Frozen shoulder, medically known as ‘adhesive capsulitis’, is a slow-developing condition. It starts with shoulder pain and can be difficult to differentiate from other shoulder conditions in the early stages. Gradually, the pain diminishes, and the shoulder becomes progressively immobile. Eventually, the shoulder ‘thaws’, and normal function (or something close to it) returns. However, the process can take several years. In this article, we’ll look at frozen shoulder, exercises that can help, and tips for making a full and fast recovery.
Symptoms of frozen shoulder
Frozen shoulder is an excruciating, exhausting and frustrating experience.
Excruciating because the nature of the pain can be deep, gnawing, burning, stabbing and shooting. It affects the shoulder itself and often travels down into the arm.
Exhausting because it disrupts sleep. The joint capsule tightens as you rest, meaning any small movement triggers pain.
And frustrating because it usually develops for no apparent reason. While it’s more common for people with certain underlying health conditions, such as diabetes, thyroid issues or Parkinson’s disease, in most cases it appears out of the blue.
Once the pain eventually starts to ease, the stiffness and immobility ramp up, making daily life a struggle. Simple activities, like reaching a high shelf or drying your hair, become a major chore. Often, sufferers learn to do all daily tasks with their other hand – although both shoulders can be simultaneously affected.
This ‘frozen’ stage can last for several months before movement starts to return. And the ‘thawing’ process is gradual. Frozen shoulder can typically last from one to three years.
The good news
Although frozen shoulder is an unpleasant and debilitating experience, the good news is that there are steps you can take to get through it as quickly and smoothly as possible. Here are our tips for managing your frozen shoulder.
1. Seek help early
This is the best course of action for several reasons.
Firstly, it’s important to have a full assessment of your shoulder to determine whether it really is adhesive capsulitis, or another condition that can mimic it, such as rotator cuff injury.
Secondly, the sooner you have a qualified expert guiding you on what to do, the better your outcome is likely to be. The correct approach is highly dependent on the exact stage of the condition, so get advice as soon as you can.
2. Rest, but don’t stop moving
While you shouldn’t push through pain to keep up with your normal activities, it’s important not to stop using your shoulder entirely. This will only encourage the development of stiffness. Maintaining some range of motion with exercises appropriate for frozen shoulder (see below) will limit the progression of the disease.
3. Use ice and warmth
Although you might think a ‘frozen’ shoulder wouldn’t benefit from ice, the fact is that ice is a great pain reliever and can ease the inflammation and swelling that typifies the early stages of the condition.
Warmth has its place, too, though. Many people find a heat pack can ease muscle tension and aching in the surrounding tissues. Warm therapy is best used after the worst inflammation has receded. It’s also helpful to warm the shoulder up in this way before embarking on your frozen shoulder exercises.
In the frozen phase, then, warmth can be especially helpful. However, there’s still a place for ice when activity or exercise causes a painful flare.
Treatment is specific to the individual’s stage, so ask your healthcare professional which temperature therapy would suit you best, and how and when to apply it.
4. Be patient and consistent
It can be hard to keep working on a stuck and painful shoulder. Even in the best scenario, the condition is likely to take a few months to resolve. But seeking help early and sticking with your action plan is a proven way to get you back to health.
5. Not all frozen shoulders are actually frozen
That doesn’t mean there’s been a misdiagnosis; but studies have demonstrated that sometimes a frozen shoulder doesn’t have the tight and contracted capsule that we’d expect to see.
Experts think that, in some cases, the immobility of a frozen shoulder comes, not from contracture of the surrounding tissues as expected, but because the central nervous system prevents the joint moving.
It’s a normal reaction for the brain to shut down muscles to protect a joint and prevent movement. It’s possible that, in some cases of frozen shoulder, this protective mechanism gets carried away.
This isn’t fully understood as yet, but it does explain why treatments to relax the muscles, desensitise the shoulder and assuage that neural inhibition can be so dramatically effective.
For example, techniques that address muscular trigger points, commonly found around a frozen shoulder, can reset the neural output from brain to shoulder. The restriction is lifted, and the shoulder can start moving again.
Find a therapist, then, that understands the role of this neural inhibition in the treatment of frozen shoulder.
Frozen shoulder exercises
It’s important to work with an osteopath or other qualified professional who can guide you in the appropriate type and level of exercise for your frozen shoulder.
These exercises can be safely done to ensure you maintain some mobility in your shoulder. The key is to do them little and often, so they don’t cause a symptom flare.
1. Pendulum swing
Stand with relaxed shoulders, feet staggered, and hold the back of a chair with your good hand. Lean forward so your affected arm hangs towards the floor. Use your body to set the arm swinging in a small circle. Swing 10 times in one direction, then repeat in the other direction.
You can progress by increasing the number of revolutions, increasing the size of the circle, or holding a small weight in the hand.
2. Walk up the wall
Stand facing a wall, around 18 inches away. Put the fingertips of the affected side on the wall at waist level. Using your fingertips, ‘walk’ up the wall as far as you comfortably can. Support your arm with the other hand as you return to the start position. Repeat 10 times.
3. Dips
Use your good hand to raise your affected arm onto a surface in front of you, about chest height. Slowly bend your knees, so your arm is raised as you lower. Dip as far as you comfortably can, trying to increase a little each time. Repeat ten times.
4. Cross-body stretch
Use your good hand to bring your affected arm up and across your chest, gripping just above the elbow. Gently press your affected arm in towards your chest, stretching the back of the shoulder. Hold the stretch for 30 seconds, then relax. Repeat 10 times.
Performing these stretches regularly will help ease the developing stiffness in your shoulder. But it’s important to seek guidance on exercises targeted to your stage and how you should progress them appropriately.
The osteopathic approach to frozen shoulder
Here at OCHK, our experienced osteopaths have a wide range of approaches to ease the pain and stiffness of frozen shoulder. Some of the ways they can help include:
- easing muscle tension and aching around the shoulder.
- addressing trigger points.
- reducing neural inhibition of the shoulder muscles.
- improving mobility in the neck, back and ribcage to support shoulder function.
There’s no quick fix for frozen shoulder. But osteopaths offer a safe, non-invasive method to reduce pain and normalise function as quickly as possible.
Book with our team today and experience the relief osteopathy can bring.