Frozen shoulder is a chronic condition of the shoulder, which causes severe stiffness of the joint. The medical term is known as adhesive capsulitis and can last for up to 2 years (Brealey et al., 2017).
Little is still known about why this condition occurs, however you are at a higher risk if you have one of the following:
- You have had an injury or surgery which prevented you from moving your shoulder properly
- A thyroid disorder
Step 1 – Assessment
The first step in treating frozen shoulder is to get a thorough assessment from your sports therapist. They will then decide as to whether frozen shoulder is a consideration. Following this, a trip to your GP is required to rule out any thyroid condition or diabetes. Your therapist/GP is then likely to send you for an x-ray to confirm the diagnosis and rule out any serious pathology.
Step 2 – Strengthening (eccentric strengthen to lengthen)
Once the above have been ruled out and you have been diagnosed with frozen shoulder, the current research (O’Sullivan 2012) indicates that eccentric strengthening is the best method for treatment.
Eccentric strengthening is when muscles are loaded, causing them to contract whilst going through the lengthening process.
The aim of this exercise is to increase the shoulders range of movement, which has been severely reduced and help lower pain levels.
Below are 2 examples of how you might eccentrically load your shoulder in external rotation (image 1) and also in internal rotation (image 2).
Image 2: Please follow the instructions as per video 2 below to help improve your internal rotation.
Exercise 1: Eccentrically lengthening the shoulder to improve external rotation.
Lay on the floor with your arm either by your side or at 90 degrees. Have the weight in an upright position and slowly lower the weight until you either experience pain or the weight touches the floor. Consider taking 4-5 seconds for this to occur. Slowly bring the weight back to an upright position. This is 1 repetition.
Exercise 2: Eccentrically lengthening the shoulder to improve internal rotation.
Assume the same position demonstrated in the video. Have your elbow resting on your knee and holding the weight. The weight starts in the upright position as you slowly lower the weight until you either experience pain or you have reached your end of range. Slowly pull the weight back to an upright position. This is 1 repetition.
Step 3: How many reps and sets do I perform?
Aim to perform 12 reps initially, for 3 sets with a 2 minute rest between each set. Perform everyday up to your tolerance limit. Depending on your pain level, use between a 2kg and 5kg weight.
First and foremost, get your shoulder assessed by a professional. Then, exclude any medical issue by following up the assessment with your GP. Finally, include the above exercises in your daily routine if safe.
A quick note: The above exercises are generic and not applied on an individual basis. If you have any questions regarding your shoulder pain, then please feel free to get in touch or book online here.
Brealey et al. (2017) ‘United Kingdom Frozen Shoulder Trial (UK FROST), multi-centre, randomised, 12 month, parallel group, superiority study to compare the clinical and cost-effectiveness of Early Structured Physiotherapy versus manipulation under anaesthesia versus arthroscopic capsular release for patients referred to secondary care with a primary frozen shoulder: study protocol for a randomised controlled trial’ 18:614 Open access (ONLINE) Available at: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-2352-2(Accessed 29/6/2018)
O’Sullivan K (2012) The effects of eccentric training on lower limb flexibility: A systematic review. Br J Sports Med. Sep;46(12):838-45