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[Patient Adviser]

Exercising the Frozen Shoulder

Rick Sandor, MD; Scott Brone, PT, CSCS


Frozen shoulder (also called adhesive capsulitis) results from shrinking and scarring of a previously normal joint. It involves significant shoulder pain and loss of movement. The pain can last from weeks to many months. Loss of movement can last months to years. Fortunately, you can take steps to control the pain and regain motion.

Frozen shoulder can occur in many situations, including shoulder injury, diabetes, thyroid problems, and heart or lung conditions. But usually the cause is unknown.

Controlling the Pain

Pain control is only required if the pain interferes with sleep or daily activities. The easiest method is applying ice packs to the shoulder for 20 to 30 minutes at a time. Higher levels of pain may require cortisone shots or medication prescribed by your doctor.

Pain control also means avoiding shoulder motions or positions that are painful. Such motions include activities that raise the arm to the side or rotate the arm outward. Daily activities that might aggravate the pain include reaching overhead, reaching into the back seat of a car, trying to open a heavy door, and driving a car. Some experts believe that trying to push through painful activities can actually prolong the course of the disease.

Once you identify your own particular set of aggravating activities, try to find other ways to do them. For example, open the heavy door with both hands or push the door open with your buttocks. When driving, don't hold your hands near the top of the steering wheel. If your right shoulder is affected, avoid using a car that has a manual transmission. For activities in which you reach overhead, stop doing them, use the other arm, or use a step stool or ladder.

Beginning exercises. The following exercises may help improve shoulder motion. Begin with the pendulum exercises (figure 1). When these can be done comfortably, try the table crawls (figure 2).

[Figure 1]

[Figure 2]

Advanced exercises. The more advanced exercises are supine wand flexes (figure 3), use of pulleys (figure 4), standing wand flexes (figure 5), and standing wand abduction (figure 6). Each exercise should be done 10 to 15 times, followed by a rest and 10 to 15 more repetitions (two sets). It is probably not necessary to do all four advanced exercises. Choose the two that cause no increase in pain and feel the most challenging.

[Figure 3]

[Figure 4]

[Figure 5]

[Figure 6]

When you have progressed to the advanced exercises, it is no longer necessary to do the pendulums or table crawls. Exercises should be done every day, but it is important to remember to be patient. Adhesive capsulitis almost always resolves completely, though it may take months or even years to do so.

This exercise program should be done with caution. Do not push through pain. If symptoms increase, contact your physician.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Sandor is a medical orthopedist with Camino Medical Group in Sunnyvale, California. Mr Brone is a physical therapist with P.O.W.E.R. Physical Therapy, Inc, in Mountain View, California.