Frozen shoulder, formally known as adhesive capsulitis, affects about 2% of Americans. Primary frozen shoulder is a bit of a mystery. It's cause is unknown but tends to happen more in postmenopausal women. It has an unusual sequence of disease - a freezing/painful phase, a frozen phase and a thawing phase. Together these phases can take 1-3 years but the course is somewhat reliable.
Secondary frozen shoulder occurs after an accident, illness or other trauma that may cause inflammation in the joint and/or things like tears in the rotator cuff muscles, car accident injuries, or broken arms that temporarily limit mobility. Immobility, forward rounding shoulders and inflammation are the perfect storm for developing frozen shoulder. Because secondary frozen shoulder is often preventable but difficult to treat once it is far along, it is important to get treatment as soon as possible for shoulder injuries, limited shoulder range of motion, and poor shoulder posture as soon as it becomes painful or before. This can reduce treatment time from years to a few months and help avoid surgery to break up the adhesions that form in the joint capsule.
For secondary frozen shoulder, it's hard to determine where to draw the line. What's a tight shoulder vs. a frozen shoulder? We really don't know whether it will stay benign or develop capsule adhesions. It's best to err on the side of caution. Frozen shoulder can be quite disabling and uncomfortable just doing your daily activities. In some professions, it may force you to stop working for a long time. If you have an inflammatory chronic illness or diabetes or you are simply a middle aged woman, your odds of a shoulder injury progressing into frozen shoulder go up significantly. Many cases go undiagnosed because of low severity. Cases can be complicated by posture, unfavorable inherited anatomy, and impingement of nerves.
Massage of the rotator cuff muscles and other muscles affecting the shoulders, arms and posture can be very helpful to reduce pain and balance the shoulder muscles for proper alignment. Techniques to help reduce adhesions in the joint capsule including neuromuscular therapy, stretches and arm pendulum mobilizations will help keep as much mobility as possible so the condition is not too disabling.
Because there are often high levels of inflammation in the joint causing adhesions, natural (like curcumin) or over the counter anti-inflammatories can sometimes slow or halt the progression of frozen shoulder, as can icing. Heat application may feel good and relaxing the rotator cuff muscles but will increase inflammation which may lead to overall regression. Another important factor in frozen shoulder healing can be hormonal imbalance, which should be addressed by a naturopath or endocrinologist after hormone testing. It's important to know, some cases of frozen shoulder will not improve much with treatment, only time.
Here are some stretches and exercises that you can do at home. Additionally, I like the alternate pendulum which is a sidelying movement and it may be the most important thing to keep doing everyday. Lay on your good side. Rotate your frozen shoulder side arm in a circle as wide as you can. Keep circling until you get a little more mobility and widening of the circle.