Frozen Shoulder: The Three Stages and Recovery Timeline

You can't reach the top shelf, fasten your bra, tuck in your shirt or sleep on that side. The shoulder aches at night and gets stiffer every week. This is the typical story of frozen shoulder, also called adhesive capsulitis.

What it is

The capsule, the tough lining around the shoulder joint, becomes inflamed, thickened and tight. Movement is lost in every direction, especially turning the arm outwards.

It is most common between ages 40 and 60, more common in women, and much more common in people with diabetes or thyroid problems. It can also follow a period of keeping the arm still, such as after an injury or surgery.

The three stages

1. Freezing (painful) stage, roughly 2 to 9 months Pain is the main problem, often worse at night. Movement gradually reduces.

2. Frozen (stiff) stage, roughly 4 to 12 months Pain often eases, but stiffness is at its worst.

3. Thawing stage, roughly 6 months to 2 years Movement slowly returns.

These times vary a lot. Overall, many people recover in 1 to 3 years, and some are left with mild long-term stiffness.

Treatment depends on the stage

In the painful stage, the aim is to calm pain without aggravating it:

• Gentle movement within comfort, not forceful stretching
• Pain relief, heat and positioning for sleep
• A steroid injection, discussed with your doctor, can help pain in this stage

In the stiff and thawing stages, the aim is to regain movement:

• Progressive stretching and mobilisation
• Strengthening once movement improves
• Manual therapy to help the capsule loosen

Simple exercises

1. Pendulum: lean forward with your good hand on a table, let the affected arm hang and gently swing it in small circles.
2. Table slides: sit at a table, slide your hand forward on a towel as far as comfortable.
3. Stick-assisted rotation: hold a stick in both hands, elbows by your sides, use the good arm to push the affected hand outwards.
4. Wall walking: walk your fingers up a wall, a little higher each week.

Sleeping with frozen shoulder

Try lying on your back with a pillow under the affected arm, or on the good side hugging a pillow.

Don't force it

Aggressive stretching in the painful stage can make things worse. Your physiotherapist will judge how hard to push based on your stage.

It's not always frozen shoulder

Rotator cuff problems and impingement can also cause shoulder pain and stiffness, but they're treated differently. A proper assessment matters.