Frozen
Shoulder
Physiotherapy for shoulder pain, stiffness and restricted movement associated with frozen shoulder — helping you gradually restore mobility and function.
When shoulder movement gradually becomes restricted.
Frozen shoulder, also called adhesive capsulitis, is a painful shoulder condition characterized by progressive restriction of both active and passive shoulder movement. External rotation is often particularly limited. :contentReference[oaicite:1]{index=1}
The condition can develop gradually. Pain may become noticeable first, followed by increasing stiffness and difficulty performing activities that require the arm to move overhead, behind the back or away from the body.
Frozen shoulder can affect sleep, dressing, bathing, reaching, lifting and other everyday activities. Although many cases improve over time, some people can experience prolonged pain and functional limitations. :contentReference[oaicite:2]{index=2}
Simple movements can become surprisingly difficult.
Pain and stiffness are the most common features. People may notice difficulty raising the arm, reaching behind the back, putting on clothes, washing their hair or reaching for objects on higher shelves.
Night pain and difficulty sleeping on the affected side can also occur, particularly during the more painful stage of the condition.
A characteristic feature is restriction of both active and passive shoulder movement rather than simply weakness. External rotation is often one of the most restricted movements. :contentReference[oaicite:3]{index=3}
The severity of symptoms and the amount of movement restriction can vary between individuals, so the rehabilitation programme should be adjusted to the person's presentation.
Frozen shoulder commonly progresses through stages.
The traditional description includes a painful "freezing" stage, a stiff "frozen" stage and a gradual "thawing" stage. Symptoms do not always follow exactly the same timeline in every person. :contentReference[oaicite:4]{index=4}
Freezing / Painful Stage
Pain gradually increases and shoulder movement begins to become restricted. Rehabilitation usually focuses on pain-sensitive movement and avoiding unnecessarily aggressive stretching.
Frozen / Stiff Stage
Pain may become less dominant while stiffness and restricted range of motion remain significant. Mobility work and appropriately selected exercises can be progressed according to irritability.
Thawing / Recovery Stage
Shoulder movement gradually begins to return. Rehabilitation can progressively focus on restoring range, strength and functional use of the arm.
Treatment should match the stage and irritability.
Frozen shoulder rehabilitation is not simply about forcing the shoulder through a large range of motion. The intensity of treatment should be adapted to pain, irritability and the amount of movement available.
Gentle range-of-motion exercises and appropriately selected manual therapy may be used to help improve shoulder mobility and function. Current clinical guidance supports manual therapy including ROM exercises as an option for improving shoulder ROM and upper-limb function. :contentReference[oaicite:5]{index=5}
Gradual progress is more important than aggressive stretching.
Exercise selection depends on the patient's symptoms and current movement. Self-stretching can be used as an adjunct when appropriately prescribed and when the patient understands how to perform it safely. :contentReference[oaicite:6]{index=6}
During the painful stage, exercises should generally remain within the person's tolerance rather than repeatedly provoking significant pain. As irritability decreases, mobility and strengthening can be progressively developed. :contentReference[oaicite:7]{index=7}
Restore useful movement one step at a time.
Restricted shoulder mobility can make simple daily activities difficult. Physiotherapy may use active movement, assisted movement, gentle stretching and manual techniques according to the person's stage and tolerance.
The goal is not necessarily to achieve a large increase in range during a single session. Instead, consistent rehabilitation aims to gradually improve the shoulder's usable movement over time.
Clinical guidance indicates that manual therapy combined with range-of-motion exercises may improve shoulder range and upper-limb function in primary frozen shoulder, although evidence quality varies. :contentReference[oaicite:8]{index=8}
Exercise helps maintain and gradually rebuild function.
Exercise may include gentle shoulder range-of-motion work, assisted movements and stretching selected according to the patient's symptoms and stage.
As pain and irritability improve, strengthening exercises can be introduced or progressed where clinically appropriate. Current guidelines note that shoulder strengthening may improve pain and function, although the evidence base for strengthening in primary frozen shoulder remains limited. :contentReference[oaicite:9]{index=9}
Consistency is important. A home exercise programme can help patients continue appropriate movement between supervised physiotherapy sessions.
Rehabilitation that fits into everyday life.
Home physiotherapy can be useful when shoulder pain or stiffness makes travelling difficult or when rehabilitation needs to fit around daily activities.
A physiotherapist can assess shoulder movement, demonstrate appropriate exercises and adjust the programme as symptoms and mobility change.
Home exercises can then be incorporated into the person's routine to maintain consistent movement between treatment sessions.
Reduce pain. Restore mobility. Return to function.
Frozen shoulder recovery can take time. A progressive approach aims to manage symptoms while gradually restoring useful shoulder movement and function.
Understand the Shoulder
Assess pain, irritability, active and passive movement and the functional activities affected by the condition.
Improve Mobility
Use appropriately dosed movement, exercise and manual techniques where indicated to gradually improve shoulder mobility.
Rebuild Function
Progress strengthening and functional activity as pain and movement tolerance improve.
Frozen shoulder, explained simply.
Common questions about pain, stiffness, physiotherapy and recovery.
What is frozen shoulder?
Can physiotherapy help frozen shoulder?
Should I force my shoulder to stretch?
What exercises are used for frozen shoulder?
How long does frozen shoulder take to recover?
Is an injection ever used for frozen shoulder?
Can frozen shoulder physiotherapy be done at home?
Rehabilitation should be guided by pain, mobility and function.
Current clinical practice guidance describes frozen shoulder as a condition involving pain and progressive restriction of shoulder movement. Non-surgical management can include exercise, range-of-motion work and manual therapy, with treatment selected according to clinical presentation. :contentReference[oaicite:12]{index=12}
Recent British Elbow and Shoulder Society guidance also emphasizes that the evidence for physiotherapy compared with the natural history of frozen shoulder remains uncertain, while physiotherapy following injection therapy is recommended. This is why treatment should be individualized rather than presented as one fixed protocol for every patient. :contentReference[oaicite:13]{index=13}
Earlier Cochrane evidence found that manual therapy combined with exercise may be less effective than glucocorticoid injection for short-term pain and function, highlighting the importance of considering the full clinical picture rather than relying on physiotherapy alone in every case. :contentReference[oaicite:14]{index=14}
2025 Clinical Practice Guidelines — Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder.
View PubMed Guideline →
British Elbow and Shoulder Society — Frozen Shoulder Patient Care Pathway, 2025.
View BESS Guideline →
Cochrane — Manual therapy and exercise for adhesive capsulitis.
View Cochrane Review →
Systematic Review — Efficacy of Physiotherapy Interventions in Adhesive Capsulitis.
View PubMed Review →
Start working towards better shoulder movement.
Individualized physiotherapy for frozen shoulder, shoulder stiffness and movement limitations, with home physiotherapy available.
Research & Sources
Clinical Practice Guidelines for Diagnosis and
Non-Surgical Treatment of Primary Frozen Shoulder.
View PubMed
British Elbow and Shoulder Society —
Frozen Shoulder Patient Care Pathway.
View BESS Guideline
Cochrane —
Manual Therapy and Exercise for Adhesive Capsulitis.
View Cochrane Review
Systematic Review —
Physiotherapy Interventions for Adhesive Capsulitis.
View PubMed Article
Frozen
Shoulder
Physiotherapy for shoulder pain, stiffness and restricted movement associated with frozen shoulder — helping you gradually restore mobility and function.
When shoulder movement gradually becomes restricted.
Frozen shoulder, also called adhesive capsulitis, is a painful shoulder condition characterized by progressive restriction of both active and passive shoulder movement. External rotation is often particularly limited. :contentReference[oaicite:1]{index=1}
The condition can develop gradually. Pain may become noticeable first, followed by increasing stiffness and difficulty performing activities that require the arm to move overhead, behind the back or away from the body.
Frozen shoulder can affect sleep, dressing, bathing, reaching, lifting and other everyday activities. Although many cases improve over time, some people can experience prolonged pain and functional limitations. :contentReference[oaicite:2]{index=2}
Simple movements can become surprisingly difficult.
Pain and stiffness are the most common features. People may notice difficulty raising the arm, reaching behind the back, putting on clothes, washing their hair or reaching for objects on higher shelves.
Night pain and difficulty sleeping on the affected side can also occur, particularly during the more painful stage of the condition.
A characteristic feature is restriction of both active and passive shoulder movement rather than simply weakness. External rotation is often one of the most restricted movements. :contentReference[oaicite:3]{index=3}
The severity of symptoms and the amount of movement restriction can vary between individuals, so the rehabilitation programme should be adjusted to the person's presentation.
Frozen shoulder commonly progresses through stages.
The traditional description includes a painful "freezing" stage, a stiff "frozen" stage and a gradual "thawing" stage. Symptoms do not always follow exactly the same timeline in every person. :contentReference[oaicite:4]{index=4}
Freezing / Painful Stage
Pain gradually increases and shoulder movement begins to become restricted. Rehabilitation usually focuses on pain-sensitive movement and avoiding unnecessarily aggressive stretching.
Frozen / Stiff Stage
Pain may become less dominant while stiffness and restricted range of motion remain significant. Mobility work and appropriately selected exercises can be progressed according to irritability.
Thawing / Recovery Stage
Shoulder movement gradually begins to return. Rehabilitation can progressively focus on restoring range, strength and functional use of the arm.
Treatment should match the stage and irritability.
Frozen shoulder rehabilitation is not simply about forcing the shoulder through a large range of motion. The intensity of treatment should be adapted to pain, irritability and the amount of movement available.
Gentle range-of-motion exercises and appropriately selected manual therapy may be used to help improve shoulder mobility and function. Current clinical guidance supports manual therapy including ROM exercises as an option for improving shoulder ROM and upper-limb function. :contentReference[oaicite:5]{index=5}
Gradual progress is more important than aggressive stretching.
Exercise selection depends on the patient's symptoms and current movement. Self-stretching can be used as an adjunct when appropriately prescribed and when the patient understands how to perform it safely. :contentReference[oaicite:6]{index=6}
During the painful stage, exercises should generally remain within the person's tolerance rather than repeatedly provoking significant pain. As irritability decreases, mobility and strengthening can be progressively developed. :contentReference[oaicite:7]{index=7}
Restore useful movement one step at a time.
Restricted shoulder mobility can make simple daily activities difficult. Physiotherapy may use active movement, assisted movement, gentle stretching and manual techniques according to the person's stage and tolerance.
The goal is not necessarily to achieve a large increase in range during a single session. Instead, consistent rehabilitation aims to gradually improve the shoulder's usable movement over time.
Clinical guidance indicates that manual therapy combined with range-of-motion exercises may improve shoulder range and upper-limb function in primary frozen shoulder, although evidence quality varies. :contentReference[oaicite:8]{index=8}
Exercise helps maintain and gradually rebuild function.
Exercise may include gentle shoulder range-of-motion work, assisted movements and stretching selected according to the patient's symptoms and stage.
As pain and irritability improve, strengthening exercises can be introduced or progressed where clinically appropriate. Current guidelines note that shoulder strengthening may improve pain and function, although the evidence base for strengthening in primary frozen shoulder remains limited. :contentReference[oaicite:9]{index=9}
Consistency is important. A home exercise programme can help patients continue appropriate movement between supervised physiotherapy sessions.
Rehabilitation that fits into everyday life.
Home physiotherapy can be useful when shoulder pain or stiffness makes travelling difficult or when rehabilitation needs to fit around daily activities.
A physiotherapist can assess shoulder movement, demonstrate appropriate exercises and adjust the programme as symptoms and mobility change.
Home exercises can then be incorporated into the person's routine to maintain consistent movement between treatment sessions.
Reduce pain. Restore mobility. Return to function.
Frozen shoulder recovery can take time. A progressive approach aims to manage symptoms while gradually restoring useful shoulder movement and function.
Understand the Shoulder
Assess pain, irritability, active and passive movement and the functional activities affected by the condition.
Improve Mobility
Use appropriately dosed movement, exercise and manual techniques where indicated to gradually improve shoulder mobility.
Rebuild Function
Progress strengthening and functional activity as pain and movement tolerance improve.
Frozen shoulder, explained simply.
Common questions about pain, stiffness, physiotherapy and recovery.
What is frozen shoulder?
Can physiotherapy help frozen shoulder?
Should I force my shoulder to stretch?
What exercises are used for frozen shoulder?
How long does frozen shoulder take to recover?
Is an injection ever used for frozen shoulder?
Can frozen shoulder physiotherapy be done at home?
Rehabilitation should be guided by pain, mobility and function.
Current clinical practice guidance describes frozen shoulder as a condition involving pain and progressive restriction of shoulder movement. Non-surgical management can include exercise, range-of-motion work and manual therapy, with treatment selected according to clinical presentation. :contentReference[oaicite:12]{index=12}
Recent British Elbow and Shoulder Society guidance also emphasizes that the evidence for physiotherapy compared with the natural history of frozen shoulder remains uncertain, while physiotherapy following injection therapy is recommended. This is why treatment should be individualized rather than presented as one fixed protocol for every patient. :contentReference[oaicite:13]{index=13}
Earlier Cochrane evidence found that manual therapy combined with exercise may be less effective than glucocorticoid injection for short-term pain and function, highlighting the importance of considering the full clinical picture rather than relying on physiotherapy alone in every case. :contentReference[oaicite:14]{index=14}
2025 Clinical Practice Guidelines — Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder.
View PubMed Guideline →
British Elbow and Shoulder Society — Frozen Shoulder Patient Care Pathway, 2025.
View BESS Guideline →
Cochrane — Manual therapy and exercise for adhesive capsulitis.
View Cochrane Review →
Systematic Review — Efficacy of Physiotherapy Interventions in Adhesive Capsulitis.
View PubMed Review →
Start working towards better shoulder movement.
Individualized physiotherapy for frozen shoulder, shoulder stiffness and movement limitations, with home physiotherapy available.
Research & Sources
Clinical Practice Guidelines for Diagnosis and
Non-Surgical Treatment of Primary Frozen Shoulder.
View PubMed
British Elbow and Shoulder Society —
Frozen Shoulder Patient Care Pathway.
View BESS Guideline
Cochrane —
Manual Therapy and Exercise for Adhesive Capsulitis.
View Cochrane Review
Systematic Review —
Physiotherapy Interventions for Adhesive Capsulitis.
View PubMed Article