Physical therapy
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Frozen shoulder (adhesive capsulitis in Latin) is a condition in which the capsule of the shoulder joint gradually thickens and tightens, so the shoulder becomes stiff and painful and the range of motion decreases. It goes through three stages: the painful stage, the stiffness stage and the recovery stage. In the vast majority of cases the condition is curable, and physical therapy and exercise usually speed up the return of movement and reduce pain. If your shoulder hurts and it is getting harder to raise your arm, the first step is an assessment by a physiotherapist. At Fizio Spa in the centre of Zrenjanin we carry out an assessment and draw up a therapy plan based on the condition of your shoulder.
Below we explain what exactly frozen shoulder is, how to recognise it, why it happens and how it is treated, step by step. This article is for information only and is not a substitute for a professional examination, but it will help you understand what is happening in your shoulder and what to expect.
The shoulder joint is surrounded by a thin capsule of connective tissue. In frozen shoulder this capsule becomes inflamed, thickens and tightens around the joint, so the space for movement shrinks. The result is a shoulder that is stiff, hard to lift to the side or overhead, and often painful, especially at night. The name frozen shoulder comes precisely from this feeling that the shoulder is frozen. Unlike an ordinary strain, here movement is lost gradually and in all directions, not just in one particular movement.
Frozen shoulder develops gradually, over weeks and months, and classically goes through three stages. Once you know which stage you are in, it is easier to understand why something hurts and when things will change:
1. Painful stage (freezing). The pain increases, appears at rest and at night, and the shoulder becomes increasingly hard to move. This stage can last several months and is often the most unpleasant.
2. Stiffness stage (frozen shoulder). The pain usually eases a little, but marked stiffness remains. Everyday tasks such as dressing, fastening buttons or reaching a shelf become difficult. At this stage, working on range of motion is especially important.
3. Recovery stage (thawing). Movement gradually returns and the shoulder loosens up. With regular exercise and therapy, this is the most rewarding stage to work in, and progress is visible week by week.
The exact cause is not always clear, but there are situations in which frozen shoulder occurs more often. It is most commonly linked to a period of shoulder inactivity, for example after an injury, a fall, surgery or prolonged immobilisation, when the shoulder has not gone through its full range of motion for a long time. It is more common in middle-aged people, slightly more in women, and in people with diabetes or thyroid disorders. Sometimes it appears for no obvious reason. If you have recently been sparing your shoulder because of pain, that very avoidance of movement can contribute to stiffness, so it is wise to consult a specialist in good time.
The aim of treatment is to reduce pain and restore range of motion step by step. For most people, the backbone is physical therapy: a combination of manual techniques, targeted stretching and strengthening exercises, and physical procedures that soothe pain and prepare the tissue for work. In the painful stage therapy is gentler and more focused on reducing pain, and as the shoulder allows, work on mobility is gradually introduced. For some patients, a doctor also recommends medication or other medical measures, which is decided by the treating physician. Therapy works best when it is regular and adapted to the stage you are in, which is why we always do an assessment first and only then a plan.
With frozen shoulder, gentle mobility exercises done regularly help the most, without forceful stretching through severe pain. A classic example is the pendulum: you lean forward slightly and let your arm hang loosely and make small circles, which warms up the shoulder without loading it. Add to this gentle stretches to the side and across the chest, within the limits your shoulder allows that day. The rule is to work up to the point of tension, not through sharp pain. It is best to get the exact choice and dosage of exercises from a physiotherapist, adapted to your stage, so that you do not make the condition worse by mistake. These are general guidelines, not a prescription for self-treatment.
For most people the whole course of frozen shoulder takes a relatively long time, often a year or more, because the condition goes through all three stages. That sounds discouraging, we know. Still, with regular therapy the pain usually eases sooner, and range of motion is preserved and returns faster than when the shoulder is left to itself. How long your recovery will take depends on the stage you start in, the cause, and how regularly you do your exercises. That is why we do not promise deadlines; we agree on a realistic plan and track progress week by week.
Massage does not solve frozen shoulder on its own, but it can bring considerable relief. Tension in the muscles of the neck, upper back and around the shoulder blade often accompanies shoulder pain, and therapeutic massage reduces that tension so the body responds better to exercise. With some patients we use massage as a pleasant preparation before mobility work. Still, in true frozen shoulder, massage is a complement to, not a substitute for, targeted physical therapy. If you are not sure where the pain is coming from, an assessment will clarify it fastest.
Not every shoulder pain is frozen shoulder, but there are signs that mean it is worth not waiting. Get in touch if the pain lasts longer than two to three weeks, if it wakes you at night, if it is getting harder to raise your arm or get dressed, or if you notice that your range of motion is shrinking week by week. An early assessment helps distinguish the condition from other causes of shoulder pain and preserve mobility in time. For pain that originates in the neck, chiropractic sometimes makes sense too, which we decide after the examination. This article is for information only and does not replace a professional examination, so with severe or persistent pain we always recommend an in-person assessment.
Not sure whether your shoulder pain is frozen shoulder or something else? Tell us how it started and what bothers you most, and we will suggest an assessment and next steps, with no pressure.
Fizio Spa is located in the very centre of Zrenjanin, at Trg Slobode 3, in hotel Vojvodina. We have 20 years of experience working with pain and injuries and a 5.0 rating based on more than 2,729 reviews. For shoulder pain and suspected frozen shoulder, we first carry out an assessment and then draw up a therapy plan based on the stage you are in. Find out more on the Physical therapy page, check the price list or contact us for advice.
Frozen shoulder goes through three stages, and for most people the whole course takes a relatively long time, often a year or more. With regular physical therapy and exercise, movement often returns faster and with less pain. The exact course depends on the person, and this is where an assessment by a physiotherapist is most useful.
In some people the shoulder loosens up on its own over time, but this can take a very long time and leave a permanently reduced range of motion. Physical therapy shortens that period, preserves mobility and eases pain, so we do not recommend putting it off.
With a strain or muscle injury, the pain is usually tied to a specific movement, whereas with frozen shoulder the range of motion itself gradually disappears in all directions, even when someone else tries to move your arm. That is why a professional assessment is important, as the two conditions are treated differently.
Massage can ease muscle tension around the shoulder and neck and be a more pleasant preparation for exercise, but on its own it does not restore range of motion. With frozen shoulder, the backbone is physical therapy with targeted exercises, and massage is a useful complement.
Get in touch if your shoulder pain lasts longer than two to three weeks, wakes you at night, or you notice it is getting harder to raise your arm and get dressed. The earlier therapy starts, the easier it is to preserve movement. At Fizio Spa in Zrenjanin we do the assessment first, then the plan.
Book a shoulder assessment and get a therapy plan tailored to your stage. Confirmation arrives by email straight away, and we will suggest next steps with no pressure.
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