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  • Writer's pictureSaira Resolve Physio



Surprisingly, nothing to do with a cold sensation, an injury or condition that only occurs during the winter or something we can ‘melt to heal’ - believe it or not these are all statements clients have made to us over the years when we’ve told them they have a ‘frozen shoulder’.

If you’ve experienced a serious injury to the shoulder, like a rotator cuff tear, you may have been warned about developing #adhesivecapsulitis, otherwise known as “frozen shoulder”. This condition gets the name “frozen shoulder” due to the significantly reduced movement and pain it causes.

What Is Frozen Shoulder? ‘Frozen shoulder’ is the common term we give to a condition called ‘adhesive capsulitis’ where a significant restraining in shoulder mobility develops slowly along with pain and can sometimes last for 1-2 years. It commonly develops during long periods of rest (e.g. post-fracture and post-surgery).

The shoulder joint has connective tissue surrounding it which we know as the capsule. This tissue serves to stabilize the ball-and-socket joint of the shoulder, and provides additional support. With a frozen shoulder the connective tissue becomes irritated, inflamed and looses its elasticity.

Who Gets Frozen Shoulder?

Adhesive capsulitis is the leading shoulder condition that causes immobility and pain after the age of 40,. The biggest risk factors for developing it include:

Non dominant hand

Recent surgery or period of immobilisation

Recent trauma


History of stroke

What Causes Frozen Shoulder?

There are two primary causes for frozen shoulder, but the way in which the condition develops is largely unknown, which means it’s hard to offer preventative treatment for.

Primary adhesive capsulitis is idiopathic this means that – pain and immobility gradually develop without any specific cause. Secondary adhesive capsulitis is associated with systemic issues of the body such as diabetes mellitus, hormone issues, rotator cuff injuries, shoulder injuries, calcific tendinitis, cervical spondylosis, and strokes to name a few.

What Are The Symptoms?

The main symptoms of adhesive capsulitis relate to pain and restricted movement.

There are three stages involving these symptoms:

1) Freezing stage: shoulder range of motion begins to diminish, and general movement (particularly overhead and behind the back) movements become painful. This stage ranges from 1-9 months.

2) Frozen stage: shoulder movements become even more stiff, though pain begins to reduce. Functional use (e.g. reaching overhead, putting a coat on) becomes much more difficult. This stage ranges from 4-12 months.

3) Thawing stage: this is when movement and pain begin to improve, and previous loss of functional movements slowly return. This stage ranges from 5-24 months.

How Do You Prevent and Manage It?

Most cases of adhesive capsulitis develop during long periods of immobility such as healing from a shoulder break, stroke, or a post-surgical rotator cuff tear. For some it will develop without any associated cause. Regardless of cause, once safe, movement is imperative Maintaining healthy movement, strength, stability, and addressing appropriate muscle and joint recovery of the neck, back and shoulder complex is key. Physiotherapy interventions that are most favourable focus on manual therapy, progressive stretching, and myofascial techniques to encourage and maintain optimal shoulder movement and strength. This is most important in frozen and thawing stage.

Myofascial techniques: focus on the muscle and fascial tension that builds with frozen shoulder, providing stimulus to aid in movement and recovery. This can be done with the hands or using ‘tools’ such as cupping and scrapping etc.

Progressive manual therapy: mixing joint mobilisation, deep tissue massage, progressive stretching, and muscle energy techniques (the type of work you are used to from us here at Resolve).

Exercise: centred around gradually challenging and progressing range of motion, scapular stability, and strength to enable functional movements. Frozen shoulder can be a long road to recovery, especially if left untreated and problems around other joints develop due to overcompensating or adopting sedentary behaviours. The right treatment can get you back to moving at your best as quickly as possible. While the options above are general there are other treatments that we offer at Resolve which may hear towards a faster recovery and relief from pain.

Ready to start managing your shoulder mobility, get in touch with us for an appointment!

0121 293 0237

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