Frozen shoulder syndrome, also called adhesive capsulitis, can be a frustrating condition. It is characterized by pain and gradually diminishing shoulder range of motion over several months. This is followed by a period of unchanging shoulder stiffness. The cause of frozen shoulder syndrome is not completely understood, but the shoulder joint becomes inflamed, and scar tissue limits mobility. Range of motion eventually improves in most cases; however, it can take up to 2 years, and the condition may not resolve completely. There are many methods for treating frozen shoulder syndrome, but stretching exercises can play an important role.
In general, mild to moderate shoulder stretches are more beneficial for a frozen shoulder than intense stretches. Overstretching is often very painful and can aggravate an already limited shoulder. Stretches are typically held for 10 to 30 seconds. According to a study published in October 2000 in the "Journal of Bone and Joint Surgery," these stretches should be performed 5 times per day. However, your doctor and physical therapist will design an individualized regimen for you, so follow their instructions.
Forward and Overhead Stretch
The forward and overhead stretch focuses on improving shoulder flexion, which is the motion used to lift the arm forward in front of your body and over your head. The stretch is performed lying on your back. The unaffected arm is used to raise the affected arm straight in front of your body and overhead until a moderate stretch is felt.
Outward Rotation Stretch
The outward rotation stretch focuses on improving shoulder external rotation -- the motion used to twist your arm outward from your body. This motion is needed to perform many daily tasks, like washing your hair or putting on a seat belt. The stretch is performed lying on your back with the affected elbow situated against the side of the body and bent into an "L" position. A dowel, broom or cane is used to push the affected arm’s palm away from the body. The affected elbow stays against the side of the body.
Inward Rotation Stretch
The inward rotation stretch focuses on improving shoulder internal rotation, the motion used to twist the arm inward toward the body. This motion is needed to perform tasks like clasping a bra, putting on a belt or scratching your back. The stretch is performed in a standing position. The affected arm reaches behind the body. The unaffected hand is then used to push on the affected elbow or forearm to further the motion up the back.
The across-the-body stretch involves improving shoulder horizontal adduction, the motion used to reach across your body. This motion is needed to perform tasks like putting on deodorant. The stretch is performed while lying on your back. The affected arm attempts to reach across the body toward the other shoulder. The unaffected arm is then used to push against the elbow of the affected arm to further the stretch.
These shoulder stretches can help improve range of motion in a frozen shoulder, though stretching exercises are just one method of treatment. Your physical therapist may also use manual techniques to help break up scar tissue. In addition, an August 2014 "Cochrane Database of Systematic Reviews" article notes that steroid injections can play an important role in diminishing pain and improving range of motion for people with frozen shoulder syndrome. If conservative treatments fail, surgery may be recommended.
Warnings and Precautions
Alert your doctor if you experience continued loss of shoulder range of motion, as this could be a sign of a more serious condition. If you experience fever, shoulder swelling, or worsening pain or weakness in the affected arm, contact your doctor right away.
- Journal of Orthopedic and Sports Physical Therapy: Shoulder Pain and Mobility Deficits: Adhesive Capsulitis
- Journal of Bone and Joint Surgery: Idiopathic Adhesive Capsulitis: A Prospective Functional Outcome Study of Nonoperative Treatment
- Cochrane Database of Systematic Reviews: Manual Therapy and Exercise for Adhesive Capsulitis (Frozen Shoulder)
- Massachusetts General Hospital Sports Medicine: Frozen Shoulder
- Clinical Orthopaedic Rehabilitation: An Evidence-Based Approach, 3rd Edition; S. Brent Brotzman and Robert C. Manske