personalised treatment plan for optimal recovery.
If your shoulder feels stuck or the pain is limiting your daily life, don’t wait — book a consultation with our experienced physiotherapist and take the first step toward feeling like yourself again!
*Please note, the content within this article is for educational purposes only, and the treatment and advice mentioned may not be suited for everyone. Please consult our physiotherapist or your local healthcare provider for specific advice tailored to you.