Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited mobility in the shoulder joint. It occurs when the connective tissue surrounding the joint becomes thick and stiff, making it difficult to move the arm. The condition typically progresses over time, with three phases:

Freezing (painful) phase: During this phase, the shoulder becomes increasingly painful and range of motion is limited.

Frozen (adhesive) phase: Pain may begin to decrease during this phase, but stiffness and limited mobility become more pronounced.

Thawing (recovery) phase: During this phase, shoulder range of motion gradually improves, and pain subsides.

The duration of each phase can vary, with the entire condition lasting several months to a few years.

Causes of Frozen Shoulder

The exact cause of frozen shoulder is not well understood, but there are several factors that may contribute to the development of the condition. Some of the common causes of frozen shoulder include:

Injury or surgery: A previous shoulder injury or surgery can lead to the development of a frozen shoulder.

Immobilization: Prolonged immobilization of the shoulder, such as wearing a sling, can cause the shoulder joint to become stiff and difficult to move.

Diabetes: People with diabetes are more likely to develop frozen shoulder, although the reason for this association is not clear.

Other health conditions: Frozen shoulder has also been linked to other health conditions, such as heart disease, Parkinson’s disease, and thyroid disorders.

Genetics: Some people may have a genetic predisposition to developing frozen shoulder.

It’s important to note that frozen shoulder can occur without an obvious cause or trigger, and it may be more likely to develop in people over the age of 40 and in women.

Signs and Symptoms of Frozen Shoulder

The main signs and symptoms of frozen shoulder include:

  • Pain: The first symptom of frozen shoulder is usually pain in the shoulder, which can be severe and often worsens at night.
  • Stiffness: As the condition progresses, the shoulder joint becomes increasingly stiff and difficult to move. This can make it difficult to perform everyday activities such as reaching or lifting.
  • Limited range of motion: The range of motion in the shoulder joint gradually decreases as the condition progresses, and in severe cases, the arm may become almost completely immobilized.
  • Difficulty sleeping: The pain and discomfort associated with frozen shoulder can make it difficult to sleep comfortably, particularly if you lie on the affected side.
  • Muscle weakness: In some cases, the muscles surrounding the shoulder joint may become weakened or atrophied as a result of disuse.
  • It’s important to note that the symptoms of frozen shoulder can vary in severity and duration, and they typically progress through three distinct stages, as described earlier. It’s also important to seek medical attention if you experience severe pain, a sudden onset of symptoms, or if you have difficulty moving your arm.

Treatment for Frozen Shoulder

Physiotherapy can play an important role in the treatment of frozen shoulder. The goal of physiotherapy is to reduce pain and stiffness, improve range of motion, and promote healing. Here are some of the common physiotherapy treatments used for frozen shoulder:

Stretching and range-of-motion exercises: Gentle stretching and range-of-motion exercises can help improve shoulder mobility and reduce stiffness. A physiotherapist will work with you to develop an exercise program that is safe and effective for your specific condition.

Strengthening exercises: Strengthening exercises can help improve muscle function and prevent further injury. Your physiotherapist may recommend specific exercises to target the muscles surrounding the shoulder joint.

Manual therapy: Manual therapy techniques, such as massage and joint mobilization, can help improve joint mobility and reduce pain.

Heat and cold therapy: Applying heat or cold to the affected area can help reduce pain and inflammation.

Transcutaneous electrical nerve stimulation (TENS): TENS is a non-invasive treatment that uses low-level electrical currents to reduce pain and improve muscle function.

It’s important to note that the treatment plan for frozen shoulder will depend on the severity of your symptoms, your overall health, and your individual needs. Your physiotherapist will work with you to develop a personalized treatment plan that is safe and effective for you. In some cases, surgery may be necessary to improve shoulder mobility, particularly if other treatments are not effective.

If you have any questions or would like to speak to a therapist about frozen shoulder please call us at 03 9836 1126.



Page MJ, Green S, Kramer S, Johnston RV, McBain B, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev.

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