January 20, 2023

Frozen shoulder, formally known as Adhesive Capsulitis, is a condition characterised by pain, stiffness, and loss of normal range of motion in the shoulder. This is a result of excessive scar tissue forming over the shoulder joint over time.


Causes and risk factors

What causes adhesive capsulitis remains unclear, however, several risk factors have been identified. These include:

  • Being female (75% greater risk than males)
  • Systemic conditions (e.g., diabetes, rheumatoid arthritis, etc.)
  • History of shoulder trauma (this includes previous injury and/or surgery of the shoulder)
  • Prolonged period of arm/shoulder immobilisation

Phases of adhesive capsulitis

Adhesive capsulitis can be divided into three stages:

  1. Freezing phase
  2. Frozen phase
  3. Thawing phase

Freezing phase

This is the most painful phase of the condition, and it can last for as long as 6 weeks to 6 months. This is when the shoulder capsule becomes inflamed and stiff, resulting in reduced shoulder mobility. Shoulder movements will become increasingly more painful and difficult. A typical sign is an inability to reach your hand behind your back.


Frozen phase

In this phase, the shoulder is extremely stiff. The hallmark sign of this phase is when the treating clinician is unable to passively move the shoulder any further than the patient can on their own. This phase may be less painful than the freezing phase but can last up to 6 months as well. The individual will continue to struggle with basic activities involving their arm, such as washing/drying their hair and reaching out for objects.


Thawing phase

This is when the shoulder joint capsule gradually loosens, allowing the individual to slowly move their arm more. This phase is quite slow and can last from 6 months to 2 years.


What can a physiotherapist do to help?

A physiotherapist can diagnose adhesive capsulitis and guide your recovery and rehabilitation. Early on, your physiotherapist will often perform manual therapy, and provide stretching and strengthening exercises to maximise mobility and maintain/improve the strength of the shoulder.

Often the individual will require a hydrodilatation – a procedure performed by a surgeon to get rid of the scar tissue thickening and relieve restriction within the shoulder joint. Soon after, it is important to see your physiotherapist again to maintain the range of motion gained from the procedure and restore your shoulder back to full strength and function.


So, if you’re experiencing symptoms similar to adhesive capsulitis or other forms of shoulder pain, book in to see one of our Physiotherapists!

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