What Is Frozen Shoulder and How Long Does It Last?

Frozen shoulder — adhesive capsulitis — occurs when the capsule surrounding the shoulder joint thickens and contracts. The result is pain and steadily increasing restriction of movement.

Its most distinguishing feature is this: you cannot lift the arm, and neither can someone else. With muscle weakness the shoulder can be lifted passively; in frozen shoulder the joint is mechanically locked.

Who gets it?

• People aged 40–60
• More often women than men
• Markedly more often, and more stubbornly, in people with diabetes
• People with thyroid disease
• After a fracture, surgery or a long period in a sling

Three stages

Freezing (2–9 months). Pain dominates and increases at night. Movement gradually reduces. Forceful stretching in this stage usually makes things worse.

Frozen (4–12 months). Pain eases but restriction is at its greatest. Brushing hair, reaching a back pocket, fastening a bra become difficult. This is the right stage to focus on regaining movement.

Thawing (5–24 months). Movement gradually returns. Strength work comes to the front here.

The whole course can run from one to three years. Knowing this matters: the process is slow and demands patience.

What does physiotherapy change?

Frozen shoulder can settle on its own with time. But a proportion of untreated cases are left with permanent movement loss. Physiotherapy contributes on three fronts:

• Making the painful stage more manageable
• Limiting movement loss and preventing lasting restriction
• Keeping the arm usable in daily life as far as possible

Stage-matched programme

In the freezing stage, pain management and gentle movement within the pain-free range come first. Pushing "through the pain" here causes harm.

In the frozen stage, joint mobilisation and more persistent range-of-motion work come in.

In the thawing stage, shoulder girdle strengthening and functional work complete the programme.

Home programme

Short sessions several times a day beat one long weekly session. Heat beforehand prepares the tissue. Keeping the dose below the level that increases night pain matters.

Fzt. Kemran Hafız builds frozen shoulder programmes by stage — the right exercise in the wrong stage lengthens the process.