Frozen Shoulder Treatment

Frozen shoulder syndrome (or adhesive capsulitis) is a painful condition that significantly limits shoulder motion and daily function. This condition is the result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the normal shoulder joint.

Get proven treatment tips from a licensed physical therapist, author of The Ultimate Frozen Shoulder Therapy Guide. As always, see a healthcare practitioner for advice specific to your situation.

7 Tips to Overcoming Your Frozen Shoulder

by Brian Schiff

Tip #1 - Support the affected arm during activities of daily living.

This includes driving, typing at the computer, sitting in a chair, and relaxing in your recliner at home. Gravity pulls the arm down when it is unsupported, which increases strain on the rotator cuff. It is best to use a soft pillow or cushion when available.

By reducing the pull of gravity throughout the day, you will naturally lessen the pain and inflammation in your shoulder. While it will take effort on your part to not violate this rule, I promise you it will make a difference.

Tip #2 - Use ice and heat accordingly to relieve pain and decrease stiffness.

Heat is a great way to start the day and reduce stiffness. Your best bet is a warm shower. Another method is applying a heating pack. Regardless, this will feel good, reduce stiffness and better prepare you to move the arm in your morning routine.

With regard to ice, I always suggest a frozen bag of veggies or professional soft wrap that conforms to the shape of the shoulder. Be sure to support the arm as mentioned previously while icing. Keep the ice on for 15-20 minutes and then off for an hour. You may ice more than once per day if desired based on pain. I usually suggest icing before bed to improve sleep.

I know you are asking yourself why put ice on a stiff shoulder. Ice really is helpful because it reduces inflammation. Heat feels good, but does not dramatically affect the inflammation. Ice should be used after periods of increased activity (e.g. work or play). So, if you have not been icing, begin using it daily to reduce pain and aid healing.

Tip #3 - Avoid forcing the arm to move in painful ranges of motion unless absolutely necessary.

With a stiff frozen shoulder, the rotator cuff gets compressed when the arm is elevated, rotated, or extended beyond the point of joint mobility due to abnormal joint mechanics, which often further aggravates the symptoms. This is problematic with getting dressed, fastening the seat belt, or placing carry-on baggage in a plane.

Depending on your pain state (acute, sub-acute, or chronic) you may have pain in different parts of the range of motion. Any significant pain with movement is a bad thing and you should try to minimize or avoid it altogether. Rest from abusive motion is absolutely critical to resolving your inflammation and returning to pre-injury levels.

However, do not stop moving the arm in those directions at all as that can cause you to lose even more mobility. Use moderation as your guide and pay attention to the pain levels day to day!

Tip #4 - Do not perform single arm or overhead heavy lifting during periods of inflammation.

The lifting position coupled with external loads will prolong your pain and slow the recovery process. It is common for people to unknowingly abuse their shoulder with daily activities including overhead lifting, carrying laptops, hauling briefcases, and even lifting luggage (especially overhead).

I know you are asking how to avoid these positions. The best answer is to switch arms or use both arms for lifting maneuvers when possible. Believe it or not, even small loads and movements can significantly increase pain and inflammation. Minimizing the number of such activities is necessary to allow the injured tissue to heal.

Use pain as your guide with daily tasks, but be careful to avoid pushing, pulling, or lifting heavy objects with the affected arm. Try to use both arms and keep them as close to the body as possible. This measure alone will accelerate healing and reduce your pain.

Tip #5 - Perform arm pendulums (clockwise and counterclockwise circles) daily.

This gentle motion stimulates receptors in the shoulder joint and helps to increase joint space and reduce pain. This motion is also a good warm-up activity prior to shoulder exercises. You can eventually add a small weight or soup can to increase the effect.

It is important to let the motion of the body direct the shoulder and not to forcefully move the shoulder in circles. The arm should hang as though it were limp and follow the lead of the body.

I generally recommend doing 20-30 repetitions of this exercise 1-2 times per day. If it causes pain, then reduce the radius of the circles or simply wait until it can be done pain free. This motion is even more effective if you perform it after a warm shower or applying moist heat to the shoulder for 10-15 minutes.

Tip #6 - Use a pillow under the arm at night to better support the injured arm.

Propping the arm up as opposed to letting it hang down against the bed will actually reduce pull and tension on the shoulder and rotator cuff. Proper positioning will keep the shoulder in a neutral position in line with the body and should feel very comfortable.

I also recommend trying to sleep on the unaffected side if possible, as lying on the sore side compresses the shoulder and will typically increase pain and wake you.

I know you are thinking it is impossible to stay in one position at night. You are probably right. But, I encourage you to at least try these options when you are in significant pain, as I know for sure that compression of the shoulder will make your symptoms worse. That also equals more pain and less sleep.

So, use a small to moderate sized pillow that achieves the optimal position described above. Even if you move during sleep, a little break from the bad positions should still aid in your recovery.

Tip #7 - Perform daily stretching and range of motion exercises.

What if your frozen shoulder is really sore? How does exercise aid healing? Exercise will increase blood flow to the tissues and doing specific exercises will not only prevent further motion loss and stiffness, but actually help you recover lost function and mobility in your frozen shoulder.

It is not acceptable to do just any exercises. They need to be specific to the problem you have and target the tight tissue in your shoulder. They must also be done at a certain frequency, intensity, and volume to reduce your pain. I have determined a clinically proven formula for doing just this.

Lower intensity and longer duration stretches coupled with specific cane range of motion exercises are essential to promote healing, reduce inflammation, and return you to pre-injury activity levels again. More importantly, effective rehab exercises will prevent future injuries and more pain and suffering. While there is no magic pill or quick fix for a frozen shoulder, these exercises help you get better.

Copyright © 2005 Brian Schiff

Brian Schiff, PT, CSCS, is a respected author, physical therapist, and fitness expert. For additional information on frozen shoulder and a proven exercise program for unlocking your stiff shoulder, visit Frozen Shoulder Therapy.