Frozen shoulder exercises including mobility, stretching and strengthening with information on which stage of frozen shoulder might be appropriate.
The following exercises focus on mobility. They are important in the early stages of frozen shoulder rehabilitation and should be done regularly every day. They may be uncomfortable but should not be painful.
Pendulum swinging of the arm is a great exercise for frozen shoulder and a gentle 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.
Pole or wand exercises are a useful way of increasing the range of motion at the shoulder. Using a long object such as a broom handle held in both hands, the affected shoulder is taken out to the side as far as possible. Apply pressure using the good arm and broomstick to try to push it a bit further. Hold for 10 seconds and try to push a bit further again. This can be done in a number of positions.
Mobilizations by a trainer or therapist are usually more effective than just exercises alone. A physical therapist will mobilize the shoulder at its end range of movement. Exercises should only be done by experienced therapists.
One method involves 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.
Another technique is the same as 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/mobilization can be applied. The therapist will usually judge this from the expression/reaction on the athlete’s face.
Frozen shoulder stretching exercises
The following exercises continue on from mobility exercises and focus on frozen shoulder stretching exercises.
Stretching exercises can be performed during the freezing phase and the frozen phase but only if they can be done pain-free. Unlike pendulum mobility exercises they should not be uncomfortable to perform.
Shoulder flexion stretch
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
The shoulder is rotated externally when it is rotated outwards. This can be achieved in a number of positions. The image above shows a therapist-assisted external rotation stretch with the arm out to the side and rotated outwards.
Another method is to 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.
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 shoulder. If the arm is kept straight whilst performing this exercise then more of the stretch will be applied to the shoulder rather than the chest.
Posterior Shoulder Stretch
This exercise stretches the back of the shoulder. Bring the arm across the body at chest height and use the other hand to pull it in until a stretch is felt in the back of the shoulder and the upper back.
Frozen shoulder 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.
Strengthening exercises should be performed when pain allows. Initially, static exercises performed against an immovable resistance can be done. We also cover shoulder blade stabilizing exercises which should be included in all shoulder rehabilitation programs.
Isometric shoulder exercises
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.
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.
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.
With any shoulder injury, it is important to try to maintain good posture throughout, as bad posture is a key contributor to shoulder injuries. When the shoulder is in pain, we have a tendency to hunch over and allow the shoulder to slip forwards. This can be prevented with stretching exercises for the chest and strengthening for the upper back muscles around the shoulder blade. A simple upper back taping technique can also encourage correct posture.
Start with the arms by the sides and the shoulders relaxed (dropped away from the ears!). Squeeze the shoulder blades together and down the back. Hold for 5 seconds, rest and repeat. Begin with three sets of 10 repetitions daily.
Hands up exercise
This exercise works the muscles at the back of the shoulder and the shoulder blade. Start with the arms by the sides and shoulders relaxed as above. Bend the elbows and bring the arms up, rotating the shoulders, until the palms face forwards as if surrendering! As you do this, squeeze the shoulder blades together, gradually increasing the movement.