If reaching for a seatbelt, hooking your bra behind your back, or sliding an arm into a jacket sleeve has turned into a small ordeal, your shoulder is probably telling you something. Frozen shoulder creeps up slowly, and by the time it's hard to ignore, it's already limiting the things you do every single day without thinking. The good news is that it responds well to the right physiotherapy, especially when you start before it locks up completely.
Doctors call it adhesive capsulitis. In plain terms, the capsule of tissue that surrounds your shoulder joint thickens and tightens, and bands of stiff tissue form inside it. That's why the shoulder stops moving freely in every direction, not just one — it's not a single tendon or muscle acting up, it's the whole joint capsule gripping down.
It typically shows up in one shoulder at a time, most often between the ages of 40 and 60, and it tends to move through three overlapping phases. First comes the "freezing" phase, where pain builds up gradually and movement starts dropping off. Then the "frozen" phase, where the sharp pain settles but the stiffness is at its worst — this is usually when people feel most stuck. Finally, the "thawing" phase, where movement slowly comes back on its own. Left alone, this whole process can drag on for one to three years. Physiotherapy is what shortens that timeline and improves how much range you get back at the end of it.
More often than not, there isn't one obvious trigger. Doctors call these idiopathic cases — the capsule just starts tightening for no clear reason. But there are patterns worth knowing about.
A shoulder that's kept still for too long is a common lead-up — after a fracture, a surgery, a stroke, or even just favouring the arm because of an unrelated injury. When a joint doesn't move through its range for weeks at a stretch, the capsule can start to contract around it. Diabetes is another strong link; people with diabetes are several times more likely to develop a frozen shoulder, and it can also take longer to resolve. Thyroid problems, heart disease, and Parkinson's have all been associated with it as well, though the exact reason isn't fully understood.
Don't wait it out for months hoping it settles on its own. See a physiotherapist if shoulder stiffness or pain has stuck around for more than two to three weeks and is starting to get in the way of dressing, driving, or sleeping. It's also worth getting checked if you notice one arm clearly doesn't lift out to the side or reach behind your back the way the other one does, or if you've had a recent shoulder injury or surgery and movement just isn't coming back as expected. Catching it in the freezing phase, rather than after it's fully locked up, makes a real difference to how quickly you recover.
Treatment isn't the same on day one as it is three months in — it changes with the stage your shoulder is in. Here's how we usually work through it.
We check range of motion in every direction, compare both shoulders, and rule out a rotator cuff tear or impingement. Knowing which phase you're in — freezing, frozen, or thawing — decides how hard or gentle the first sessions should be.
While pain is still sharp, the focus stays on gentle mobility and calming things down rather than pushing into a hard stretch. Forcing range too early in this stage usually backfires and flares the pain up again.
As the sharp pain eases, hands-on joint mobilisation and progressive stretching bring range back gradually. Once movement improves, we shift into rebuilding strength around the shoulder blade and rotator cuff so daily tasks stop feeling like hard work.
We pick from these based on which stage your shoulder is in — not every technique suits every week of recovery.
Hands-on joint mobilisation to ease capsular tightness and coax range of motion back gradually.
Targeted capsular stretches held at a pace your shoulder can tolerate, building up gradually.
Guided range-of-motion and strengthening exercises that progress as your shoulder allows more load.
Used where surrounding muscles have tightened up from guarding the joint, to ease that muscle tension.
Heat and TENS-based pain relief, often used to loosen the area before hands-on mobilisation.
Supportive taping to ease discomfort and remind you to keep good shoulder positioning between sessions.
Recovery from a frozen shoulder is rarely quick, and it looks a little different for everyone. Left untreated, the freezing phase can run two to nine months, the frozen phase four to twelve months, and thawing anywhere from five months to two years. With physiotherapy started early, most people notice a real improvement in movement within six to twelve weeks, though getting back to full, pain-free range can still take several months depending on how advanced the stiffness was when you started, whether diabetes is a factor, and how consistent you are with your home exercises. Your physiotherapist will give you a more specific idea once they've assessed your shoulder directly.
No. A rotator cuff tear usually causes pain with specific movements while the rest of the range stays fairly free. Frozen shoulder restricts movement in almost every direction at once, because it's the joint capsule tightening rather than a tendon injury. The two can also occur together, which is exactly why a proper assessment matters before starting treatment.
It often does resolve eventually, but that can take one to three years, and some people are left with a bit of permanent stiffness. Physiotherapy speeds the process up considerably and generally leaves you with a better final range of movement than waiting it out would.
Some discomfort during stretching and mobilisation is normal and expected, especially in the frozen stage. It shouldn't ever be sharp or lingering pain, though. We grade every session to what your shoulder can handle that day, and that changes as you progress.
It depends on the stage you're in. The frozen and thawing stages usually respond well to two to three sessions a week to begin with, tapering down as range improves. Freezing-stage shoulders are treated more gently and a little less frequently, since the priority there is calming things down rather than forcing movement.
Lower body work and cardio are usually fine to continue as normal. Upper body training generally needs modifying around whatever your shoulder can currently tolerate — your physiotherapist will tell you what to hold off on for now and what's safe to keep doing.
It's uncommon in the same shoulder once it's fully thawed. There is, however, a real chance — quoted at roughly one in ten to one in six — of it developing in the other shoulder within a few years, which is higher again if diabetes is involved. That's worth keeping an eye on.
The exact reason isn't fully settled, but long-term high blood sugar is thought to affect the collagen in the joint capsule, making it stiffer and more prone to the changes that cause frozen shoulder. People with diabetes are several times more likely to develop it, and it can take a bit longer to resolve too.
It tends to get stiffer before it gets better, and the longer it's left, the longer the whole process usually drags on. Ignoring it also means missing the window where gentle, early treatment tends to work best — by the time the joint is fully locked up, progress is slower and takes more patience.
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The sooner a frozen shoulder is assessed, the sooner it stops running your day. Come in and let's work out which stage you're at and what it'll take to get your reach back.
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