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Home » Anatomy » Physical Therapy Treatment for Frozen Shoulder: A Guide to Exercises, Stretches, and Manual Therapy

Physical Therapy Treatment for Frozen Shoulder: A Guide to Exercises, Stretches, and Manual Therapy

In this article, we will discuss Physical therapy treatment for frozen shoulder. It helps to improve range of motion, reduce stiffness, and alleviate pain. It is the first choice of treatment for frozen shoulder. If it fails to treat the condition than doctors recommend surgery. The adhesive capsulitis physical therapy treatment plan will depend on the severity of the condition, causes, symptoms and medical history. Following are the exercises with proposed sets and repetitions for patients:

Frozen shoulder Range of motion exercises

Range of motion exercises are a type of physical therapy exercise that improve flexibility and reduce stiffness. These exercises may be perform passively or actively, depending on the patients capacity and the severity of the frozen shoulder. Here are some common range of motion exercises for adhesive capsulitis:

Pendulum exercise

Patient me standing or sitting with their effected arm hanging by the side of table. This exercise involves gently swinging the arm back and forth, side to side, and in a circular motion to help improve flexibility and reduce stiffness in the shoulder joint. this exercise is also helpful in reducing pain.

Sets and repetitions

Perform 10-15 repetitions for each direction (forward and backward, side to side, and circular motion) for 1-2 sets.

 Wall crawl

This exercise involves standing in front of a wall and “crawling” the fingers up the wall, using the arm to reach as high as possible. This can help improve range of motion in the shoulder joint.

Sets and repetitions

Perform 10-15 repetitions, reaching as high as possible, for 1-2 sets.

Towel stretch

Patient perform this exercise by  holding a towel behind the back with one hand and pulling it up with the other hand.

Sets and repetitions

Hold the stretch for 10-30 seconds and repeat 3-5 times.

Cross-body stretch

This exercise is perform using one arm to pull the other arm across the body, improving range of motion.

Sets and repetitions

Hold the stretch for 10-30 seconds and repeat 3-5 times on each side.

External rotation stretch

External rotation ROM exercises  involves using a resistance band or towel to gently stretch the shoulder joint in an external rotation, improving flexibility and reducing stiffness.

Sets and repetitions

Hold the stretch for 10-30 seconds and repeat 3-5 times on each side.

Stretching exercises for adhesive capsulitis

Stretching exercises can be an effective physical therapy treatment for adhesive capsulitis. Here are some common stretching exercises for frozen shoulder, along with details on how to perform them and the recommended amount of repetitions and sets:

Sleeper stretch

Lie on your side with the affected shoulder on top. Bend your elbow to 90 degrees and rest your forearm on your chest. Use your other hand to gently push your forearm toward the ground until you feel a stretch in your shoulder.

Sets and repetitions

Hold the stretch for 15-30 seconds and repeat 3-5 times on each side.

Cross-body stretch

Use your unaffected arm to pull your affected arm across your body, stretching the shoulder.

Sets and repetitions

Hold the stretch for 15-30 seconds and repeat 3-5 times on each side.

Chest stretch

Stand facing a corner with your hands on the wall at shoulder height. Step forward with one foot and lean forward, stretching the chest muscles and shoulder joint.

Sets and repetitions

Hold the stretch for 15-30 seconds and repeat 3-5 times.

 Doorway stretch

Stand in a doorway with your affected arm raised to shoulder height and your elbow bent to 90 degrees. Place your hand on the door frame and gently lean forward, stretching the shoulder joint.

Sets and repetitions

Hold the stretch for 15-30 seconds and repeat 3-5 times.

Arm circles

Stand with your arms at your sides and slowly make circles with your affected arm, first forward and then backward. Start with small circles and gradually increase the size.

Sets and repetitions

Perform 10-15 repetitions in each direction for 1-2 sets.

Strengthening exercises for frozen shoulder

Strengthening exercises can be an effective treatment for frozen shoulder by helping to build up the muscles around the joint and improving stability. Here are some common strengthening exercises for frozen shoulder, along with details on how to perform them and the recommended amount of repetitions and sets:

Shoulder blade squeeze

Sit or stand with your arms at your sides. Squeeze your shoulder blades together and hold for 5-10 seconds before releasing.

Sets and repetitions

Perform 10-15 repetitions for 1-2 sets.

Scapular retraction

Stand with your arms at your sides and your palms facing forward. Pull your shoulders back and down, squeezing your shoulder blades together. Hold for 5-10 seconds before releasing.

Sets and repetitions

Perform 10-15 repetitions for 1-2 sets.

Shoulder external rotation

Stand with your affected arm against a wall, elbow bent to 90 degrees and palm facing up. Use a resistance band or light weight to externally rotate your shoulder, keeping your elbow against the wall.

Sets and repetitions

Perform 10-15 repetitions for 1-2 sets.

Shoulder internal rotation

Stand with your affected arm against a wall, elbow bent to 90 degrees and palm facing down. Use a resistance band or light weight to internally rotate your shoulder, keeping your elbow against the wall.

Sets and repetitions

Perform 10-15 repetitions for 1-2 sets.

Shoulder flexion

Stand or sit with your arms at your sides. Slowly raise your affected arm in front of you to shoulder height, keeping your elbow straight. Hold for 5-10 seconds before lowering.

Sets and repetitions

Perform 10-15 repetitions for 1-2 sets.

Adhesive capsulitis Manual therapy treartment

Manual therapy help improve joint mobility and reduce pain in frozen shoulder . Here are some common manual therapy exercises for frozen shoulder, along with details on how to perform them and the recommended amount of repetitions and sets:

Joint mobilization

A physical therapist will use their hands to gently move affected shoulder joint through a range of motions. Joint mobilization techniques for external rotation and flexion in frozen shoulder can help to improve range of motion and reduce pain in the affected shoulder joint. Here are some commonly used techniques:

Supine external rotation mobilization:

Therapist position

standing or sitting on the affected side

Patient position

Supine lying

Procedure

The patient lies on their back, with the affected shoulder just not touching the treatment table and the physical therapist gently rotates the arm externally, providing support at the elbow and wrist. The therapist may apply gentle pressure in the anterior or upward direction  according to the kaltenborn convex concave rule to the shoulder joint to increase the range of motion gradually.

Seated external rotation mobilization:

Therapist position

Standing or sitting on the affected side

Patient position

Sitting

Procedure

The patient sits with their arm resting on a table or armrest, and the physical therapist gently rotates the arm externally. The therapist may use their other hand to provide additional support to the elbow or wrist. The therapist may apply gentle pressure in the anterior direction according to the kaltenborn convex concave rule.

Supine flexion mobilization

Therapist position

Standing or sitting on the affected side

Patient position

Supine lying

Procedure

The patient lies on their back, and the physical therapist gently lifts the arm overhead, traction force is applied. The therapist may apply gentle pressure in posterior or downward direction to the shoulder joint to increase the range of motion gradually.

Seated flexion mobilization

Therapist position

Standing or sitting on the affected side

Patient position

Sitting

Procedure

The patient sits with their arm resting on a table or armrest, and the physical therapist gently lifts the arm overhead. Traction force is applied to shoulder joint. The therapist may apply gentle pressure in posterior direction to the shoulder joint in accordance with kaltenborn convex concave rule.

Soft tissue massage

A physical therapist will use their hands to apply pressure to the muscles and soft tissues around the affected shoulder joint, helping to reduce tension and improve blood flow.

Heat and cold therapy

Heat Therapy

  • Apply a warm compress or heating pad to the affected shoulder for 15-20 minutes at a time.
  • Use a temperature that is comfortable and not too hot to avoid burns.
  • Heat therapy can be repeated 2-3 times a day or as needed.
  • This can help to increase blood flow to the area, relax muscles, and reduce stiffness.

Cold Therapy

  • Apply a cold compress or ice pack to the affected shoulder for 15-20 minutes at a time.
  • Use a cloth or towel to wrap the cold pack to avoid direct contact with the skin.
  • Cold therapy can be repeated 2-3 times a day or as needed.
  • This can help to reduce inflammation, swelling, and pain

Electrical stimulation for frozen shoulder

How Electrical Stimulation Works

Electrical stimulation works by sending small electrical currents to the muscles in the affected area. This can help to stimulate the muscles and nerves, reduce pain, and improve range of motion. There are several different types of electrical stimulation, including transcutaneous electrical nerve stimulation (TENS), interferential therapy, and neuromuscular electrical stimulation (NMES).

How Electrical Stimulation is Used

Electrical stimulation is typically administered by a physical therapist or healthcare professional. The therapist will place electrodes on the skin near the affected shoulder and adjust the settings to the appropriate level of intensity. The patient may feel a tingling or buzzing sensation during the therapy, but it should not be painful.

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