Common Conditions

Frozen Shoulder

Types, Symptoms and Treatments

Understanding Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. It occurs when the capsule surrounding the shoulder joint thickens and tightens, due to reduced synovial fluid and increasing scar tissue formation during natural aging process, resulting in movement restriction. People with frozen shoulder may have pain and stiffness over the shoulder region for several months or even years. The condition typically develops gradually and progresses through three stages: the freezing stage, frozen stage, and thawing stage.

Frozen shoulder is more common in individuals aged 40-60 and is frequently associated with diabetes, prolonged immobility, or previous shoulder injuries.

Symptoms of Frozen Shoulder

There are typically three stages in frozen shoulder people with different symptoms. Each of the stage may last for six to nine months, or even longer in severe cases:

Freezing Stage (Painful Stage):

Persistent pain in the shoulder, especially at night
Increasing stiffness with progressive loss of movement
Symptoms last from weeks to several months

Frozen Stage (Stiff Stage):

Reduced pain, but significant restriction in shoulder movement
Difficulty with overhead and rotational movements
Symptoms last between 4 to 12 months

Thawing Stage (Recovery Stage):

Gradual improvement in shoulder mobility
Slow return to normal function
Full recovery may take months to years

Causes and Risk Factors

The exact cause of frozen shoulder is not fully understood, but the following factors increase the risk:

Age & Gender: Most common in individuals aged 40-60, with a higher prevalence in women
Diabetes: Increased risk due to changes in connective tissue and inflammation
Prolonged Immobilization: Shoulder injuries, post-surgical immobilisation, or extended periods of inactivity can lead to stiffness
Other Medical Conditions: Thyroid disorders, cardiovascular diseases, and Parkinson’s disease are associated with frozen shoulder

Assessment and Treatment

Consulting a healthcare professional is vital for accurate diagnosis and effective recovery from frozen shoulder. Our experienced therapists will conduct a thorough physical examination to check your range of motion and evaluate your medical history.

Treatment options may include:

Manual Therapy

Physiotherapists utilize various manual therapy techniques, including passive joint mobilization and soft tissue release, to enhance joint mobility and reduce stiffness. Targeted mobilization of the shoulder joint and scapula helps improve overall movement and alleviate muscle tightness.

Advanced Modalities

In severe cases, patients may experience intense shoulder pain that significantly impacts their quality of life. Physiotherapists utilize various pain relief methods, such as ultrasound therapy, interferential therapy, and cryotherapy, to alleviate pain in inflamed tissues. Additionally, shockwave therapy is used to break down adhesions and accelerate tissue healing for better pain management.

Dry Needling & Acupuncture

Dry needling therapy is effective in relaxing tense muscles and promoting blood circulation, by inserting needles into specific muscle or fascia points, this technique helps reduce muscle tension, enhances blood flow, and alleviates shoulder pain and discomfort. For patients with frozen shoulder, dry needling therapy can assist in restoring the range of motion, improving shoulder flexibility, and promoting the repair of damaged tissues.

Exercise Therapy

Exercise therapy is essential in the recovery process, and we strongly recommend that patients begin shoulder strengthening exercises as soon as the pain is tolerable to prevent reinjury. Additionally, joint mobility exercises help restore shoulder movement, while stretching exercises maintain joint flexibility.

Self tests for examining for frozen shoulder

There is no specific medical test for frozen shoulder yet. Instead, due to the capsular pattern of shoulder joint, people with frozen shoulder would have limitation in shoulder abduction, internal rotation and external rotation. Here are two simple self tests:

Shoulder Abduction: sit straight on a chair, elevate your shoulder sideway (Abduction)
Shoulder internal and external rotation: lying on a bed with arm abducted 90 degree. Gradually rotating your shoulder internally and externally

If you cannot abduct > 90 degree, internal rotate > 20 degree, external rotate > 30 degree, there is a high chance that you are suffering from a frozen shoulder

Frequently Asked Questions

Does frozen shoulder always require physiotherapy??

Yes, if frozen shoulder is not treated, it could lead to long-term shoulder mobility issues. Treatment can help alleviate symptoms, reduce pain, and restore the range of motion in the shoulder.

Can frozen shoulder heal on its own?

Yes, but recovery can take months to years. Physiotherapy helps accelerate recovery and prevent long-term stiffness.

When should i seek for physiotherapy?

Early intervention is recommended to manage pain and prevent worsening stiffness. If you experience persistent shoulder pain or difficulty moving your arm, seeking physiotherapy can help restore function.

Can frozen shoulder recur?

While recurrence in the same shoulder is rare, there is a risk of developing frozen shoulder in the opposite shoulder in some individuals.

Testimonials & Reviews

Excellent service. The physiotherapists are very professional, easy to communicate with and also give clear instructions on some home exercises that can help ease my pain.

As a stay at home mom, I need a lot of strength on my daily routine and whenever I have any pain and problems I go to Avery for therapies and he is always helpful and caring Highly recommended!

Samantha Lee

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I had never been a believer in physio therapy in the past or that my experience with multiple chain medical physiotherapy center had brought me nothing but temporary improvements. Until I had came across mobilize physiotherapy where they take the extra mile to examine your situation and tailor a physiotherapy session. The physiotherapists at Mobilize not only identifies the root cause and provide massages for pain relievers but also to provide take home exercises for improvements. I was never rush out the door for the next session and they ensure that I had receive the right treatment before the session ends.
I would highly recommend this physiotherapy center.

Edmond Chan

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I went to MOBILIZE while on holiday here in Hong Kong, visiting from the UK and had an excellent experience. The physio Will was empathetic and incredibly thorough - more so than any physio I’d met with back home. As opposed to only providing me with temporary relief, there was genuine interest to get to the bottom of the back/neck issues I’d been suffering with for a number of years.

I can’t thank Will and the MOBILIZE staff enough for booking me in for multiple appointments on such short notice, giving me some relief from my pain and, most impressively, exercises/stretches that can hopefully provide a permanent fix.

William Burdett

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passionate, precise and comprehensive physiotherapy service, highly recommended for sudden onset or prolonged pain with unknown reason.

Sam Sam

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I can't recommend my physio partner enough! They are always patient and provide valuable guidance to help me relieve chronic pain and improve my performance in jiu-jitsu. Their expertise has been invaluable to me. Highly recommended!

Felix Kung

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Nice and patient physiotherapy place, went the extra mile and even taught me a few exercises to work on it myself!

Hogan Lam

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