Frozen Shoulder: Exercises to Restore Mobility

Stiffness from frozen shoulder can last 1 to 3 years.  Performing regular home exercise can expedite recovery.  As mentioned in a previous article, the exercise program must be individually tailored and match the stage of the disorder.  Gentle exercise with minimal pain is recommended early during the freezing stage.  The vigor and volume of stretching can be increased during the frozen stage but the pain must be respected.  During the thawing stage, pain during exercise is expected provided it dissipates soon afterward.  The exercises which follow in this article are a few examples of those commonly prescribed by physical therapists.  The effectiveness of these exercises can be enhanced by combining them with manual physical therapy.

Supine Shoulder Flexion

Performing stretching exercises in the lying position will minimize the effects of gravity.  This results in less pain and improved range of motion.  Begin lying on the back with the hips and knees bent.  With the uninvolved hand grasp the wrist of the involved side.  Use the uninvolved arm to passively lift the involved arm overhead.  Maintain a straight elbow.  At the onset of mild discomfort or a stretch, pause for 5 to 10 seconds.  Perform 10 repetitions.  This exercise is typically prescribed during the freezing stage of frozen shoulder.  As pain begins to diminish the exercise can be progressed by increasing the duration of the stretch up to 30 seconds.

Supine Shoulder External Rotation

Begin lying on the back with a small pillow or towel roll under the upper arm.  Hold a cane, golf club, or similar object with both hands.  Use the uninvolved arm to passively rotate the involved arm out to the side.  The elbow of the involved arm should be maintained at a 90-degree angle throughout the exercise.  At the onset of mild discomfort or a stretch, pause for 5 to 10 seconds.  Perform 10 repetitions.  This exercise is typically prescribed during the freezing stage of frozen shoulder.  As pain begins to diminish the exercise can be progressed by increasing the duration of the stretch up to 30 seconds.

Standing Shoulder Extension

Restoring the ability to reach behind the body is important for people with frozen shoulder.  This takes repetition and time.  Be patient.  Standing shoulder extension with a cane or golf club is a great starting point.  Stand tall holding the cane behind the body with the arms straight.  Maintain both elbows straight and lift the cane backward until mild discomfort, or a stretch is felt.  Pause in this position for 5 to 10 seconds.  Perform 10 repetitions.  This exercise is typically prescribed during the freezing stage of frozen shoulder.  As pain begins to diminish the exercise can be progressed to the cross body or sleep stretch described below.

Cross Body Stretch

This stretch addresses the posterior shoulder joint and muscles which are prone tightness in those with frozen shoulder.   It is most appropriate for those in the frozen and thawing stages of frozen shoulder.  This stretch is performed lying on the involved side with hips and knees bent.  The involved shoulder and elbow are positioned in 90 degrees of flexion.  The hand of the uninvolved arm grasps the elbow of the involved arm and gently pulls it across the body.  Once a mild stretch is felt on the outside or back of the shoulder, this position is held for approximately 30 seconds.  The stretch is typically performed 2-3 times each session.

Sleeper Stretch

The sleeper stretch is effective for improving the ability to reach behind the back.  Difficulty with dressing behind the back is a common complaint about those with frozen shoulder.  For this stretch, the same starting position as the cross body stretch is assumed.  However, with the sleeper stretch, the wrist and forearm of the involved arm are gently moved down towards the table.  Once a mild stretch is felt on the outside or back of the shoulder, this position is held for approximately 30 seconds.  The stretch is typically performed 2-3 times each session.   This stretch is most appropriate for those in the thawing stage of frozen shoulder.

Closing Comments

Patience and persistence are the keys to success with these exercises.  The rate of recovery from frozen shoulder can only be increased to a certain point.  Overly aggressive stretching early when pain levels are high can prolong recovery.  Conversely, infrequent or painless stretching, later on, can result in incomplete recovery.  Dealing with frozen shoulder is a marathon, not a sprint.  Team up with a physical therapist so can plan the exercise strategy which is best for you.

 


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