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Frozen Shoulder: What Is It and How to Improve It

Frozen shoulder, also called adhesive capsulitis, is when your shoulder gets stiff and hard to move. This is due to the stiffening of the capsule which surrounds the shoulder joint. The fibrous capsule helps keep the ball in in the socket. The muscles around the shoulder serve the same purpose but they are contractile tissues unlike the capsule which does not actively contract under your own control. This stiffening can cause serious restrictions in your motion, especially into external rotation and abduction (rotating out and lifting elbow out to the side).

Imagine it like your shoulder is stuck in place, making it difficult and painful to do things like washing your hair or reaching out to the side. This can be especially discouraging because our shoulders are designed to be one of the most mobile joints in our body.

Frozen shoulder is split into 3 phases:

1. Freezing Stage: At first, your shoulder starts to hurt more and more, and it becomes harder to move. This usually lasts about 3-6 months.

2. Frozen Stage: Your shoulder gets stiffer, and the pain might not be as bad, but moving it is still tough. This can take 4-12 months.

3. Thawing Stage: Finally, your shoulder starts to loosen up, and you can move it more easily again. It can take 6 months- 2 years to resolve.


Why does frozen shoulder happen?

Usually, the exact cause isn’t clear. But there are some factors that can put you at risk for developing a frozen shoulder.

1. Inflammation: Sometimes, inflammation in the shoulder joint can lead to the thickening and tightening of the shoulder capsule, which is the tissue that surrounds the joint.

2. Immobilization: If you're unable to move your shoulder for an extended period due to injury, surgery, or other reasons, it can lead to the development of scar tissue and stiffness in the joint.

3. Medical conditions: Certain medical conditions like diabetes, thyroid disorders, or heart disease may increase the risk of developing frozen shoulder.

4. Age and gender: Frozen shoulder tends to occur more often in people between 40 and 60 years old, and it's more common in women than in men.

How is this different than a muscle injury like a rotator cuff tear?

Typically, our shoulder will allow more passive range of motion (PROM) than active range of motion (AROM). PROM is when the shoulder is totally relaxed and AROM is when you move your shoulder on your own. But a sign of frozen shoulder is when the joint allows the same amount of PROM and AROM. Your shoulder physically won’t go any further. This tells us there is a restriction in the capsule.


A performance physical therapist in Asheville, NC moves a patient's shoulder to improve their frozen shoulder aka adhesive capsulitis.

Now I am a bit biased, but physical therapy can be crucial for recovering from a frozen shoulder. But that isn’t to say that some folks can’t find some great information online and try to treat themselves. The most important thing is that you do not, I repeat, DO NOT, protect your shoulder by keeping your elbow by your side all the time for weeks…months…years.

So here are some of the basics that are important for getting your shoulder moving again.

1. Breathe: Focus on regulating your nervous system by breathing! Seems simple, right? But your bodies protective muscle guarding can really prevent your shoulder from making gains in range of motion. If you can’t breathe in the position you’re trying to get your shoulder into, then it probably isn’t doing you much good.

2. Focus on areas around the shoulder: If you can get your spine moving better (especially the neck and upper back), then you can yield some improvements in other neighboring areas. Also focus on getting your shoulder blade moving as it plays a big role in helping your shoulder (glenohumeral joint) move.

3. Use variations of shoulder mobilizations, low load long duration stretches, and light weight “strengthening” through full available ranges of motion.

4. Be consistent. When you find something that feels decent for the shoulder and seems like it’s helping you make some progress, then be consistent. I’m sure you saw the time frames of frozen shoulder above. It can take a LONG time for healing. I recommend folks spend shorter amounts of time with the shoulder multiple times a day for best results.


If pain is making progress feel impossible or you’ve just been slamming your head against the wall for a while, then it could be time to see a performance physical therapist. Or maybe you’re just a bit overwhelmed and unsure where to start. If you’re in Asheville or the surrounding areas and think you might be dealing with a frozen shoulder, then click here to set up a free call with me. I’d love to hear about your story so far and your goals, then tell you more about how I could help if we are a good fit.

Keep the hope alive! This too will improve.


Dr. Sieara Hinshaw






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