Frozen shoulder — medically known as adhesive capsulitis — is a condition that causes pain and gradually worsening stiffness in the shoulder joint. It can be a frustrating experience because it tends to develop slowly and can last for a considerable period without appropriate management.
What Is Frozen Shoulder?
The shoulder joint is surrounded by a capsule of connective tissue. In frozen shoulder, this capsule becomes inflamed and thickened, leading to a significant reduction in the volume inside the joint and a corresponding loss of movement. The exact cause is not always clear, but it is more common in people aged 40 to 60, in women, and in people with certain conditions such as diabetes or thyroid problems.
The Three Stages of Frozen Shoulder
Frozen shoulder typically progresses through three stages:
**Stage 1 — Freezing (Painful Phase)** This stage is characterised by a gradual increase in shoulder pain, often worse at night. Movement becomes more limited over time. This phase can last from two to nine months.
**Stage 2 — Frozen (Adhesive Phase)** Pain may begin to reduce, but the shoulder becomes significantly stiff. Range of motion is markedly reduced, making daily tasks — such as dressing, reaching overhead or behind the back — difficult. This stage can last four to twelve months.
**Stage 3 — Thawing (Recovery Phase)** Movement gradually returns, though this can take several months. Full recovery is possible in many cases, though some people retain a slight reduction in range of motion.
How Can Physiotherapy Help?
Physiotherapy for frozen shoulder is tailored to the stage of the condition:
During the Painful Phase - Gentle range of motion exercises within a comfortable range - Pain management strategies — including electrotherapy (TENS), heat or cold - Education on positioning and activity modification to avoid aggravating the condition - Pendulum exercises to maintain some joint movement
During the Frozen Phase - Gradual stretching and mobilisation exercises to encourage improved range of motion - Manual therapy — joint mobilisation to help restore movement - Progressive exercise programme as tolerated - Continued pain management
During the Recovery Phase - Active strengthening of the rotator cuff and shoulder stabilisers - Progressive return to full daily activities - Sport-specific rehabilitation if returning to athletic activity
What Should You Expect?
Progress with frozen shoulder can be slow and it is important to have realistic expectations. Physiotherapy does not cure frozen shoulder overnight, but it can help maintain movement, manage pain and support the natural recovery process. People who engage consistently with physiotherapy and their home exercise programme generally do better than those who avoid movement due to pain.
When to See a Physiotherapist for Shoulder Pain
If your shoulder has become progressively stiffer and more painful over the past weeks or months, it is worth having it assessed. Other causes of shoulder stiffness and pain — such as rotator cuff tears or arthritis — can be identified during a thorough clinical assessment and may need different management.
Shoulder Physiotherapy in Dehradun
Physiotherapy assessment for frozen shoulder and other shoulder conditions is available at our Bhaniyawala clinic center. Home visits can be arranged across Dehradun for patients who cannot travel to the clinic.
This article is for general information only and does not constitute medical advice.
