Top 5 Exercises for Frozen Shoulder
What is Frozen shoulder?
Frozen shoulder (adhesive capsulitis) is a common condition where the shoulder becomes gradually difficult to move and increasingly painful. It is associated with the inflammation of the joint capsule lubrication (synovium) and the capsule contracture (thickening and tightening scar tissue). Patients mostly complain about difficulty sleeping on the affected shoulder and have a reduction in raising their arm above their head or getting dressed (e.g., wearing a shirt or reaching your bra strap). Frozen shoulder is common during the sixth decade of life, the peak age is between 50-60 and occurs slightly more in women than men.
Most often, frozen shoulder occurs after trauma, such as fractures, dislocation, and soft tissue injuries. Nontraumatic incidences could be related to osteoarthritis, rotator cuff tendinopathy and calcific tendinitis. Commonly it is associated with conditions like diabetes, thyroid diseases and cardiopulmonary (heart and lung) diseases. However, at Surrey Physio, the most common time we see frozen shoulder is post-surgery.
Stages of frozen shoulder
Research mostly divides frozen shoulder into 3 stages which include:
- Freezing (an onset of shoulder pain with increase difficulty of moving)
- Frozen (pain improves with stagnation of movement)
- Thawing (improvement of motion and relief from symptoms)
Although theses stages are reported in research there are variations and stages can differ in duration and symptoms. There are also questions raised by a number of therapists (including ourselves) on the actual validity of the three stages, as frozen shoulders can, in some cases, get very stiff very quickly.
Suitable treatment is required to ensure patients make a good recovery and reduce the burden on their daily activities. Conservative treatments include oral medication, physical therapy, exercise, steroid injection, and hydrodilatation all of which have positive outcomes. Treatment varies in different stages, in the freezing stage pain is mostly prominent. Therefore, a steroid injection and anti-inflammatory pain relief can help with symptoms. Applying heat to the shoulder can also help with pain. The frozen phase benefits from therapy focusing on improving the range of movement such as mobilisation techniques, exercises prescription and education. Thawing stage benefits from introducing further functional movements and restoring strength through physiotherapy.
Other treatments include:
Surgical procedure, this occurs only when all other non-operative options have not worked as well. The decision to operate is the last outcome and you should discuss along with your doctor surgery as an option. This commonly includes manipulation under anaesthesia or arthroscopic capsular release. Manipulation under anaesthesia involves being under general anaesthesia while the surgeon firmly moves and rotates your arm to mobilise the scar tissues. However, if the scar tissue is too thick, an electrical knife may be used to cut both the capsule and scar tissue during a keyhole procedure called capsular release.
In most cases frozen shoulder can last up to one year with some lasting over 2 years. It is important to get seen early in one of our Surrey Physio clinics to ensure adequate knowledge and to start the rehabilitation process. It is also recommended that you discuss with your doctor the potential for recovery using conservative treatments, as well as the risks associated with surgery.
At Surrey Physio we provide a personalised approach to each stage of this condition. At our initial appointment we will thoroughly examine and talk about your shoulder pain. We provide education on the diagnosis, prognosis and provide a hands-on approach using various manual techniques along with a personalised exercise program sent to your email.
In the meantime, here are 5 exercises that could help if you suspect a frozen shoulder.
1. Football supporter shoulder exercise lying
Take a scarf, hand towel or dowel rod, and grasp both ends. Lift it to 90 degrees as shown, and slowly move the scarf from side-to-side. his exercise will help improve mobility to the shoulder, but if your shoulder is stiff, start gently as it can be uncomfortable.
2. Rock the baby shoulder exercise
Keep your stronger arm under your painful arm, so that your stronger arm is supporting it. Gently rock your arm to one side, and then the other, as if you were rocking a baby. This is an excellent mobility exercise for stiff and painful shoulders. Try 20 repetitions with 3 sets, twice a day.
3. Wall crawl
Walk your fingers up the wall, but not directly to the side, but at a 30-degree angle from the front as shown in the picture. When you reach your limit (discuss what point this should be with your therapist), walk your fingers back down the wall. This exercise will improve mobility to your shoulder. Try 10 repetitions with 4 sets 4 times daily.
4. Towel dryer shoulder exercise
Your good arm holds the towel above your head, and your sore arm relaxes behind your back. Lift your sore arm by pulling upwards with your good arm. You will feel a stretch/discomfort deep in your shoulder. Sometimes if your shoulder is sore, this exercise can be uncomfortable, but it does increase the mobility of your shoulder.
Try 10 reps with a small 2 sec pause at the top of the movement, 3-4 sets 3 time daily.
5. Pec stretch
Hook your fingers around a door frame or corner of a wall, and lean forwards creating a stretch across your upper arm, front shoulder and slightly into your chest. This exercise stretches the pectoral muscle.
Frozen shoulder can be debilitating and affect your daily activities, if your feel you have some of the symptoms mentioned talk to us at Surrey Physio for a full and thorough assessment and guidance throughout your rehabilitation.
(Therapists reading this page, these videos are provided by Rehab My Patient – the best exercise prescription software for therapists to prescribe exercises www.rehabmypatient.com. If you are a patient needing advice, call Surrey Physio to book a telephone/video consultation with one of our expert physios or osteopaths, or book in face-to-face for an appointment. You can call us on 0208 685 6930 or book online by clicking the link at the top of the page).