Frozen shoulder, also known as adhesive capsulitis, is a condition that causes stiffness, pain, and limited mobility in the shoulder joint. It typically develops gradually and can significantly impact daily activities. It often starts after a shoulder insult such as shoulder surgery, joint damage or rotator cuff tear, each where the shoulder is often immobile for a period of time.

The actual tissue damage is still not well understood. The joint connective tissue seems to go through an inflammatory phase, then a stiffening phase, before starting to recover by itself.  There is growing evidence it could be some type of autoimmune condition.  

Stage 1: Freezing Phase

• Gradual onset of shoulder pain, which worsens over time.
• Stiffness begins, limiting shoulder movement in most directions.
• Pain is often worse at night, affecting sleep quality.

Stage 2: Frozen Phase

• Severe stiffness with marked reduction in mobility.
• Pain may decrease, but the shoulder remains immobile.
• Difficulty performing everyday activities, such as dressing or reaching.

Stage 3: Thawing Phase

• Gradual improvement in mobility as stiffness subsides.
• Pain diminishes significantly during this phase.
• Full recovery can take months or even years.

This is where Clinic 88 comes in!  We pride ourselves as being Canberra’s most skillful manual therapists.

Manual therapy can be very effective in managing frozen shoulder, alleviating pain and improving mobility.  It fast tracks your progress through the three phases – especially phase 3 where the biggest changes with treatment occur.

Don’t be fooled into believing there is a magic cure for frozen shoulder.  There isn’t.  Time is needed for the shoulder damage to repair.  Treatment often helps reduce pain and increase mobility but time is still necessary for full recovery.

You may start to get rapid changes with manual therapy in the ‘thawing’ phase of frozen shoulder.  This is when the shoulder is healing itself and is often more responsive to treatment.  

Joint Mobilisation

• Gentle techniques to improve the range of motion in the shoulder joint.
• Focuses on reducing stiffness and enhancing flexibility.

Soft Tissue Massage

• This focuses on the rotator cuff (four muscles that stabilise and move the shoulder joint).  Some or all of these muscles are often a major component of your frozen shoulder symptoms
• Focusing on areas beyond your shoulder is important to reduce any cervical (neck), scapula (shoulder blade) or thoracic spine (upper back) involvement

Stretching Exercises

• Active (moving while stretching) and passive stretches (stretching while staying still) to improve shoulder mobility.
• These are often repetitive swaying motions of the shoulder joint, while holding a weight of some type.  This distracts the connective tissue of the joint, adding a stretch to this tissue, while taking it gently through a range of motion that you have lost
• These can slowly progress as your symptoms reduce
• Don’t start to aggressively or you run the risk of worsening your symptoms

Dry Needling

• Targets trigger points to release muscle tension of local muscles and referred pain that can exacerbate or mimic frozen shoulder pain
• Dry Needling often has analgesic effect 

Postural Correction

• Addresses poor posture habits that may exacerbate shoulder stiffness.
• Focuses on realigning the shoulders and upper back.

Lymphatic Drainage

• Reduces swelling and enhances fluid movement around the shoulder.
• Promotes healing and reduces inflammation.

Strengthening Exercises

• Builds endurance in the shoulder and surrounding muscles.  This usually begins in the ‘thawing’ phase as exercises are almost impossible during the first two phases
• Focuses on restoring functional movements.