Frozen Shoulder


Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, but it often occurs for no known reason. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.


Most often, frozen shoulder occurs with no associated injury or discernible cause. There are patients who develop a frozen shoulder after a traumatic injury to the shoulder, but this is not the usual cause. Some risk factors for developing a frozen shoulder include:

Age & Gender
Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is twice as common in women than in men.

Endocrine Disorders
Patients with diabetes are at particular risk for developing a frozen shoulder. Other endocrine abnormalities, such as thyroid problems, can also lead to this condition.

Shoulder Trauma or Surgery
Patients who sustain a shoulder injury, or undergo surgery on the shoulder can develop a frozen shoulder joint. When injury or surgery is followed by prolonged joint immobilization, the risk of developing a frozen shoulder is highest.

Other Systemic Conditions
Several systemic conditions such as heart disease and Parkinson’s disease have also been associated with an increased risk for developing a frozen shoulder.


Pain due to frozen shoulder is usually dull or aching. It can be worsened with attempted motion. The pain is usually located over the outer shoulder area and sometimes the upper arm.

The hallmark of the disorder is restricted motion or stiffness in the shoulder. The affected individual cannot move the shoulder normally. Motion is also limited when someone else attempts to move the shoulder for the patient.

Some physicians have described the normal course of a frozen shoulder as having three stages:

  • Stage one: In the “freezing” stage, the patient develops a slow onset of pain. As the pain worsens, the shoulder loses motion. This stage may last from six weeks to nine months.
  • Stage two: The “frozen” stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months.
  • Stage three: The final stage is the “thawing,” during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 month.


A doctor will examine the patient and ask for his medical history to be able to accurately diagnosis his condition. Other conditions have similar symptoms to adhesive capsulitis so the doctor may need to take an X-ray.

The most common test used is the MRI scan. An MRI scan is used to create pictures that look like slices of the shoulder. This scan is used to create pictures that look like slices of the shoulder. It can show the tendons as well as the bones, and whether there has been a tear in those tendons.


Successful treatment of adhesive capsulitis include:

  •  Anti-inflammatory drugs
  •  Cortisone injections to the shoulder
  •  Physical therapy

Anti-inflammatory drugs and cortisone injections reduce the inflammation of the shoulder allowing the shoulder to be more easily stretched. Physical therapy is essential because it helps regain the range of motion in the shoulder.

Treatment can be a long process. Initial treatment is aimed at reducing inflammation and pain and increasing the range of motion of the shoulder. Exercise is a very important part of the treatment. Exercises will help break up the scar tissue in the shoulder and should be done twice a day. The doctor or physical therapist will show the patient what kind of exercises should be performed. Since the exercises may be painful, using ice packs afterwards may help. With all exercises, the patient should warm up before attempting to do them.

If progress is slow, the doctor may recommend a manipulation of the shoulder while the patient is under anaesthesia. This procedure allows the doctor to stretch the shoulder joint capsule, and break up the scar tissue. In most cases, a manipulation of the shoulder will increase the motion in the shoulder joint faster than allowing nature to take its course. It may be necessary to repeat this procedure several times.

Arthroscopic surgery may also help break up the scar tissue. A camera is inserted through a small incision allowing the doctor to access the damage to the joint and at the same time, aid in the healing process.


At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Pain relief
  • Reduce stiffness
  • Reduce swelling
  • Strengthening of muscle
  • Regain full range of motion
  • Sports specific training

Visit Physioline for further Consultation and treatment