Adhesive capsulitis, commonly known as frozen shoulder, is a painful and often debilitating condition that significantly limits shoulder movement. Whether you’re a patient navigating recovery or a healthcare professional seeking a clear, effective rehabilitation strategy, understanding the right rehab protocol is essential for successful healing.
In this article, we’ll break down a comprehensive, evidence-based rehab protocol for adhesive capsulitis, explore the condition’s phases, and provide actionable steps to support shoulder recovery.
What is Adhesive Capsulitis?
Adhesive capsulitis is a condition characterized by stiffness and pain in the shoulder joint. It typically progresses through three distinct phases:
1. Freezing Phase
- Gradual onset of shoulder pain.
- Increasing stiffness.
- Lasts from 6 weeks to 9 months.
2. Frozen Phase
- Pain may reduce slightly.
- Significant loss of shoulder motion.
- Can last from 4 to 6 months.
3. Thawing Phase
- Gradual return of mobility.
- Pain continues to decline.
- Duration ranges from 6 months to 2 years.
Understanding these phases helps tailor rehabilitation strategies to each stage for optimal results.
Goals of Rehabilitation
The primary objectives of an adhesive capsulitis rehab protocol include:
- Pain reduction
- Improvement of range of motion (ROM)
- Restoration of functional mobility
- Preventing further stiffness and complications
Each phase of recovery requires specific interventions aligned with these goals.
Phase-Specific Rehabilitation Protocol
Phase 1: Freezing Phase (Pain Management & Early Mobility)
Key Goals: Minimize pain, maintain as much ROM as possible.
Recommended Interventions:
- NSAIDs and/or corticosteroid injections to reduce inflammation.
- Gentle pendulum exercises and passive ROM stretches.
- Avoid aggressive stretching that could worsen symptoms.
- Modalities: Heat therapy, ultrasound, or TENS for pain relief.
Phase 2: Frozen Phase (Maintaining ROM & Reducing Pain)
Key Goals: Prevent further joint stiffness, support mobility.
Recommended Interventions:
- Continue passive and active-assisted ROM exercises.
- Initiate capsular stretching: cross-body stretch, doorway stretch.
- Gentle isometric strengthening for surrounding muscles.
- Gradual progression based on pain tolerance.
Phase 3: Thawing Phase (Restoration of Function)
Key Goals: Regain full ROM and shoulder strength.
Recommended Interventions:
- Progress to active ROM and resistive strengthening exercises.
- Incorporate functional movements like overhead reaching.
- Focus on postural control and scapular stabilization.
- Continue stretching and joint mobilizations as needed.
Sample Daily Exercise Routine
Here’s a simple home routine that can support recovery (under supervision of a professional):
Morning:
- Pendulum swings – 1 min
- Passive shoulder flexion with stick – 10 reps
Afternoon:
- Cross-body stretch – 3 reps, 30 sec hold
- Isometric shoulder abduction – 5 reps, 5 sec hold
Evening:
- Doorway external rotation stretch – 3 reps, 30 sec hold
- Wall walks – 10 reps
Note: Adjust intensity based on your current phase and pain level.
Tips for a Successful Recovery
- Consistency is key – follow your program daily.
- Work with a physical therapist to ensure proper technique.
- Modify activities to avoid aggravating the shoulder.
- Use ice or heat as needed to manage symptoms.
- Be patient – recovery takes time.
When to Seek Medical Help
While most cases of adhesive capsulitis resolve over time, seek medical advice if:
- Pain severely disrupts sleep or daily function.
- There’s no improvement after several weeks of rehab.
- You experience new or worsening symptoms.
Early intervention can make a significant difference in your recovery timeline.
Final Thoughts
Recovering from adhesive capsulitis is a marathon, not a sprint. With the right rehab protocol tailored to each recovery phase, consistent effort, and professional guidance, most individuals regain functional shoulder mobility.
If you’re dealing with frozen shoulder, don’t wait—start your rehab journey today and take control of your recovery.
Need help building a personalized rehab plan? Consult a licensed physical therapist or healthcare provider to guide your progress.
Kallie Snyder is an author at Stonegate Health Rehab, providing valuable insights, recovery guidance, and rehab resources to help individuals achieve better health and well-being.