The Do’s and Don’ts of Managing Frozen Shoulder with Physiotherapy
Frozen shoulder, also known as adhesive capsulitis, is a painful condition that leads to stiffness and restricted movement in the shoulder joint. It typically develops gradually and can last anywhere from several months to years if not properly managed. The good news? Physiotherapy plays a crucial role in managing frozen shoulder, helping to reduce pain, improve mobility, and restore function. However, knowing what to do (and what not to do) is essential to a successful recovery. In this blog, we’ll cover the do’s and don’ts of managing frozen shoulder effectively with physiotherapy.
What is a Frozen Shoulder?
Frozen shoulder is characterised by inflammation and thickening of the joint capsule, leading to pain, stiffness, and limited range of motion. It generally progresses through three stages:
Freezing Stage: Gradual onset of pain and increasing stiffness. Range of motion becomes more restricted.
Frozen Stage: Pain may decrease, but stiffness and movement limitations persist.
Thawing Stage: Gradual improvement in mobility as the shoulder begins to “thaw.”
The condition can be caused by injury, surgery, prolonged immobilisation, or underlying medical conditions such as diabetes or thyroid disorders.
Why is Physiotherapy Important for Frozen Shoulder?
Physiotherapy is a highly effective, non-surgical treatment option for frozen shoulder that helps:
Reduce pain and inflammation.
Improve shoulder mobility and flexibility.
Restore strength and function.
Prevent muscle atrophy and compensatory movement patterns.
However, improper exercises or overexertion can worsen symptoms, so it’s crucial to follow the right guidelines.
The Do’s of Managing Frozen Shoulder
1. Do Gentle Range of Motion Exercises
Why? Gentle exercises help maintain mobility and reduce stiffness without aggravating pain.
Examples:
Pendulum Exercises: Lean forward and let your arm hang. Gently swing it in small circles.
Passive Shoulder Flexion: Use your unaffected arm to assist in lifting the affected arm.
Wall Crawls: Slide your fingers up a wall to increase shoulder elevation gradually.
Tip: Perform these exercises slowly and within a pain-free range to avoid irritation.
2. Do Stretch Regularly
Why? Stretching helps improve flexibility and reduce tightness in the shoulder joint.
Recommended Stretches:
Cross-Body Stretch: Gently pull the affected arm across your body using your other arm.
Towel Stretch: Hold a towel behind your back with one arm and gently pull it upward with the other.
Tip: Hold each stretch for 15-30 seconds and repeat 2-3 times daily.
3. Do Apply Heat Therapy
Why? Applying heat helps relax tight muscles and improve blood circulation.
How to Use:
Use a warm towel or heating pad for 15-20 minutes before stretching or exercising.
Tip: Ensure the heat source is warm, not hot, to avoid burns.
4. Do Strengthening Exercises (During Thawing Stage)
Why? As pain decreases and mobility improves, strengthening exercises restore muscle function and stability.
Examples:
Isometric Shoulder Exercises: Press your hand against a wall without moving the shoulder joint.
External Rotation with Resistance Band: Strengthens the rotator cuff muscles.
Tip: Start with light resistance and gradually increase as tolerated.
5. Do Maintain Good Posture
Why? Proper posture reduces stress on the shoulder joint and promotes better alignment.
Tip: Keep your shoulders relaxed and avoid slouching, especially during prolonged sitting.
The Don’ts of Managing Frozen Shoulder
1. Don’t Force Painful Movements
Why? Pushing through pain can worsen inflammation and prolong recovery.
Tip: Perform exercises only within a pain-free range. Stop immediately if you feel sharp pain.
2. Don’t Overstretch or Overuse the Shoulder
Why? Overstretching can cause micro-tears and increase stiffness and pain.
Tip: Avoid aggressive stretching or heavy lifting until mobility has improved.
3. Don’t Immobilize the Shoulder Completely
Why? Complete immobilization leads to muscle atrophy and joint stiffness, worsening the condition.
Tip: Continue gentle movements and activities within a pain-free range to maintain mobility.
4. Don’t Ignore Pain at Night
Why? Night pain is common in frozen shoulder and can disrupt sleep, affecting overall recovery.
Tip: Sleep on your unaffected side with a pillow to support the affected arm in a comfortable position.
5. Don’t Self-Diagnose or Self-Treat
Why? Misdiagnosis can lead to ineffective or harmful treatments.
Tip: Always consult a physiotherapist or healthcare professional for an accurate diagnosis and personalised treatment plan.
When to Seek Physiotherapy?
Consult a physiotherapist if you:
Experience persistent shoulder pain and stiffness lasting more than a few weeks.
Have difficulty performing daily activities, such as dressing or reaching overhead.
Notice reduced shoulder mobility affecting your work or hobbies.
Need guidance on safe and effective exercises to restore function.
Early intervention with physiotherapy can significantly improve outcomes and shorten recovery time.
How Physiotherapy Helps in Each Stage of Frozen Shoulder
Freezing Stage: Focus on pain relief, gentle mobility exercises, and maintaining function.
Frozen Stage: Emphasise gentle stretching, mobility exercises, and maintaining muscle strength.
Thawing Stage: Incorporate strengthening exercises, active range of motion, and functional movements.
Physiotherapists also use pain-relief modalities like ultrasound, TENS (Transcutaneous Electrical Nerve Stimulation), and manual therapy techniques to reduce discomfort and improve mobility.
Conclusion
Managing frozen shoulder requires patience, consistency, and the right approach. Physiotherapy plays an essential role in alleviating pain, restoring mobility, and enhancing overall function. By following the do’s and don’ts outlined in this guide, you can navigate the challenges of frozen shoulder safely and effectively.
If you’re struggling with shoulder pain and stiffness, don’t wait for it to worsen. Our team of experienced physiotherapists is here to help you regain mobility and get back to your daily activities pain-free.
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