13/08/2025
๐๐ง๐ค๐ฏ๐๐ฃ ๐๐๐ค๐ช๐ก๐๐๐ง ๐๐ฉ๐๐๐๐จ
Frozen shoulder, or adhesive capsulitis, is a condition marked by progressive pain and stiffness of the shoulder joint due to inflammation and thickening of the joint capsule. It typically progresses through three distinct stages, each with characteristic symptoms and duration.
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๐๐ฉ๐๐๐ 1: Freezing Stage (Painful Phase)
โขDuration: 6 weeks to 9 months
โขKey Features:
-Gradual onset of pain โ often worse at night and with movement.
-Progressive loss of shoulder motion, especially external rotation.
-Pain is deep, dull, and constant in nature.
-Activities like reaching overhead, behind the back, or lifting objects become painful.
-Muscle guarding due to pain leads to decreased range of motion.
๐๐๐ฎ๐จ๐๐ค๐ก๐ค๐๐๐๐๐ก ๐๐ญ๐ฅ๐ก๐๐ฃ๐๐ฉ๐๐ค๐ฃ
-Synovial inflammation begins.
-The capsule starts to thicken and lose pliability.
-Adhesions start forming inside the joint capsule.
๐๐๐ฎ๐จ๐๐ค๐ฉ๐๐๐ง๐๐ฅ๐ฎ ๐๐ค๐๐ช๐จ
-Pain management (ice, heat, TENS, gentle joint mobilization).
-Education to avoid overuse but prevent complete immobility.
-Maintain as much ROM as possible with gentle active-assisted movements.
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๐๐ฉ๐๐๐ 2: Frozen Stage (Adhesive/ Stiffening Phase)
โขDuration: 4 to 12 months
โขKey Features
-Stiffness becomes the main symptom; pain may reduce but persists at end ranges.
-Major restrictions in active and passive movements.
-Activities of daily living become very limited.
-The joint feels hard to move despite reduced pain.
๐๐๐ฎ๐จ๐๐ค๐ก๐ค๐๐๐๐๐ก ๐๐ญ๐ฅ๐ก๐๐ฃ๐๐ฉ๐๐ค๐ฃ
-The capsule becomes thicker and more fibrotic.
-Adhesions become dense and restrict normal gliding.
-Synovial inflammation reduces, but tightness increases.
๐๐๐ฎ๐จ๐๐ค๐ฉ๐๐๐ง๐๐ฅ๐ฎ ๐๐ค๐๐ช๐จ
-Emphasis shifts to mobilization and stretching.
-Grade III and IV joint mobilizations (posterior glide, inferior glide).
-Heat therapy before mobilization.
-Pendulum exercises, wall climbing, wand exercises to maintain mobility.
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๐๐ฉ๐๐๐ 3: Thawing Stage (Recovery Phase)
โขDuration: 6 months to 2 years
โขKey Features:
-Gradual improvement in range of motion.
-Minimal or no pain.
-Stiffness starts to resolve slowly.
-Function begins to return.
๐๐๐ฎ๐จ๐๐ค๐ก๐ค๐๐๐๐๐ก ๐๐ญ๐ฅ๐ก๐๐ฃ๐๐ฉ๐๐ค๐ฃ
-Capsular remodeling occurs.
-Adhesions soften and stretch.
-Inflammation is resolved.
๐๐๐ฎ๐จ๐๐ค๐ฉ๐๐๐ง๐๐ฅ๐ฎ ๐๐ค๐๐ช๐จ
-Continue aggressive stretching and functional strengthening.
-Encourage full active range exercises.
-Use resistance bands, pulley systems, functional task training.
-Restore strength and proprioception of rotator cuff and scapular muscles.
Doctor of physical therapy