Does exercise really help frozen shoulder?

Key points in 30 seconds

1. Frozen shoulder tends to get better over time, but it takes years.
2. It goes through a painful stage, a stiffening stage, and a thawing stage, each with different things to do.
3. Forcing a stretch during the most painful stage actually makes it stiffer.
4. You can check the left-right difference by reaching both hands toward each other behind your back.
5. If it suddenly won't lift after an injury, or you have diabetes, a separate check is needed.

What we often hear

• "I heard frozen shoulder heals if you leave it alone. Is that true?"
• "I'm told to exercise, but it hurts too much."
• "When I force my arm up, it hurts more."

Does exercise really help frozen shoulder?

It helps. But it's not about doing the same exercise at any time; what you do changes completely depending on which stage you're in now.

Frozen shoulder is a condition that tends to get better on its own over time. That doesn't mean you should just wait and see. The process takes years, and how you get through that time affects the range of movement you're left with at the end.

In medicine, it's called "adhesive capsulitis." It means the capsule surrounding the shoulder stiffens and sticks.

How are the stages divided?

Frozen shoulder goes through three stages

1. The painful stage. The shoulder hurts deep inside, worse at night. It's hard to lift the arm yourself, but if someone else lifts it for you, it hurts but the range is there.
2. The stiffening stage. Pain at rest decreases, but now the arm won't go up even when someone else lifts it. The range of movement really starts to shrink.
3. The thawing stage. The pain decreases and the range comes back little by little. But a catching feeling at the very top often remains.

Going through these three stages takes several years in total. What to do is decided by which stage you're in now.

What's different at each stage?

In the painful stage, we don't force stretching; we treat the pain. From the stiffening stage, we start working on increasing the range in earnest.

If you force exercises that raise the arm during the most painful stage, it actually gets stiffer. At this time, we reduce the pain and move only enough to keep it from stiffening.

Once you enter the stiffening stage, it's the opposite. If you don't stretch here, that range stays as it is. A little every day, often, up to the point where it doesn't hurt, is better than one hard session.

Can I tell my current stage at home?

Reach one arm over your shoulder to touch your back, and the other arm around from below to touch your back. If the gap between your fingertips is much wider than on the other side, your range has decreased.

If you try both arms the same way in front of a mirror, the left-right difference becomes clear. Checking this difference now and then lets you see for yourself whether it's getting better or staying the same.

Is it enough to look only at the shoulder?

The shoulder alone usually doesn't loosen up well. When you raise your arm, not just the shoulder but also the neck, upper back, and chest move together.

While the shoulder is stiff, the body learns to move elsewhere instead. If that's left as it is, even when the shoulder loosens up, you won't use it as before. That's why we also look at the neck, upper back, and chest.

Are there cases where another doctor comes first?

Yes. When the arm suddenly won't go up after an injury, when you have diabetes or a thyroid condition, or when a problem from the neck overlaps.

A torn tendon can look similar but is a different condition and is handled differently. If you have diabetes, frozen shoulder tends to develop more easily and last longer, so that needs looking after too.

What are the limits of this assessment?

Because it's a condition that tends to get better over time, it's hard to tell whether improvement came from treatment or from time passing.

One more note. That's why we don't say, "We'll get you better quickly." What we aim to do is help you get through that period with less difficulty, and keep the range left at the end as wide as possible.

We measure your current angle before recommending exercise. Stretching without knowing how stiff it is only hurts and doesn't increase the range.

If stretching on your own hasn't changed anything, come in and get measured. We'll start with what you can do at your current angle.

Results differ from person to person depending on the stage and any accompanying conditions.