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

• 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.

Mobilising exercises

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.

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.

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.

1. 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.
   
   
2. Also, kneel on all fours and keeping the hands in the same spot, lower your buttocks towards your heels (image 2). 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.
   
   
3. 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 (image 3). Hold for 10 seconds and try to push a bit further again. This can be done into most positions.
   
   
4. 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.

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 on the right.