If you've noticed your shoulder becoming increasingly stiff, painful or difficult to move, particularly without a significant injury, you may have frozen shoulder. Simple tasks such as reaching overhead, fastening a bra, putting on a jacket or reaching into your back pocket can become frustrating and painful.
At The Addison Physiotherapy, we help people understand each stage of frozen shoulder and provide personalised rehabilitation to reduce pain, improve movement and guide recovery.
Key Takeaways
- Frozen shoulder causes pain and significant loss of shoulder movement.
- It usually develops gradually without a major injury.
- Recovery occurs in stages and may take several months.
- Physiotherapy helps improve function and manage symptoms.
- Most people recover without surgery.
What is frozen shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a condition where the capsule surrounding the shoulder joint becomes thickened and stiff. As the capsule tightens, shoulder movement becomes progressively restricted.
Unlike many other shoulder conditions, frozen shoulder affects movement in almost every direction, even when someone else tries to move your arm.
Although the exact cause isn't fully understood, the condition is generally self-limiting, meaning it improves over time. Physiotherapy aims to help manage symptoms and maximise recovery throughout the process.
What causes a frozen shoulder?
The exact cause isn't always known, but several factors increase your risk.
Common risk factors include:
- Age between 40 and 65 years
- Diabetes
- Thyroid disorders
- Previous shoulder injury
- Shoulder surgery
- Prolonged shoulder immobilisation
Many people develop frozen shoulder without any obvious trigger.
What causes a frozen shoulder?
The exact cause isn't always known, but several factors increase your risk.
Common causes include:
- Age between 40 and 65 years
- Diabetes
- Thyroid disorders
- Previous shoulder injury
- Shoulder surgery
- Prolonged shoulder immobilisation
Many people develop frozen shoulder without any obvious trigger.
What are the frozen shoulder impingement?
People commonly experience:
- Increasing shoulder pain
- Progressive stiffness
- Difficulty reaching overhead
- Difficulty reaching behind your back
- Pain when dressing
- Pain at night
- Loss of movement in all directions
What are the stages of frozen shoulder?
Frozen shoulder typically progresses through three stages.
Stage 1 – Freezing
Pain gradually increases and shoulder movement begins to reduce. This stage can last several months.
Stage 2 – Frozen
Pain often settles slightly, but stiffness becomes the main problem. Everyday tasks become increasingly difficult due to limited shoulder movement.
Stage 3 – Thawing
Shoulder movement gradually improves, and function slowly returns. Recovery during this stage may continue for many months.
Everyone progresses through these stages differently, and recovery times vary.
When should I see a physiotherapist?
It's worth booking an assessment if:
- Your shoulder is becoming progressively stiffer.
- Pain is affecting your sleep.
- Everyday activities are becoming difficult.
- You cannot reach overhead or behind your back.
- Symptoms have continued to worsen over several weeks.
Early assessment helps confirm the diagnosis and rule out other causes of shoulder pain.
Do I need imaging?
Usually, no.
Frozen shoulder is primarily diagnosed through a clinical assessment. Imaging is sometimes used to exclude other shoulder conditions if the diagnosis is unclear.
Your physiotherapist may recommend imaging if:
- Your symptoms don't fit the typical pattern.
- There has been significant trauma.
- Another shoulder condition is suspected.
How is frozen shoulder treated?
Treatment depends on which stage of frozen shoulder you're experiencing.
Treatment usually includes:
Education
Understanding the condition and knowing what to expect can reduce anxiety and help guide appropriate activity levels.
Pain Management
During the painful stage, treatment focuses on reducing discomfort and maintaining as much movement as possible without significantly aggravating symptoms.
Mobility Exercises
Gentle exercises help maintain available movement and reduce stiffness where appropriate.
Strengthening
As pain settles and movement begins returning, strengthening exercises help restore shoulder function and confidence.
Treatment is always individualised based on the stage of recovery.
Can I keep exercising?
Usually, yes.
Although some movements may be uncomfortable, completely avoiding shoulder movement often leads to further stiffness.
Exercises should be modified according to your symptoms, with an emphasis on maintaining mobility rather than forcing painful stretches.
Your physiotherapist will guide you on what is appropriate during each stage.
How long does recovery take?
Frozen shoulder often takes longer to recover than many other shoulder conditions.
