Our Eight Favorite Exercises For Frozen Shoulder

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If you’ve been experiencing stiffness and pain in your shoulder, you might be dealing with a condition known as frozen shoulder. This condition (also known as adhesive capsulitis in the medical community) isn’t as icy as it sounds.

Still, it can be quite a pain, literally. It develops slowly through three stages: freezing, freezing, and thawing. Each phase can last several months, and the entire process can take up to two years to resolve completely.

In this article, we’ll explore the details of the best exercises for frozen shoulder and what you can do about it if you have recently been diagnosed with this all-too-common condition.

Causes and Risk Factors

Ever wondered why it’s called “frozen shoulder?” Imagine a door hinge that hasn’t been oiled for a while. It’s stiff and doesn’t swing as freely as it should. That’s precisely what happens with a frozen shoulder. The capsule surrounding your shoulder joint thickens and tightens, restricting its movement (1).

The exact cause remains unknown. However, we’ve identified certain risk factors. Age is significant, with most patients between 40 and 60 years old. It’s also more common in women than men. 

Other risks include prolonged immobility or reduced mobility of the shoulder. This can occur after an injury, fracture, or surgery. People with certain diseases like diabetes, thyroid disorders, or cardiovascular disease are also more susceptible.¹ 

Differentiating Frozen Shoulder from Rotator Cuff Issues

Frozen shoulder and rotator cuff issues can be confusing since they involve shoulder pain. However, they’re not the same. 

A frozen shoulder is characterized by stiffness and a limited range of motion in the shoulder. In contrast, rotator cuff issues often involve weakness in the shoulder, making it difficult to lift heavy objects or perform overhead activities. 

Pain patterns differ as well. Frozen shoulder pain is typically dull or aching. It is usually felt over the outer shoulder area and sometimes the upper arm. Rotator cuff pain, on the other hand, is often described as a deep ache in the shoulder.¹ 

The Connection Between Frozen Shoulder and Menopause

Interestingly, there’s a link between frozen shoulder and menopause. Research shows post-menopausal women are more likely to develop frozen shoulder.² 

Although the reason isn’t entirely apparent, it’s believed that hormonal changes during menopause may affect the shoulder joint’s connective tissues. This can lead to inflammation and shoulder stiffness, resulting in a frozen shoulder. Remember, understanding your condition is the first step towards effective management. 

Coping Strategies for a Frozen Shoulder Diagnosis

A frozen shoulder can be particularly challenging to manage due to the intense pain and limited range of motion it causes. Thankfully, there are effective strategies you can use to manage this condition.

Firstly, it’s crucial to keep moving. It may be tempting to avoid using the affected arm due to the pain. Still, inactivity can exacerbate the condition by causing the shoulder joint to stiffen further. Gentle range-of-motion exercises can help to keep the joint flexible and reduce pain.⁴

It’s also essential to avoid certain activities. High-impact sports and heavy lifting can strain the shoulder joint, potentially worsening your symptoms. So, opt for low-impact exercises like swimming or cycling, which can help to keep you active without putting undue stress on your shoulder.

Importance of Proper Sleep and Techniques for Sleeping with a Frozen Shoulder

We all know a good night’s sleep is crucial for overall health. Still, it’s imperative when dealing with a frozen shoulder. Proper rest can help your body to repair itself and reduce inflammation.

However, sleeping with a frozen shoulder can be a challenge due to the discomfort it causes. Here are a few techniques that can help:

1. Use a Pillow: Positioning a pillow to support your affected arm can help alleviate pain and promote better sleep.
2. Sleep on your Back: This position can help keep your shoulder joint neutral, reducing strain and discomfort.
3. Mindful Breathing: Practicing mindful breathing before bed can help to relax your muscles and reduce pain perception, making it easier to fall asleep.

Physical Therapy Exercises for Frozen Shoulder

As we age, our bodies often encounter new challenges. Usually, my patients come into the clinic with stiff shoulder joints, making their movements painful and difficult. But there’s good news.

Physical therapy can be a significant ally in treating frozen shoulders, offering non-invasive relief and improved mobility. PT focuses on exercises stretching the shoulder joint and strengthening the surrounding muscles, helping reduce stiffness and improving overall range of motion.

Stretching Exercises for Frozen Shoulder

Let’s walk through some initial stretching exercises to help alleviate frozen shoulder symptoms once they have begun.

Pendulum stretch

• Stand beside a table, leaning slightly over it with your good arm for support.
• Let your affected arm hang down, swinging it gently in a pendulum motion.
• Gradually increase the diameter of your swings as your symptoms improve.
• Repeat this exercise for several minutes daily, gradually increasing the time as your shoulder becomes more flexible. 

Towel Shoulder Stretch

• Grab a towel and hold one end behind your back behind your neck with your non-injured arm
• Reach behind you and grab the other end hanging behind your hips
• With your unaffected arm, pull the towel upward, giving your affected shoulder a nice stretch. 

Crossover Arm Stretch

• Hold your affected arm at the elbow with your good hand and gently pull it across your body.
• You should feel a stretch in the back of your shoulder.
• Hold this position for 15 to 20 seconds, then slowly lower your arm.
• Repeat this exercise several times each day.

Armpit stretch

• Place your palms against a door jamb or against the walls in a corner, as seen in the video
• Lean forward until you begin to feel a stretch in your chest.
• Hold this stretch for 30 seconds to a minute, then rest. Repeat as needed.

Strength Exercises

Once your range of motion has increased and pain decreased to where you can comfortably move your arm around, it is time to introduce some strengthening exercises. 

Resistance Band External Rotation

• Securely tie a resistance band around a doorknob or handle at waist level.
• Stand perpendicular to the door and grab the free end of the band with your affected arm.
• Keep your elbow bent at a 90-degree angle and rotate your forearm away from your body.
• Do 10-15 repetitions, and increase as your strength improves. 

Wall Push-ups

• Stand facing a wall at arm’s length.
• Place your palms against the wall at shoulder height and shoulder width apart.
• Slowly bend your elbows and bring your chest towards the wall, then push back to the starting position.
• This exercise helps to strengthen the chest and shoulder muscles without putting too much strain on the affected area.

Dumbbell Scaption

This exercise strengthens the muscles that stabilize the shoulder joint.

• Hold a light dumbbell in each hand with your palms facing each other.
• With your arms slightly bent, lift the weights diagonally before you to shoulder height, creating a ‘Y’ shape.
• Lower the weights slowly back to the starting position.

Shoulder CARs

This exercise helps to maintain a full range of motion in the shoulder. CARs stands for ‘Controlled Articular Rotations.’ Doing CARs allows you to practice a full, healthy range of motion of your shoulder joint. This is how you do shoulder CARs:

• Sit or stand with an upright posture and your arms at your sides.
• Raise your arm straight out in front of you with your palm facing up until you are reaching overhead.
• Rotate your palm to face backward as you reach your arm behind you, slowly lowering back to the start position.
• Do 3-5 repetitions, then repeat on the other arm.

Always consult a medical professional or a trained PT before starting any new exercise regimen to ensure the exercises are safe and suitable for your condition. And always stop if you experience any pain.

Preventive Measures

Adopting preventive measures is crucial to warding off the risk of developing a frozen shoulder. Firstly, prioritize regular movement of your shoulder joints, even when stiffness or pain sets in, as this can contribute to long-term joint health. 

Consider embracing the therapeutic warmth of heat therapy before engaging in exercises, as it aids in loosening the shoulder joint and facilitating smoother movements. Forge a partnership with a physical therapist who can guide you through a personalized exercise regimen and closely monitor your progress on this preventive journey.⁵ 

Additionally, maintain a balanced diet incorporating Omega-3 fatty acids, found in sources like fish and flaxseeds, as they possess anti-inflammatory properties that can help mitigate the risk of shoulder-related issues.

Incorporating these preventive measures into your routine can contribute significantly to the overall well-being of your shoulder joints and reduce the likelihood of developing a frozen shoulder.

Exploring Alternative Therapies

While physical therapy and targeted exercises effectively treat frozen shoulder, they’re not the only options. Many patients have found relief with alternative therapies like acupuncture.

Acupuncture for Frozen Shoulder

Acupuncture, a practice that originated in ancient China, involves inserting thin needles into specific points on the body. It’s thought to balance the body’s energy flow, or “qi,” and it’s been recognized by the World Health Organization as a treatment for a range of conditions, including frozen shoulder. 

In a study published in the Journal of Traditional Chinese Medicine, acupuncture was found to significantly improve the symptoms of frozen shoulder. If you’re open to trying alternative therapies, acupuncture could be a viable option to explore alongside your physical therapy routine.⁶

Living with a Frozen Shoulder

Let’s dive into the world of Robert, a 68-year-old retired teacher. He used to love tossing a frisbee with his grandkids in the park until he noticed a nagging pain in his shoulder. The ache was persistent, and soon he could not lift his arm above his head. 

After a visit to the doctor, he was diagnosed with frozen shoulder. He was then referred to physical therapy for further stretching, strengthening, and mobility training.

Robert’s story is familiar. In my practice, I’ve met many patients like him who’ve experienced the debilitating effects of a frozen shoulder.

Effective Strategies and Treatments

While the condition can be challenging, there are ways to manage it effectively. Let’s look at how Robert found relief.

Physical Therapy

This is the most common treatment for frozen shoulder. Robert enrolled in a physical therapy program, which involved a series of exercises designed to restore movement and flexibility to his shoulder. His regimen involved gentle stretching and range-of-motion exercises.

Medication 

To help manage the pain and inflammation, Robert’s doctor prescribed non-steroidal anti-inflammatory drugs (NSAIDs). These medications can reduce discomfort and allow patients to participate more effectively in physical therapy.

Heat and Cold Therapy

Robert used a mix of heat and cold therapy at home. Warm showers or a heated pad helped to relax the shoulder muscles, while a cold pack helped to reduce inflammation and numb the pain.

Lifestyle Modifications

Robert also made some changes in his daily routine. He avoided activities that exacerbated his pain and found new ways to perform tasks that required shoulder movement.

Patience and Persistence 

Perhaps the most crucial part of Robert’s journey was his mindset. He understood that recovery from a frozen shoulder takes time. He stayed committed to his physical therapy regimen and made necessary lifestyle changes, ultimately significantly improving his condition.

A frozen shoulder can be a painful and frustrating condition. Still, it can be managed effectively with the proper treatment and a positive mindset. The experiences of Robert and others like him serve as a testament to that.

Key Takeaways

• Frozen shoulder, or adhesive capsulitis, progresses through stages and is characterized by stiffness, limited range of motion, and distinct pain patterns.
• Age, gender, and underlying conditions like diabetes or cardiovascular disease increase the likelihood of developing frozen shoulder.
• Regular, gentle movement is vital for managing a frozen shoulder, as inactivity can worsen symptoms.
• Low-impact exercises like swimming are preferable, while high-impact activities should be avoided.
• Adequate sleep is crucial for overall health, especially when dealing with frozen shoulder.
• Supportive pillows, sleeping on the back, and mindful breathing can improve sleep quality despite shoulder discomfort.
• Stretching and strengthening exercises are vital in improving flexibility and muscle function.
• Regular shoulder joint movement, heat therapy, and a balanced diet with Omega-3 fatty acids contribute to long-term joint health.
• Collaboration with a physical therapist provides personalized guidance and progress monitoring, reducing the risk of developing a frozen shoulder.
• Combining conventional treatments, such as physical therapy and medication, with alternative therapies like acupuncture can enhance overall outcomes in managing a frozen shoulder.
• Real-life experiences like Robert’s underscore the challenges and effective strategies in dealing with and improving frozen shoulders over time.

References

1. Pal B, Anderson J, Dick WC, Griffiths ID, “Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus,” British Journal of Rheumatology, vol. 24, no. 9, pp. 147-151, 1986.
2. Hand C, Clipsham K, Rees JL, Carr AJ, “Long-term outcome of frozen shoulder,” Journal of Shoulder and Elbow Surgery, vol. 17, no. 2, pp. 231-236, 2008.
3. J. D. Kelly et al., “Frozen shoulder: Evidence and a proposed model guiding rehabilitation,” Journal of Orthopaedic & Sports Physical Therapy, vol. 39, no. 2, pp. 135-148, 2009.
4. American Physical Therapy Association. “Physical Therapy for Frozen Shoulder.”
5. C. Sun et al., “Acupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis of randomized controlled trials,” Journal of Traditional Chinese Medicine, vol. 38, no. 3, pp. 309–319, 2018.
6. Mezian K, Coffey R, Chang KV. Frozen Shoulder. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482162/