7 Simplest Exercises and Natural Therapies to Unlock a Frozen Shoulder

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rozen shoulder is debilitating for most people. The extreme pain limits the range of motion of the shoulder joint that could interfere with activities of daily living. People suffering from frozen shoulder could barely lift their arm or turning the forearm. To make matters worse, the process of recovery is quite slow. In most cases, it takes about two to three years to get rid of the pain and restore the normal function of the shoulder joint. In a number of cases, after unlocking a frozen shoulder, the other shoulder may start troubling you after a few months. Even for physical therapists fixing a frozen shoulder is a challenging task. [1]

The medical term for frozen shoulder is adhesive capsulitis. It is a common joint problem in people between 40 to 60 years of age. Women are more susceptible to frozen shoulder than men. The risk is especially higher in diabetes patients. About 10 to 36% people with diabetes are believed to suffer from frozen shoulder. Furthermore, the speed of recovery tends to be slower in people suffering from diabetes. [2][3]

In addition to primary or idiopathic frozen shoulder, frozen shoulder could be secondary, associated with a trauma, impingement or disease of the rotator cuff, cardiovascular disorder, hemiparesis or diabetes. [4] However, according to the American Shoulder and Elbow Surgeons and the American Academy of Orthopaedic Surgeons’ definitions of frozen shoulder, the key characteristic of a frozen shoulder that helps to differentiate it from other shoulder problems is loss of passive range of motion. Frozen shoulder is a condition that significantly limits not only active but also passive shoulder movements without a known shoulder disorder other than osteopenia. Though significant pain and limitation in active range of motion is reported in other shoulder conditions like partial rotator cuff tear, calcifying tendinitis and subacromial bursitis, none of these conditions are associated with loss of passive range of motion. [5]


Symptoms of Frozen Shoulder

Pain and shoulder joint stiffness are the main symptoms of frozen shoulder. The dull and aching pain is primarily experienced over the outer shoulder area. It could also spread to the upper arm. During the course of the condition, pain is more intense in the early stage when you can still move your arm.

Development of frozen shoulder passes through three stages, each overlapping with the other. The first stage, known as the freezing phase, usually lasts for two to nine months. This stage is characterized by acute pain. The severity of the pain increases over time. The pain pattern remains constant throughout this stage. Worsening of the pain restricts movement of the shoulder joint.

The second stage is known as the frozen phase. The intensity of the pain declines during this stage. However, stiffness persists throughout the phase and range of motion is limited. Stiffening or freezing of the joint persists for four to twelve months. The third stage is the thawing stage. The affected shoulder gradually regains its range of motion during the last phase. Pain may exist until the condition resolves fully. This phase usually lasts for 12 to 42 months.

Since these phases overlap with each other, a number of medical practitioners and researchers prefer classifying the stages of the frozen shoulder as pain predominant and stiffness predominant stages. [6][7]


Causes of Frozen Shoulder

Frozen shoulder develops when the shoulder capsule that encases the bones, tendons, and ligaments thickens and become tight. The exact reason why the shoulder capsule tightens is not clear. Systemic diseases such as diabetes, thyroid disorder, cardiovascular disease, Parkinson’s disease or tuberculosis appear to play a role because most people with frozen shoulder are found to suffer from any one of these diseases. Risk of developing a frozen shoulder tend to increase during prolonged immobility or restricted mobility of the shoulder joint due to rotator cuff injury, arm fracture, stroke or while recovering from surgery. [8]


How to Unlock a Frozen Shoulder

Frozen shoulder is a self-limited condition. The symptoms are known to improve over time. Without medical intervention, it may take up to three years for the pain and stiffness to subside. The aim of treatment is to alleviate pain and speed up recovery. In most cases, non-steroidal anti-inflammatory drugs are used as the first line treatment for alleviating pain. In some cases, to reduce the inflammation and improve joint movement, cortisone is injected directly into the shoulder joint. Symptoms that do not respond to pain relief drugs and steroid injections may be treated through hydrodilatation. It involves stretching the shoulder joint capsule by injected a large volume of sterile fluid directly into the affected area. Physical therapies including stretching or range-of-motion exercises are best known for reducing the joint stiffness and improving motion. [9]


Exercises for Frozen Shoulder

The following are some best exercises, you can adopt for frozen shoulder are:

1. Finger Wall Walk

Stand to face a wall at about three-quarters of an arm’s length. Keeping the elbows slightly bent, at the level of your waist, touch the wall with the fingertips of your affected arm. Now slowly walk your fingers upwards as high as you can. Reach the maximum height possible without moving your shoulder muscles. Lower your arm slowly. Repeat the finger walk a few times. This easy exercise can be performed several times a day.

2. Pendulum Stretch

Place the palm of your good arm on the edge of a table and lean slightly. Relax your shoulders and swing the affected arm in a small circle. Swing the arm 10 times in clockwise direction and then in the anticlockwise direction. The diameter of the circle should be about a foot. As the symptoms start improving, gradually increase the diameter of the circle. With further improvement in the symptoms, hold a 3 to 5-pound weight in the affected arm while swinging it.

3. Armpit Stretch

Stand in front of a breast-high shelf. Rest the affected arm on the shelf. Use your unaffected arm to lift the affected arm. Gently bend the knees to open the armpit. This helps stretch the armpit. Then straighten the knee to release the stretch, and return to the starting position. Repeat the exercise. While repeating the exercise, try to bend your knees a little deeper to increase the armpit stretch. Perform this exercise several times a day.

4. Cross Body Reach

This shoulder stretch can be done either by standing or sitting. Use your good arm to lift the affected arm and support it at the elbow. The affected arm should extend across your chest. Apply gentle pressure with the good arm to stretch the shoulder. Hold for about 15 to 20 seconds and then slowly lower the arm. You can do this shoulder stretch several times a day.

5. Forward Flexion

To do this shoulder stretch, lie on your back. With your good arm support the affected arm at the elbow and lift it overhead. When you start feeling a gentle stretch, stop pushing the arm further. Hold the stretch for about 15 seconds and slowly lower the arm. Repeat the exercise.

6. External Rotation

Stand in front of a door. Bend the elbow of the affected arm at a 90-degree angle and grasp the doorjamb. Rotate your body away from the door frame until you feel a gentle stretch. Hold the stretch for 30 seconds and then return to the starting position. Relax and repeat the exercise.

7. Towel Stretch

Take a three feet long towel. Hold the towel horizontally behind your back. Pull one end of the towel upwards with your good arm until you feel a gentle stretch on the affected shoulder. Alternatively, this exercise can be performed by holding the towel vertically on your back. Place the towel over the unaffected shoulder and hold the top end with the good arm and the lower end with the affected arm. With your good arm, pull the towel upwards until the affected shoulder starts stretching. Hold the stretch for a few seconds and then release the stretch. Relax and repeat this exercise.


Natural Remedies for Frozen Shoulder

The following are the natural remedies for Frozen Shoulder

1. Ice Massage

Application of ice packs or cold therapy temporarily numbs the painful shoulder. In addition to providing relief from pain, applying ice before the shoulder stretches, could help you perform the gentle exercises with ease. Gently massage the shoulder with ice for about 8 to 10 minutes. Relax for a few minutes to allow the area to warm up slightly. Now do the gentle range-of-motion exercises. [10]

2. Heat Therapy

When inflammation is present, a cold application is best suited for relieving pain and easing movement of the affected shoulder. However, if the affected area is not swollen, you can apply heat. Studies suggest that the application of heat while exercising the shoulder helps in stretching the joint better. [11]

3. Contrast Heat and Cold Therapy

Alternating hot and cold compresses, hot fomentations and ice massages, hot and cold partial baths or hot and cold sprays could help in relieving the pain associated with frozen shoulder. Apply heat by placing a moist heating pad or towel on the affected shoulder for three minutes. Next, soak a washcloth in ice water, wring out the excess water and place it on the affected area for 30 seconds. Massaging the area with ice for a minute could also help. Reapply the hot compress followed by the cold compress two times more. [12]

4. Mustard Plaster

Applying mustard plaster to the frozen shoulder helps in keeping the area warm. The warmth of mustard helps in stimulating local circulation, thereby mitigating the pain. To prepare the mustard plaster you will need four tablespoons of wheat flour, one tablespoon of mustard powder and lukewarm water. Blend the ingredients to make a paste. Spread the paste on the middle of a cloth. Fold the cloth on four sides and cover the affected shoulder with the mustard smeared cloth. Make sure that a thin layer of cloth remains between the skin and the mustard paste. Remove the mustard plaster from the frozen shoulder after 20 minutes. [13]

5. Supplements

Dietary supplements that are known for their anti-inflammatory property can help in reducing the symptoms of frozen shoulder. Omega-3 fatty acids rich fish oil can help in reducing the swelling of the shoulder joint. You can also get relief by taking the antioxidant vitamins C and E. Supplementation with bromelain, devil’s claw extract and green-lipped mussel extracts are believed to be effective in reducing joint inflammation. To improve the lubrication of the shoulder joint, you can take glucosamine sulfate that could help in promoting synovial fluid secretion. Dietary supplements containing ginger, Boswellia and turmeric extract can help in relieving the inflammation. A magnesium supplement is believed to relax the muscles, thereby helping in reducing the acute symptoms. You can take up to 1000 mg of magnesium per day.

In addition to the dietary supplements, add foods with anti-inflammatory components to your daily diet. Oily fish such as salmon, red snapper, sardines, mackerel, and cod are rich in anti-inflammatory fatty acids. Pineapple is a natural source of bromelain that helps fight inflammation. Cherries are rich in anti-inflammatory bioflavonoids that you can eat frequently. Increase intake of anti-inflammatory spices such as cayenne pepper, turmeric, and ginger. [14][13]

6. Essential Oils

Essential oils with analgesic and anti-inflammatory properties can help in alleviating the pain and inflammation associated with frozen shoulder. For better result, the oil massage should be preceded by a warm cabbage compress. For the cabbage compress, you will need one large outer leaf of cabbage. Warm the cabbage leaf and place it on the frozen shoulder for about 15 minutes. To one teaspoon of vegetable oil add one drop each of clove, peppermint and lavender essential oil and two drops of rosemary essential oil. Blend the oils and gently massage the affected shoulder with the massage oil. You can also prepare massage oil by blending three drops each of clove, thyme, and chamomile essential oils and diluting the oil blend in two teaspoons of vegetable oil. [14]

7. Natural Therapies

Several natural therapies, apart from physical therapy, are known to be effective in improving the range of motion of the affected shoulder joint. Chiropractic and osteopathy can help in improving the shoulder joint condition. Acupuncture is known to provide relief from acute pain. Magnet therapies are believed to alleviate pain by stimulating blood flow to the shoulder joint. You can use magnet shoulder holders for the purpose. [15]