Frozen shoulder home exercise program
Frozen shoulder is a condition that causes pain and stiffness of the ball and socket joint of the shoulder. It is important to know the 4 stages of the disease so you can decide what treatment is best for you.
Stage 1: starts with pain, especially at night, especially at the top of the shoulder.
Stage 2: you start to develop stiffness. The pain continues to increase.
Stage 3: pain starts to decrease, but the stiffness continues.
Stage 4: the pain is virtually gone, and the stiffness starts to slowly loosen up.
Going through all 4 stages can take 18-30 months. The most important thing is to be patient and not push yourself. Studies have shown aggressive treatment of frozen shoulder leads to worse outcomes.1
All stretches should be done after heat is applied to the shoulder. The easiest way to do this is to apply hot water to the shoulder while in the shower. All exercises should be done daily.1
If you are in Stage 1:
Pendulum exercises only: lean over a table while standing up. Lean your good arm on the table to stabilize yourself. Let your frozen shoulder hang with gravity. Perform rotations, clockwise and counter-clockwise. Then swing the shoulder forward and backward and side-to-side. Do 20 repetitions in each direction.
If you are in Stage 2:
Add cane exercises: Hold a cane in both hands. Use your good hand to slowly and gently stretch your frozen shoulder in the following directions: arms in front of you and arms behind you. Next keep your elbow tucked into your body and push your hand away from your body and then pull your hand into the middle of your body. Finally, straighten your elbow and push your arm away from your body to the side. Perform each direction 3 sets of 10 repetitions.
If you are in Stage 3 or 4:
When there is less pain, be more aggressive about stretching your shoulder. Hold the stretches for longer (up to 5 seconds) and push them further. Please refer to the website and print out the rotator cuff tendinopathy protocol. Only perform these exercises if you can do so with minimal discomfort, otherwise you are likely not ready for them. They will help to further stretch and strengthen your shoulder.
Follow-up:
If you have severe, constant, and debilitating pain in stage 1 or 2, you may want to talk to your doctor about an x-ray guided steroid injection to help with the pain. The injections are not without risks and side effects, so the decision should be made with your doctor if it is the best course of action for you. The injections are for short term use only; only a very small difference is seen at 3 months and even smaller at one year.2 You should decide with your doctor how often it makes sense to be seen in follow-up. There are no specific recommendations, but checking with your doctor before progressing your exercises is generally a good idea.
1. Neviaser A, Hannafin JA. Adhesive Capsulitis : A Review of Current Treatment.
Am J Sports Med. 2010;38:2346-58.
2. Blanchard V, Barr S, Cerisola L. The effectiveness of corticosteroid injections compared with physiotherapeutic interventions for adhesive capusilitis: a systematic review. Physiotherapy. 2010;96:95-107.
