Is My Shoulder Frozen?

As a physical therapist I'm often asked how to tell if someone's shoulder pain and stiffness means they are getting (or have) a frozen shoulder. A frozen shoulder (or Adhesive Capsulitis) is a specific condition typically involving adhesions which form around the joint capsule. The joint capsule is simply a fibrous structure encasing shoulder joint.

This capsule can shrink with disuse of the shoulder, such as after long term immobilization after a fracture (called adaptive shortening) causing increased stiffness and pain with range of motion. This is not a true presentation of primary frozen shoulder. Primary frozen shoulder seems to appear without cause or warning, often presenting as painful shoulder motion at first, then progressing to increased stiffness.

The treatment of these two presentations differ (at least they should), because the type of exercise used for treating a primary frozen shoulder is different than treating simple adaptive shortening. In primary frozen shoulder the first motion lost is external rotation (reach back and touch the palm of your hand to the back of your head), followed by loss of abduction (raising your arm out to the side), then flexion (forward elevation of the arm overhead), and finally internal rotation (reach behind your back as if fastening a bra (or threading your belt if you're a male).

In addition, a primary frozen shoulder will be painful at night without movement of the arm/shoulder. In contrast, adaptive shortening does not follow this pattern of loss of motion as any direction can be stiff/painful. Also with adaptive shortening the shoulder does not typically hurt at rest.

So if or a love on is asking "Is my shoulder frozen" the you can follow the above descriptions to better decide which condition you may have. In any case you should get a formal diagnosis from a physician and seek treatment from qualified professionals. It's important to get specific treatment for frozen shoulder syndrome as the wrong exercise can actually delay healing and prolong symptoms.

An excellent program for treating frozen shoulder is designed by a physical therapist and covers specific exercises and the best frozen shoulder exercise strategies for this painful condition.