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What is frozen shoulder?
Frozen shoulder is when your shoulder gets very stiff and painful. It’s caused by a thickening of the area around the shoulder joint, called the shoulder capsule, and the development of bands of thick tissue (adhesions).
Frozen shoulder has three stages:
- Freezing: Lasting 2–9 months, this stage is when the pain and stiffness begins and gets gradually worse.
- Frozen: This stage lasts 4–6 months and is when you have extreme stiffness, making it hard to do movements that require both arms. The plus side is that it may not be as painful.
- Thawing: You begin to get back more and more range of motion. Within 6 months to 2 years of thawing, your shoulder should be back to normal.
Doing certain stretching and strengthening exercises can help pain and stiffness.
When to start exercising
Freezing stage: Wait
In general, you should wait until after the freezing stage to start exercising. Pushing your body too much during the freezing stage, when inflammation is very high, can make your pain worse and won’t improve your shoulder movement. If you do anything, make sure it's very gentle stretching exercises, like the pendulum swing described below, but only do them for 1 to 5 seconds at a time and stop if you feel any pain.
Frozen stage: Start stretching exercising
In the frozen stage, exercising can help you move your shoulder more and more easily. Start with gentle stretching exercises that focus on improving range of motion. The key is not doing anything that causes more pain in the moment—a sign you're pushing yourself too far.
Thawing stage: Add strengthening exercises
In the thawing stage, once you get back some range of motion, you can start adding in some resistance-based strengthening exercises. These use resistance bands, free weights, or a weight machine to work your muscles. Continue with stretching during the thawing stage, gradually increasing the intensity of the stretches and how long you hold them.
What to expect in physical therapy
If you have a frozen shoulder, your healthcare provider will likely recommend physical therapy. The goal of physical therapy is to help you move your shoulder safely with correct form, so that you don’t push yourself too far and cause more damage.
During your physical therapy appointments, you’ll likely be given a heating pad to relax the muscles around the shoulder before your physical therapist guides you through a series of exercises. Whether the exercises are gentle stretches or more movement-based depends on the stage you’re in. You’ll also get a personalized program to do at home.
You’ll have physical therapy more often right after you’re diagnosed, but once you’ve learned the movements and how far to move your arm, you’ll be able to do them at home by yourself. You’ll still need to check in with your physical therapist, especially when you transition from one phase to another since your exercises will change.
Frozen shoulder stretches
Stretching a frozen shoulder can help loosen up tight muscles and improve your range of motion. If possible, take a warm shower or use a heating pad for about 10 minutes before stretching. Here are three to try:
Freezing stage: Pendulum swings
Bend over slightly at the waist and let the arm on the affected side hang down (you can place your other hand on a table or top of a chair for support). Gently swing the arm side to side, forward and back, or in small circles. You should not feel any pain when doing this movement.
Frozen stage: Towel stretch
Hold a towel behind your lower back in both hands. Use your unaffected arm to pull the affected arm gently up and across your lower back to the point of tension, not pain. Hold for a few seconds, then slowly lower and repeat.
Frozen/Thawing stage: Overhead raises
Stand tall with both hands in front of you and interlock your fingers. Keeping both arms slightly bent, slowly raise them overhead—you want to try to get your upper arms in line with your ears. Hold for a few seconds, then slowly lower and repeat.
Because you haven’t been moving your shoulder that much for months, the muscles around it, like your upper back and chest muscles, may have gotten very weak. Strengthening exercises can help make them stronger again. Keep in mind that you don’t want to do too much, too fast, since that can aggravate the joint and cause more pain.
Frozen stage: Scapular retraction
Sit or stand tall with both arms down at your side. Squeeze your shoulder blades down and together and hold for a few seconds, then release. Repeat.
Frozen stage: Abduction
Stand next to a wall with the affected side closest to the wall and the arm straight down at your side. Push the arm out so that it’s pushing against the wall. Hold for 5–10 seconds, then release. Repeat.
Thawing stage: Push up to child’s pose
Start in a push-up position on your knees. Lower your chest to the floor, then push back up, continuing the motion so that you’re sitting back on your heels (keep your arms where they are so that they are extended in front of you with palms on the floor). Hold briefly, then return to the starting position and repeat.
It can be easy to go too hard and feel some pain after doing exercises. When that happens, try ice or heat or an NSAID pain reliever like ibuprofen (Advil, Motrin). And remember: If you ever aren’t sure about how to do a move correctly, talk to your physical therapist.
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