Frozen Shoulder (Adhesive Capsulitis)

Often called a stiff or “frozen shoulder,” adhesive capsulitis is the stiffening
of the shoulder due to scar tissue, which results in painful movement and loss of motion. Some believe it is caused by inflammation, such as when the lining of a joint becomes inflamed (synovitis), and some believe it is caused by autoimmune reactions, where the body launches an “attack” against its own substances and tissues.

Other possible causes include:

  • Reactions after an injury or surgery 

  • Pain from other conditions—such as arthritis, a rotator cuff tear, bursitis, or tendinitis—that has caused you to stop moving your shoulder 

  • Immobilization of your arm, such as in a sling, after surgery or fracture

Adhesive capsulitis can be broken down into 4 stages, and your physical 
therapist can help determine what stage you are in:

Stage 1 - “Pre-Freezing”: You’ve had pain and loss of motion symptoms for 1 to 3 months, and they’re getting worse.

Stage 2 – “Freezing”: By this stage, you’ve had progressive symptoms for 3 to 9 months, especially at night.

Stage 3 – “Frozen”: Your symptoms have persisted for 9 to 14 months, and you have greatly decreased range of shoulder movement.

Stage 4 – “Thawing”: You’ve had symptoms for 12 to 15 months, and there is a big decrease in pain. You still have a limited range of movement, but your ability to complete your daily activities involving overhead motion is improving at a rapid rate.


Your physical therapist’s overall goal is to restore your movement so that you can perform your activities and life roles. Once the evaluation process has identified the stage of your condition, your therapist will create an exercise program tailored to your needs. Exercise has been found to be most effective for those who are in stage 2 or higher. 

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