What is a Frozen Shoulder?

30 March 2023
By Brett Durney

If you’ve got a frozen shoulder, there’s every chance just holding your phone and scrolling is a painful experience – and that’s without thinking about how agonising it can be brushing your teeth or getting comfortable in bed.

At any one time, around 7% of adults in the UK have an issue with a shoulder joint. 7% might not sound like many – but in reality, it could be upwards of 3-4 million people – making shoulder issues officially a ‘significant cause’ of disability in the population.

So, what can we do about it?

As much as we wish we could – we can’t magic that shoulder pain away, and 4 million+ therapy sessions would take us a while to work through. In the meantime though, we can share some of our frozen shoulder knowledge – including:

  • How a frozen shoulder occurs
  • What’s going on inside your frozen shoulder
  • Some really important dos and don’ts if you’re developing frozen shoulder symptoms
  • An explanation of how to release a frozen shoulder for pain relief

Understanding a frozen shoulder

Frozen shoulder – or ‘adhesive capsulitis’ – is a common shoulder joint disorder that causes stiffness and pain, and can often limit the range of motion you have in your shoulder. In short – it’s really painful, and it stops you doing a lot of otherwise simple things.

Unfortunately, frozen shoulder tends to get worse if untreated – so even if you seek help from your doctor or GP, it’s essential that you know what’s going on in your shoulder, so you can take your own additional steps to make it better.

Your shoulder is an extremely complex joint

Part of the reason humans are so susceptible to shoulder injuries comes down to just how much is going on when you articulate your arms. The shoulder joint has a wider range of motion than any other part of your body – and more motion means there’s more to go wrong.

At the core of your shoulder, there’s a ball and socket joint called the ‘glenohumeral joint’ – which connects the top of the upper arm bone to part of your shoulder blade. This connection is made by a joint capsule – in this case, your shoulder joint capsule. This capsule is filled with a kind of lubricant that keeps things moving – and it’s surrounded by tendons, ligaments, and a kind of padding that cushions everything as you move. When it’s time to move your arm, this incredible structure pulls, pushes and twists thanks to a band of muscles and connections referred to as the ‘rotator cuff’.

As miraculous as our shoulder anatomy is, the sheer amount of connective tissue and variations of movement in our shoulders make them very susceptible to wear and tear, and trauma.

Okay, but what is the main cause of a frozen shoulder?!

We’ve gone into detail about shoulder muscles and shoulder movement because – quite honestly – there’s no ‘one thing’ that causes a frozen shoulder.

A physical therapist will explain that a frozen shoulder typically starts with an injury of some kind. Now, that could be something immediately noticeable like a fracture – but equally, it could be something that creeps up on you, like on-going inflammation of the soft connective tissues around the joints.

Either way, it’s the inflammation that generally causes the biggest problems. Incidentally, that’s exactly what the name ‘adhesive capsulitis‘ name means; ‘itis‘ is inflammation, ‘capsul‘ refers to the shoulder capsule, and adhesive means ‘stuck‘. So, if for some reason you want to look like a shoulder-mobility nerd, you’ve now got a bit of Latin in your toolkit.

Why does a bit of shoulder joint inflammation matter?

Inflammation isn’t always bad. When it’s working as it should, it fights infection, heals injuries, and generally protects the inflamed area. However, when inflammation is over-active or not given the chance to reduce, it can lead to a host of really serious issues, including Parkinson’s disease, cardiovascular disease, arthritis, and other life-limiting or life-shortening issues.

When it comes to shoulder injuries, inflammation is public enemy number one. Inflammation of the area causes the connective tissues surrounding your shoulder joint to thicken and contract – and as it does, it loses its natural capacity to stretch. With this tissue inflamed, it’ll hurt move your shoulder – but a lack of movement will lead to further tightening of the capsule. In extreme cases – if a rotator cuff tear has led to a frozen shoulder for instance – scar tissue can increase pain and stiffness even more.

How can you tell if you’ve got a frozen shoulder?

Chances are, you’ll effectively be able to diagnose your own frozen shoulder if you’re experiencing a lot of pain and limited movement in your arm.

For most people, the first sign is pain when you’re taking part in ordinarily pain-free tasks. If your shoulder becomes unusually sore or tight when you’re getting dressed, showering, brushing your teeth, exercising, driving, or lifting things from high shelves – it’s a good idea to explore your symptoms with a professional.

The different stages of a frozen shoulder

Most medical professionals talk about a frozen shoulder in terms of three different stages; they are:

Stage 1: The ‘freezing’ or painful stage

This is where the condition is most sore or worsening. If you pick up an injury, this stage can come on quickly – but more often than not, a frozen shoulder will get worse over the course of between 6 weeks to 9 months.

Stage 2: The ‘frozen’ or stiff stage

The second stage of the injury tends to be less painful – but instead is characterised by a reduced range of motion and stiffness. This stage can last between 6 and 9 months, depending on how much physical therapy you engage with.

Stage 3: The ‘unfreezing’ or ‘thawing’ stage

In the later stages of the condition, movement will become easier and pain reduces significantly. Although your range of motion will only gradually improve over 6 months to 2 years, the condition becomes far less life-limiting.

What should (and shouldn’t) you do if you’ve got a frozen shoulder?

One of the therapy team here at FitnessLab will be able to help to outline some specific treatment options alongside health information from your doctor – but generally, there are some definite frozen shoulder dos and don’ts:

✓ DO: Keep the shoulder moving as much as your pain will allow. Our therapists can provide some very light shoulder exercises to help.

✓ DO: Seek medical advice. Some people don’t like taking pain medications – but they can be exactly what’s needed to get natural movement back. Painkillers, anti-inflammatory medications, or steroid injections can make an immediate difference.

✓ DO: Consider a trip to the hospital for an x-ray or scan if the doctor or a therapist suggests it. The root cause could be a fracture or a torn muscle.

 DON’T: Push through the pain of your injury. This will often cause further inflammation and damage.

 DON’T: Take part in any tasks or exercises where the shoulder can be suddenly jerked or pulled.

Who can diagnose frozen shoulder?

Although they’re a very good place to start, your doctor won’t always be able to diagnose an exact shoulder problem. 

Instead, they’ll often refer you to a physiotherapist or osteopath who will work with you to see exactly what the problem is. A therapist will usually treat frozen shoulder problems in their clinic, then put together a home exercise program based around your symptoms. They may also direct you to further medical help if it’s required.

How do you unfreeze a frozen shoulder?

As people who’ve suffered at the hands of a shoulder injury, we know you’ve probably scrolled down to this point to see if we can offer a miracle cure.

Unfortunately, we can’t. But we can give you some tips that’ll put you on the road to recovery sooner rather than later:

Get medical and/or therapeutic help for your shoulder injury ASAP

Talk to a doctor about the pain you’re experiencing in the affected arm – the longer you hold off, the more inflammation and swelling can kick-in, limiting your range of motion and increasing pain.

Embrace the cold

Get an ice pack (or pack of peas) out of the freezer. Cold therapy can significantly reduce inflammation when used for 10-15 minutes 3-4 times across the course of the day.

Will your frozen shoulder need surgery?

It’s understandable that the idea of shoulder surgery might make you nervous – but don’t worry, surgical options are generally only explored if physical therapy isn’t showing any positive results. Often, a steroid injection is a good non-surgical intervention and can be done quickly and relatively painlessly as an outpatient.

Hoping to exercise around a frozen shoulder?

At FitnessLab, we appreciate that a frozen shoulder can cause pain and discomfort for months – and sometimes even years. However, we also appreciate that you don’t want to put a halt to staying fit and health while you get better.

This is exactly why our services revolve around you and any conditions you may be facing. Our expert team can put together fitness and therapy plans that work hand-in-hand to keep your fitness goals in sight without compromising your long-term health and well-being.

Contact Fitness Lab today to see how we can help

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