Rehabilitation Exercises for Frozen Shoulder

The following is for information purposes only. We recommend seeking professional advice before attempting any rehab.

Frozen Shoulder Rehab

• A frozen shoulder usually passes through three phases. The first phase has reasonable movement but is very painful.
• Through the next phase the pain is reduced but movement becomes very limited (frozen).
• Finally the shoulder loosens up and returns hopefully to normal function. This whole process may take 1 to 3 years.

Freezing Phase Treatments

This phase is usually the most painful and so the following treatments can help to control this.

• NSAID's (non steroidal anti inflammatory drugs) e.g. Ibuprofen may help reduce inflammation and pain - although will be of less value in later phases.
• Electrotherapy modalities such as ultrasound, TENS and laser treatment may help reduce pain and inflammation.
• Pain free mobility exercises such as the pendulum and assisted shoulder exercises (see below) can help maintain shoulder mobility.

Frozen Shoulder Exercises - Mobility

The aim of these exercises is to increase or at least maintain the range of motion at the shoulder joint. The first two exercises may be performed with the help of a physiotherapist or sports therapist.

Therapist Mobilisations

1. Lying on your back, raise the arm upwards. If the athlete can raise the arm 90 degrees then the weight of the arm will act as a mobilizing force. The therapist can either use short firm oscillating movements or sustained pressure at the end range of movement to increase joint range.
   
   
2. Same as the above but the athlete is in the side lying position. The arm is abducted (moved out to the side) to 90 degrees or as far as possible and then either sustained pressure or oscillating movements can be used. The less painful the restriction, the more vigorously the stretch / mobilisation can be applied. The therapist will usually judge this from the expression / reaction on the athletes face.

Patient Mobility Exercises

There are plenty of other exercises that you can do for yourself at home. These should be performed on a daily basis and may be uncomfortable, but should not be painful. During these early stages, activities which involve stretching through painful range of motion should be avoided.

Pendulum Exercises

Pendulum swinging of the arm is a great way of improving mobility. Stand in a slightly bent over position and support the body weight with the unaffected arm on a chair or table. Swing the affected arm in back and forth and circular motions, starting small and gradually increasing the movement.

Wand Exercises

Use a long object such as a broom handle. Hold it in both hands, take the affected shoulder out to the side as far as possible. Apply pressure using the good arm and broom stick to try to push it a bit further. Hold for 10 seconds and try to push a bit further again. This can be done into most positions.

Stretching

Static stretches can also be useful to stretch not only the surrounding muscles but also the shoulder capsule itself. Chest and posterior shoulder stretches can be viewed above.

Shoulder Flexion Stretch

Also, kneel on all fours and keeping the hands in the same spot, lower your buttocks towards your heels. This increases the degree of flexion at the shoulder joint. Hold this position at the point when you feel a gentle pulling sensation. If this eases, sit back a little further. Hold for 30 seconds, rest and repeat 2 more times.

External Rotation Stretch

Lay on your back with your hands under your neck and elbows pointing to the ceiling. Slowly let your elbows move away from the side of your head and drop out to the side. Gravity will pull the arms further down, which increases external rotation at the shoulder joint. Hold for up to 30 seconds, rest and repeat 2 more times.

Chest Stretch

Position the forearm against the wall, with the elbow bent and upper arm horizontal. Lean slightly forwards and rotate the body away from the wall until a stretch is felt in the chest and front of the ahoulder.

Posterior Shoulder Stretch

Bring the arm across the body at chest height and use the other hand to pull it in until a stretch is felt in teh back of the shoulder and the upper back.

Strengthening

Gentle strengthening exercises can be used to maintain the strength of the shoulder as much as possible. Isometric, or static exercises are the easiest to perform and will cause the least discomfort.

Isometric Abduction

This is performed standing sideways on to a wall, with the arm straight and by the side. The arm is pushed outwards, against the wall. Hold for 5-10 seconds, rest and repeat 5-10 times.

Isometric External Rotation

Again standing sideways on, with the elbow bent to 90 degrees and the upper arm by the side. The back of the wrist is pushed against the wall, as if trying to rotate the arm at the shoulder. Hold for 5-10 seconds, rest and repeat 5-10 times.

Isometric Internal Rotation

Standing face on to a corner such as a door frame, the elbow is bent and upper arm by the side. The front of the wrist is pushed against the wall, as if trying to rotate the shoulder so the forearm would move towards the stomach. Hold for 5-10 seconds, rest and repeat 5-10 times.