Physical Therapy and Frozen Shoulder

Anthony Crespo
Anthony Crespo Clinic Manager at AHS

Frozen shoulder

Frozen Shoulder or adhesive capsulitis is a condition which affects about 2% to 5% of the American population(.1). Like many conditions this one affects the women population more than it does men and is typically diagnosed in people over the age of 45 however there are exceptions to this. 

What is it?

Adhesive capsulitis is the stiffening or hardening of the shoulder due to scar tissue. The result from this developed stiffness is pain and loss of motion in the shoulder area. The actual cause of adhesive capsulitis is still up for debate with some believing that it is caused by the inflammatory response of the shoulder joint tissue (synovitis). Others believe that it is an autoimmune response where the body launches an “attack” against its own tissue(.1). Other proposed causes include

  • Post surgical reactions
  • Arthritis
  • Rotator cuff tear
  • Immobilization of the arm, such as in a sling

As mentioned most people with adhesive Capsulitis develop worsening pain and a loss of movement. Adhesive capsulitis can be broken down into 4 stages and with the assessment of a physical therapist you can pinpoint which stage you are in.


The 4 stages

Stage 1: “Pre Freezing

During this stage it may be difficult to diagnose your problem as adhesive capsulitis. Symptoms have been present for around 1 – 3 months and are progressively getting worse. Movement of the shoulder causes pain and aches when you are not using it. 

Stage 2: “Freezing

During stage 2 you’ve had symptoms for around 3 – 9 months typically accompanied with a progressive loss of shoulder movement and an increase of night time pain.

Stage 3: “Frozen” 

During stage 3 symptoms have persisted for 9 – 14 months and you have a greatly decreased range of motion in the shoulder. There is a substantial amount of pain 

Stage 4: “Thawing

In the final stage you have endured 14 – 18 months of the symptoms, but in this stage there is a big decrease in pain, most notably at night. You still have range of motion impairments but your day to day activity will improve as time goes on. 

These stages are estimations so some exceptions may present themselves on a case by case basis.

How can a Physical Therapist help?

The overall goal of the PT is to restore the movement in the shoulder. The PT will conduct an initial evaluation which will help identify what stage you are in. Based on this evaluation the PT will create an individualized exercise program to cater to your needs and regain the range of motion lost. It has been found that exercise has been found to be the most effective for individuals who are in stage 2 and up. So if you or a loved one suspects or has adhesive capsulitis contact us to schedule an appointment today!


  1. Physical Therapy Guide to Frozen Shoulder (Adhesive Capsulitis). (2020, August 20). Retrieved November 09, 2020, from
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