Most people are tired of being “lectured” or “shouted” at by Therapists of varying descriptions who claim to “fix” you; they can’t and you shouldn’t believe them. Therefore, here’s a little information on how you can try and help yourself, especially if you are suffering the debilitation that is a “Frozen Shoulder”. As always, if you’re not sure, ask a trusted professional before embarking on anything you feel hesitant or nervous about when starting some rehab; it’s vital to get the correct diagnosis on your own particular shoulder condition as there can be many ways it can be injured with “Frozen Shoulder” sometimes used in a throw-away and alarmist fashion.
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Frozen Shoulder (Adhesive Capsulitis)
Stretch and Strengthen
Heat application before starting exercise
Heat should be applied prior to exercise to prepare the tissues for stretching. Heat can be applied by
• Warm bath/shower
• Hot pack/moist heat
Apply heat to the affected shoulder for 15 minutes prior to the exercises. Place a small pillow beneath the shoulder so the shoulder is comfortable and the elbow is supported .
Begin with shoulder pendulums as a warm-up
• Bend from the waist, letting your arms hang down.
• Keep your arm and shoulder muscles relaxed.
• Allow your arm to swing forward to back, then side to side, then in small circles in each direction (no greater than 1 foot in any direction). Only minimal pain should be felt. perform 15-25 repetitions.
• Stretch the arm only initially (without added weight) for a week. Progress this exercise by adding 1 to 2 pounds (0.5 to 1 kg) each week and gradually increasing the diameter of the movements (not to exceed 18 to 24 inches or 45 to 60 cm ). Hold the stretch for 20 – 30 seconds.
• Do the exercise 3 times a day.
Range of motion exercise:
to increase flexibility and decrease pain
Wand exercises/Stick exercises
- Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
- Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
- External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
- Internal rotation: Stand with one arm behind your head holding the end of a stick. Put your other arm behind your back at waist level and grab the stick. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.
- Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
Scapular range of motion
• Stand and shrug your shoulders up and hold for 5 seconds.
• Then squeeze your shoulder blades back and together and hold 5 seconds.
• Next, pull your shoulder blades downward as if putting them in your back pocket. Relax.
• Repeat 10 times.
Wall Climb (forward flexion stretch)
• Face the wall. Stand about 18 inches from it.
• Place the fingertips of both hands against the wall and walk the fingers up the wall until you feel a stretch in your shoulders.
• Hold the stretch for 15-20 seconds. Repeat 10 times.
Wall Climb (abduction stretch)
• Turn sideways. Place the fingertips on the wall.
• Arm should be slightly toward the front of body, rather than straight out to the side (at about a 30 degree angle to the front of the body).
• Walk the fingers up the wall as high as they can go until you feel a stretch under the shoulder.
• Hold the stretch for 15-20 seconds.Repeat 10 times
Internal Rotation Stretch (sitting on a chair)
• Sit upright towards front of chair.
• Place involved hand behind your back. With uninvolved hand, grasp wrist of the involved arm and slide hands up your back. Hold for 5 seconds.
• Repeat 10 times. Hold position longer if tolerable.
Towel Stretch (to improve Internal Rotation)
• Place right hand behind back.
• With the left hand, dangle a towel behind the back.
• Grasp the towel with the right hand.
• Gently pull the right hand upward by raising the left arm to stretch the right shoulder.
• Towel should be in vertical position.
• Hold for 30 seconds. Repeat.
Cross-Arm Stretch/Posterior capsular stretch
• Bring your arm across your chest toward the opposite shoulder.
• With the opposite arm grasp your arm at your elbow.
• Gently pull arm across body to produce a stretch in the back of the shoulder. Hold stretch for 20-30 seconds. Repeat.
Note: If you feel a pinching sensation in the front of your shoulder, discontinue this stretch and use the Sleeper Stretch to accomplish a similar stretch for this portion of the shoulder.
• Lie on your dominant shoulder in a position you might adopt when sleeping on your side.
• Place your dominant arm directly in front of you, with the elbow bent 90 degrees.
• Using your other arm, push your hand down toward your feet, internally rotating your shoulder
• Hold for 20 to 30 seconds. Repeat.
Doorway stretch/Anterior Capsular Stretch/Pectoralis stretch
• Standing in a doorway with elbow straight, arm abducted to 90 degrees, grip object with hand.
• Place gentle pressure forward to create a gentle stretch to the front of the shoulder.
• Hold for 20-30 seconds. Repeat.
• Stand facing a wall (about 6 inches away from the wall).
• Raise your arm out to your side and place the thumb side of your hand against the wall (palm down).
• Keep your elbow straight. Rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps.
• Hold 15 seconds. Repeat
Overhead stretch/ Inferior Capsular Stretch
• Hold arm overhead with elbow bent and arm straight ahead.
• Using opposite arm stretch arm further overhead.
• Bring arm to point where gentle stretching sensation is felt.
• Hold for 20-30 seconds. Repeat.
Scapular Stabilisation Exercises
Shrug your shoulders, bringing them up towards your ears. Relax and repeat.
• Stand with arms at side.
• Move shoulders forward, shrug shoulders up, and move shoulders backward – squeezing shoulder blades together, pull shoulders downward. Repeat 5 times.
• Repeat shoulder roll 5 times in opposite direction – shoulders backward, shoulders up, shoulders forward, in one slow continuous circular motion.
Shoulder Blade Squeeze
• Stand /Sit. Pull shoulders down and back.
• Bend elbows at 90-degree angle. Pull elbows back, squeezing shoulder blades together.
• Hold for 10 seconds. Repeat 5 times
With your arms straight out in front of your, reach forward as far as possible. Relax and repeat.
Diagonal Shoulder Exercises
The following exercises use combined patterns of motion which is in our daily activities (i.e. fastening seatbelt, throwing a softball, etc.). Each exercise should be done with both your right and left arm. Keep your elbow straight and watch your hand as you do the exercise.
D1 Flexion/ Extension
• Start with your left arm out to the side with your palm facing behind you.
• Raise your arm up and across your chest with your thumb pointing toward the ceiling. Repeat.
D2 Flexion/ Extension
• Start with your left arm up and over your left shoulder with you palm facing you.
• Bring your left arm down across your body with your thumb
pointing towards your right hip. Repeat.
should be started after the scapular stabilization is achieved
Outward rotation exercise:
Hold your elbows at 90 degrees, close to your sides. Holding a towel between your torso and the inside of your elbow will cue you to keep your elbow by your side. Hold one end of a rubber band in each hand and rotate the affected lower arm outward two or three inches, holding for five seconds. Repeat 10 to 15 times.
Perform the exercise through all available pain-free ranges of motion. Keep the shoulder blades squeezed down and back while performing this exercise.
Inward rotation exercise:
Hold your elbow at 90 degrees, close to your side. Hook the rubber band onto a door handle and grasp with only one hand. Rotate your forearm towards the body two or three inches and hold for five seconds. The forearm swings like a door. Repeat 10 to 15 times.
Bend your elbow to 90 degrees. Place the rubber band near the elbows and lift your arms up four or five inches away from the body, holding for 5 seconds. Repeat 10 to 15 times.
Mild soreness can occur with these exercises. Sharp or severe pain may indicate some underlying problem. Stop these exercises for a few days if this occurs.