Phases of Frozen Shoulder

• Freezing Phase: Pain gradually increases, and range of motion starts to decrease.

• Frozen Phase: Pain may reduce, but stiffness is prominent, and movement is severely limited.

• Thawing Phase: Gradual improvement in range of motion and function.

Goals of Physiotherapy

• Reduce pain and inflammation

• Restore normal range of motion (ROM)

• Strengthen surrounding shoulder muscles

• Improve functional activities

Physiotherapy Treatments

1. Pain Relief Techniques

• Heat Therapy: Moist heat packs to relax muscles and improve blood flow.

• Cold Therapy: Ice packs to reduce inflammation during acute pain.

• Transcutaneous Electrical Nerve Stimulation (TENS): Helps in pain modulation.

2. Stretching and Range of Motion Exercises

• Pendulum Exercises: Gentle swinging of the arm to maintain mobility.

• Passive ROM Exercises: Therapist moves the arm gently to stretch the capsule.

• Active Assisted ROM Exercises: Using the other arm or tools to assist movement.

• Wall Climbing (Finger Walk): Walking fingers up the wall to gradually increase flexion.

• Cross-body Stretch: Stretching the affected arm across the chest.

• External Rotation Stretch: Using a stick or towel to gently rotate outward.

3. Strengthening Exercises

Once pain decreases and mobility improves:

• Rotator Cuff Strengthening: Internal and external rotation with light resistance.

• Scapular Stabilization Exercises: Strengthening the muscles around the shoulder blade.

• TheraBand Exercises: Gradual resistance exercises to improve strength.

4. Joint Mobilization Techniques

• Performed by a physiotherapist to loosen the stiff shoulder joint capsule.

• Techniques include anterior, posterior, and inferior glides to improve movement.

5. Postural and Functional Training

• Correct posture to prevent secondary shoulder problems.

• Training for daily activities to regain functional independence.

Frequency and Duration

• Typically, physiotherapy sessions are 2–5 times per week initially.

• Home exercise programs are essential for maintaining gains.

• Full recovery may take 3–12 months depending on the severity and compliance.