Comprehensive Guide on Physiotherapy for Frozen Shoulder: Causes, Diagnosis, and Treatment

Frozen shoulder, or adhesive capsulitis as it’s scientifically termed, is a debilitating condition characterised by stiffness, pain, and limited range of motion in your shoulder.

As one of the leading treatments, physiotherapy for frozen shoulder plays a crucial role in alleviating symptoms and restoring mobility.

This comprehensive guide is designed to provide a thorough understanding of the causes, diagnosis, and physiotherapy treatment options for frozen shoulder.

Understanding Frozen Shoulder

Frozen shoulder is a condition where the shoulder joint becomes so stiff and painful that it’s likened to being ‘frozen’.

It primarily affects individuals between 40 and 60 years old, with a higher incidence in women and people with certain medical conditions, like diabetes or thyroid disorders.

The shoulder is a ball-and-socket joint encapsulated by the shoulder capsule, a flexible tissue.

In frozen shoulder, this capsule thickens and tightens, causing discomfort and limiting movement.

Symptoms typically develop gradually, often starting with mild pain and progressing to severe stiffness over time.

The Role of Physiotherapy in Treatment

Physiotherapy is central to the treatment of frozen shoulder.

Its benefits include pain reduction, improved flexibility, and enhanced quality of life.

Physiotherapy interventions aim to restore the normal functioning of the shoulder joint through a combination of exercises and hands-on techniques.

A growing body of research indicates the effectiveness of physiotherapy in treating frozen shoulder.

For instance, a 2019 study published in the Journal of Physical Therapy Science found that physiotherapy techniques significantly improved shoulder mobility and pain levels in patients with the condition.

Diagnosis of the Condition

Diagnosis of frozen shoulder typically involves a physical examination by a physiotherapist or doctor.

They will assess the range of movement in your shoulder and may also observe how you perform certain actions, such as raising your arm.

Further medical tests, like X-rays or MRI scans, may also be required to rule out other conditions that could cause similar symptoms.

Physiotherapy Techniques

Physiotherapy for frozen shoulder often involves a combination of manual therapy techniques and specific exercises.

The therapist may use mobilisation techniques, involving slow, controlled movements of the shoulder joint, and manipulation, which are quicker movements.

The aim is to stretch or release the shoulder capsule, thereby relieving stiffness and increasing range of motion.

Another key component of treatment is therapeutic exercise.

This may involve range-of-motion exercises, strengthening exercises, and functional training to improve the overall functionality of the shoulder.

Physiotherapy Exercises at Home for Frozen Shoulder

Alongside in-clinic treatment, home exercises are an integral part of the therapeutic journey for frozen shoulder patients. These exercises, when executed regularly, help maintain and enhance the shoulder’s flexibility and strength. A set of these exercises include:

  1. Pendulum stretch: Stand and lean slightly forward, letting your affected arm hang down. Swing your arm gently in small circular motions, both clockwise and anti-clockwise. Gradually increase the radius of the swing as your comfort allows.
  2. Towel stretch: Take a towel and hold it behind your back with both hands, with one hand reaching from above your shoulder and the other from below your waist. Using your good arm, gently pull the affected arm upward to stretch your shoulder.
  3. Cross-body reach: Use your good arm to lift your affected arm at the elbow, bringing it up and across your body. Exert gentle pressure to stretch the shoulder.
  4. Doorway stretch: Stand in an open doorway and spread your arms out to the side. Grip the door frame with each hand at or below shoulder height, then lean or step forward until you feel a stretch in your shoulders.
  5. Wall crawl: Stand facing a wall. Use the fingers of your affected arm to ‘crawl’ up the wall as far as possible, increasing the stretch and range of motion.
  6. Outward rotation: Hold a rubber exercise band between your hands with your elbows at a 90-degree angle close to your sides. Rotate the lower part of the affected arm outward two or three inches and hold for five seconds.
  7. Inward rotation: Stand next to a closed door, and hook one end of a rubber exercise band around the door knob. Hold the other end with the hand of the affected arm, holding your elbow at a 90-degree angle. Pull the band towards your body two or three inches and hold for five seconds.

Remember, these exercises aim to gradually increase your range of motion without causing undue pain.

Regular performance of these exercises is crucial for optimal results.


Q: How long does it take to recover from frozen shoulder with physiotherapy? A: Recovery times vary, but most people experience significant improvement within 6 to 9 months of consistent physiotherapy.

Q: Can frozen shoulder return after physiotherapy? A: While possible, recurrence is relatively rare, especially if preventive exercises are continued.

Q: Is surgery necessary for frozen shoulder? A: While surgery is an option, it’s usually considered only if symptoms are severe or if physiotherapy and other treatments haven’t helped after six months.

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