Frozen Shoulder: Stages, Physiotherapy Treatment and Recovery Time

Frozen shoulder (adhesive capsulitis) happens when the tissue around the shoulder joint becomes inflamed, thickened and tight. The shoulder becomes painful and then very stiff — reaching up, behind your back or into a back pocket gets difficult.

Who gets frozen shoulder?

• Mostly people between 40 and 60 years old, more often women.
• People with diabetes or thyroid problems are at higher risk.
• It can follow a period of not moving the shoulder, for example after an injury, surgery or stroke.

The three stages

1. 1Freezing — pain slowly increases, especially at night, and movement starts to reduce. Often lasts a few months up to around 9 months.
2. 2Frozen — pain may ease, but the shoulder is very stiff. Often lasts several months up to about a year.
3. 3Thawing — movement gradually returns. This can take from a few months to two years.

Every person is different, and the full course often takes one to three years. Physiotherapy aims to reduce pain, protect the movement you have, and help you get back to daily tasks sooner.

How physiotherapy helps

• Pain relief with gentle hands-on techniques, heat and electrotherapy where suitable.
• Joint mobilisation to help the capsule stretch.
• A graded stretching programme matched to your stage — gentler when the shoulder is irritable, firmer as it settles.
• Strengthening of the shoulder and shoulder-blade muscles as movement returns.

Your doctor may also suggest pain medicine or an injection; physiotherapy works alongside these.

Gentle home exercises

Only move into mild discomfort, never sharp pain.

1. 1Pendulum swings — lean on a table with your good arm and let the sore arm hang. Gently swing it in small circles. 1 minute, a few times a day.
2. 2Wall finger walk — face a wall and walk your fingers up as high as is comfortable, then slowly down. 10 times.
3. 3Towel stretch — hold a towel behind your back with both hands and use the good arm to gently pull the sore arm upwards. 10 times.
4. 4Cross-body stretch — use the good arm to bring the sore arm across your chest. Hold 20 seconds. 3 times.

When to get help

See a physiotherapist if shoulder pain is waking you at night or stiffness is stopping you from dressing, combing your hair or reaching up. An assessment also rules out other causes, such as a rotator cuff problem, which need different treatment.

This article is general information, not a diagnosis.