Frozen Shoulder or Adhesive Capsulitis is a shoulder condition in which shoulder movements are restricted due to capsular (shoulder joint capsule) thickening and tightness. It causes pain, stiffness, and restricted shoulder range of motion. The commonly restricted movements are external rotation, abduction, and internal rotation of the shoulder or in simpler terms, lifting arm forwards or sideways above head becomes difficult. It becomes challenging to comb your hair or touch your upper back. If you are having these difficulties, it’s probable that you are having a Frozen/ Locked Shoulder.

Frozen shoulder results from a variety of causes like immobilization after a shoulder injury, surgery, or stroke. The common high risk is secondary to Type 2 diabetes, Thyroid disorders, Cardiovascular disorders, or Parkinson’s disease. Sometimes it is idiopathic also, that is some unknown reason. It progresses slowly over a period of 2-9 months, starts with pain, limited shoulder movement due to pain which further restricts the ROM (range of motion) resulting in stiffness. Whatever is the reason, it becomes very difficult to do the activities of daily living. So here are some easy to do exercises and tips to follow to unlock your frozen shoulder and get relief from constant pain and stiffness.

1. Use Cold packs/ hot packs for 10-15 min twice a day for pain relief. Alternating between the two really helps.
2. Stretching exercises of shoulder joint.
   • Pendulum Stretch-Stand and lean over little, with affected arm hanging slightly. Take support of a table with the unaffected side hand. Now rotate the affected arm freely in circles, clockwise and anti-clockwise direction as much your shoulder permits. Gradually widen the circle to stretch the shoulder joint capsule. Once you are comfortable, add weights (0.5 kg to start with) to your hand and do the same motion. In the same position, you can do forward-backward movement and side to side movement of the shoulder.
   • Shoulder blade squeeze– In relaxed standing position with palms facing outwards so that thumbs are pointing away from you, pull your shoulder blades towards each other, hold for 10-15 seconds and repeat 10 times, twice a day.
   • Supported shoulder raise- With the unaffected arm supporting the affected arm just above the elbow, try to raise your arm to above shoulder level, hold it there for 15-30 sec, 10-15reps. This exercise can also be done by holding a cane in your hands and lifting it up all the way.
   • Cross body reach– Grab the affected arm just above the elbow by the unaffected arm and pull it across the body towards the unaffected side. Hold for 15-30 sec, 10-15 reps.
   • Backward pull– Grab your affected arm just above the wrist behind your back and pull it sideways and downwards towards the unaffected arm side. Hold for 10-15seconds, 10 reps.
   • Towel stretch– Grab a towel between your hands, bring it behind your back in a diagonal position such that the unaffected side hand is at the top and affected side at the bottom. Now pull the towel up with the good arm so that, it in turn pulls the affected arm up stretching the involved shoulder. Hold for 10-15sec, 10-15 reps.
   • Child Pose of yoga-Kneel down on all fours (knees and hands), feet together and knees shoulder width apart. Now bend further such that your torso lies on your thighs and outreach your arms so that forearm and hands are touching the floor. Stay in this pose for 30sec to 1 min.
3. Strengthening exercises of shoulder.
   • Use a theraband (Check the post on “Understanding Therabands” in my blog) or 0.5 -1 kg weight to start with and perform shoulder ROM exercises i.e. lifting arm forward, lifting arm sideways, lifting arm backwards and with upper arm close to the body and elbow bent to 90 degrees, just move your hand close to your navel and away from your navel. Do 10 reps of each movement. Gradually increase it to 3 sets of 10 reps and once you are comfortable with it, increase weight by 0.5 kg.
4. Shoulder Joint Mobilization– Done by a Physical Therapist or Physiotherapist
5. Massage– Gently massage around the shoulder joint with your other hand, using a foam roller or electric massage tools. Your Physiotherapist can give you deep friction massage to loosen up the tight capsule.
6. Postural corrections–
   • While sleeping on your back, place a pillow under your affected arm and rest your hand on the stomach or try to sleep on the unaffected side hugging a pillow with affected arm across your chest.
   • Avoid slumped posture and keep your shoulders retracted, back and down.

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• Neck and Shoulder Conditions