Frozen shoulder (also known as adhesive capsulitis) is a condition in which the capsule surrounding the shoulder joint becomes inflamed, thickened, and tight. This typically develops gradually over months and often progresses through three stages.
Stage 1: Freezing
- Shoulder pain gradually worsens, particularly at night.
- As pain increases, shoulder movement continues to be limited.
- Common duration is ~2-9 months.
Stage 2: Frozen
- Pain may start to reduce, but the shoulder is dominantly stiff.
- Everyday activities such as reaching overhead or putting on a shirt can become challenging.
- Common duration is ~4-12 months.
Stage 3: Thawing
- The shoulder slowly regains movement and function. Recovery can continue over several months.
- Common duration is ~6-24 months.
What Causes Frozen Shoulder?
There is no exact cause of frozen shoulder, but there are several risk factors:
- Diabetes
- Thyroid disorders
- Previous shoulder injury or surgery
- Prolonged shoulder immobilisation
- Aged 40-60
- This condition is more common in females than males.
Common Symptoms
- Persistent shoulder pain
- Pain that is worse at night
- Difficulty reaching overhead, behind the back, dressing, grooming or lifting objects
- Reduced shoulder mobility and stiffness that continues to worsen
The Role of Physiotherapy:
Physiotherapy is considered one of the most effective non-surgical treatments for frozen shoulder. Treatment is tailored to the stage of the condition and your individual symptoms.
Pain Management
Specifically, during the painful 'freezing' stage:
- Gentle manual therapy
- Activity modification advice and education about managing symptoms
Restoring Movement & Strength
Specifically, during the 'frozen' to 'thawing' phases:
- Improving shoulder mobility with prescribed stretching and mobilisation exercises, with physiotherapy guidance to ensure no aggravation
- Individualised strengthening exercises are prescribed to restore shoulder muscle control and function, specifically around the shoulder and rotator cuff musculature
When to see a Physiotherapist?
If shoulder pain and stiffness persist for more than a few weeks or are interfering with your daily activities or sleep, it's worth seeking professional assessment and individualised plan for your shoulder. Early diagnosis can help rule out other shoulder conditions and ensure you receive the most appropriate treatment plan.
Summary:
Frozen shoulder can make everyday activities difficult, but recovery is possible. With the right physiotherapy treatment, regular exercises, and a little patience, most people can ease their pain, improve their movement, and get back to doing the things they enjoy.
If you would like help with your shoulder pain, please reach out to our team who can assess and help! Call 9313 3414 or book online now!
Website: https://www.backinmotion.com.au/como
Phone Number: 9313 3414
This blog is written by Mathew Piccoli, Senior Physiotherapist at Back In Motion Como
References:
Tedeschi, R., Vita, F., Platano, D., & Donati, D. (2026). Decision-making in adhesive capsulitis: a comprehensive approach to the diagnosis and management of frozen shoulder.
European Journal of Manual Medicine, 64(1), 33-35. https://link.springer.com/article/10.1007/s00337-024-01114-5
Pandey, V., & Madi, S. (2021). Clinical guidelines in the management of frozen shoulder: an update! Indian Journal of Orthopaedics, 55, 299-309.
https://link.springer.com/article/10.1007/s43465-021-00351-3