What Is Frozen Shoulder?

Frozen shoulder (adhesive capsulitis) is a condition where the shoulder joint becomes increasingly painful and stiff, significantly limiting your ability to move your arm. The capsule surrounding the shoulder joint thickens and tightens, forming adhesions that restrict movement.

It affects 2-5% of the general population, but up to 20% of people with diabetes - a particularly relevant statistic in Malaysia where diabetes prevalence is among the highest in Asia.

Who Gets Frozen Shoulder?

Risk factors include:

  • Diabetes - 10-20% of diabetics develop frozen shoulder (Malaysia has one of the highest diabetes rates in the region)
  • Age 40-60 - most common age group
  • Women - slightly more common than men
  • Thyroid disorders - both overactive and underactive
  • Prolonged immobility - after surgery, injury, or stroke
  • Heart disease or Parkinson's disease

The Three Stages of Frozen Shoulder

Stage 1: Freezing (2-9 months)

  • Pain gradually increases, often worst at night
  • Shoulder movement becomes increasingly limited
  • Pain may radiate down the arm
  • Many patients struggle to sleep on the affected side

Stage 2: Frozen (4-12 months)

  • Pain may actually decrease slightly
  • Stiffness becomes the main problem - significant loss of movement
  • Daily activities become difficult: reaching overhead, fastening a bra, tucking in a shirt, washing hair
  • The shoulder may feel "stuck"

Stage 3: Thawing (5-24 months)

  • Movement gradually returns
  • Pain continues to decrease
  • Recovery is often incomplete without physiotherapy - some stiffness may remain

Total duration without treatment: typically 1-3 years. With proper physiotherapy, recovery can be significantly shortened.

Physiotherapy Treatment

Physiotherapy is the cornerstone of frozen shoulder treatment. Your treatment will be different depending on which stage you are in:

During Freezing Stage

  • Gentle range-of-motion exercises within pain tolerance
  • Pain management: heat therapy, TENS, gentle manual therapy
  • Education: understanding the condition reduces anxiety
  • Avoiding aggressive stretching - this can worsen inflammation

During Frozen Stage

  • Progressive stretching programme: gradually pushing the boundaries of movement
  • Joint mobilisation: your physiotherapist uses hands-on techniques to improve joint movement
  • Wall climbing exercises: fingers walk up a wall to gradually increase reach
  • Pendulum exercises: gentle swinging of the arm to maintain movement
  • Pulley exercises: using a rope over a door to assist movement

During Thawing Stage

  • Strengthening exercises: rebuilding muscle strength that was lost during inactivity
  • Functional training: relearning daily movement patterns
  • Stretching maintenance: preventing recurrence of stiffness
  • Return to normal activities: gradual progression

Home Exercises (Do These Daily)

1. Pendulum Exercise

Bend forward at the waist, let the affected arm hang down. Swing the arm gently in small circles - 10 circles each direction.

Gradually increase circle size.

2. Towel Stretch

Hold a towel behind your back with both hands. Use the unaffected arm to gently pull the affected arm upward.

Hold 15-20 seconds, repeat 10 times.

3. Finger Wall Walk

Face a wall, place your fingers at waist height. Walk your fingers up the wall as high as you can without pain.

Hold 15 seconds. Do 10 repetitions.

4. Cross-Body Stretch

Use your good arm to lift the affected arm at the elbow and bring it across your body. Hold 15-20 seconds, repeat 10 times.

Other Treatment Options

Corticosteroid Injection

A steroid injection into the shoulder joint can provide significant pain relief, especially during the freezing stage. This can make physiotherapy more effective.

Available at hospitals and some clinics in Melaka.

Hydrodilatation

A procedure where fluid is injected into the joint capsule to stretch it. Done under imaging guidance at hospitals in Melaka.

Manipulation Under Anaesthesia

The surgeon moves the shoulder through a full range of motion while you are asleep, breaking the adhesions. Reserved for cases that do not respond to physiotherapy after 6+ months.

Costs in Melaka

  • Physiotherapy: RM80-200 per session (12-20 sessions typical over 3-6 months)
  • Corticosteroid injection: RM200-500 (private)
  • Hydrodilatation: RM1,000-2,000 (private)
  • Manipulation under anaesthesia: RM3,000-8,000 (private)

Important Tip for Diabetic Patients

If you have diabetes, frozen shoulder tends to be more severe and slower to recover. Good blood sugar control is important for healing.

Work with both your doctor (for diabetes management) and your physiotherapist (for shoulder rehabilitation) for the best outcome.

WhatsApp PhysioMelaka to find a physiotherapist experienced in treating frozen shoulder near you. Early treatment shortens recovery time significantly.