Managing Frozen Shoulder in the Summer Heat

At the time of writing today, it is 90 degrees outside and sunny. In times like these, it feels good to grab some ice cream or ice cubes out of the freezer for some much-needed relief.

However, there’s nothing relieving about frozen shoulder, aka adhesive capsulitis. Frozen shoulder is a health condition that seems to afflict the shoulder and only the shoulder (not the knees, hips, elbows, etc.). In stage 1, the “freezing” phase, your shoulder range of motion begins to decline for no clear reason, especially into external rotation (washing your hair) and abduction (raising your arm to the side). This can be very painful and extremely frustrating, so the urge to work aggressively on improving range of motion is high.

Eventually you progress to stage 2, the “frozen” phase. Your shoulder range of motion isn’t getting worse but it’s not getting better either; for lack of a better term, it’s frozen. This can last for two weeks or nine months, or longer. The longest I’ve worked with someone in this phase is 1.5 years. Can you imagine what he went through??

But even in your darkest moment, you should know that it WILL get better! Eventually you enter stage 3, the “thawing” phase. That metaphorical block of ice encapsulating your shoulder begins to “melt” and your range of motion gradually improves.

Physical therapy is most helpful in this third stage of adhesive capsulitis, although it can help in the first couple stages, too. We can begin progressing your joint and arm mobility gradually in this third stage so you can return to your pain-free activities of daily living.

Part of the trouble with adhesive capsulitis is that it is unpredictable and poorly understood. Most of us are a bit impatient with the rehabilitation process, myself included, so physical therapy in decades past has made the mistake of pushing and cranking on that shoulder in stages 1 and 2 far too much. But all this does, as far as medical science is aware (sidebar: keep in mind that adhesive capsulitis is a poorly understood medical condition and much more research is needed), is encourage the pathological capsular inflammatory process to speed up. In other words, when the shoulder is cranky, if you push too hard too early, you’ll make it A LOT worse.

So what do you do in phases 1 and 2? Physical therapy can help most with overall condition management. We know folks with diabetes, prior shoulder injuries, poor sleep habits, and high stress levels are more prone to adhesive capsulitis and to having longer recovery periods. So let’s talk about your diet and A1C. Let’s get that stress level down and sleep management up. And perhaps most importantly, let’s help prevent future recurrences and frozen shoulder on the OTHER side by managing posture, scapulothoracic kinematics, neck mobility, and more. I’ve worked with a handful of folks with frozen shoulder in both shoulders at the same time and trust me, I wouldn’t wish that on anyone.

Questions, comments, or concerns? You know who to call: your shoulder and adhesive capsulitis experts, Premier Physical Therapy!