Last updated 26/02/2024 by The pain clinics - Interdisciplinary Health

20 exercises for frozen shoulder

An exercise guide with 20 recommended exercises for frozen shoulder (adhesive shoulder capsulitis). We categorize exercises for shoulder capsulitis into 3 phases, according to the phase of the patient's condition.

Frozen shoulder causes greatly reduced movement and pain over a longer period of time. It is therefore also common that one gets Pain in the neck og pain in the shoulder blade as the muscles try to compensate for the lack of movement. Because this is a long-term diagnosis, we always recommend that you combine physical treatment with exercises and training.

Phase-specific exercise guide against frozen shoulder

The frozen shoulder goes through different "phases" (phases 1 to 3), so it is not certain that you can do all of these exercises, it must be assessed by the individual, based on which phase you are in. But in this guide We therefore go through 20 exercises that can be used in the different phases. Please also read the section on what the research says about how to treat frozen shoulder.

- Adhesive capsulitis is long-lasting, but persevere and take active measures for faster recovery

It is a classic misconception that frozen shoulder'passes by itself'. This does not entail complete accuracy, and such information probably leads to many people not taking this diagnosis seriously enough. The truth is that as many as 20-50% end up in the fourth phase of shoulder capsulitis, known as the chronic phase in Nevier's classification (phase 4).⁵ The diagnosis is known to last for 1.5 – 2 years. But there is good documentation that a holistic and active approach to the ailments leads to shorter duration and less reduction in shoulder strength (due to muscle wasting). By our clinic departments belonging to the Vondtklinikkenne Tverrfaglig Helse, we often see that the duration can be reduced considerably by using specific rehabilitation exercises and active treatment (including the use of therapeutic laser, dry needling and pressure wave therapy).

Research: Cortisone injections significantly increase the risk of tendon tears

There is also clear documentation that cortisone injections in the shoulder can significantly increase the risk of tendon tears in the area. Studies have shown that a frighteningly high number, as much as 17%, experience a complete tendon rupture within 3 months.⁶ A possible side effect that the majority of patients are not informed about when they are presented with cortisone injection treatment.

"The article has been written and quality checked by publicly authorized health personnel. This includes both physiotherapists and chiropractors at Pain clinics Interdisciplinary Health (see clinic overview here). You can get to know our core values ​​and quality focus better here . We always recommend having your pain assessed by knowledgeable healthcare personnel. "

Tips: Further down in this article shows chiropractor Alexander Andorff three different training videos with recommended exercises for frozen shoulder in phase 1, 2 and 3. The training programs have been put together by physiotherapists and chiropractors based on recommended, evidence-based guidelines. In this article, we also give concrete advice on self-measures and self-help, such as self-massage massage balls, training with pilates bands and mobilization with foam roll. Links to product recommendations open in a new browser window.

In this article you will learn more about:

1. Neviaser's classification: The three phases of shoulder capsulitis (and the lesser-known fourth phase)

2. 5 exercises for phase 1 of frozen shoulder (with video)

3. 6 exercises for phase 2 of frozen shoulder (with video)

4. 7 exercises towards phase 3 (with video)

5. Physical therapy for frozen shoulder (evidence-based)

6. Recommended self-measures and self-help against shoulder capsulitis

1. Neviaser's classification: 3 phases of frozen shoulder (and the lesser-known fourth phase)

The doctor brothers Neviaser were the ones who developed the phase classification of frozen shoulder. In fact, they divided the progression of adhesive capsulitis into four phases, yet there are three of these that we usually refer to:

• Phase 1: The painful phase

• Phase 2: The rigid phase

• Phase 3: The thawing phase

When you get 'served it' in this way, it is of course easy to believe that this shoulder diagnosis will thus 'go over'. But the fact is that for very many (20-50%) patients, such an attitude could lead to them ending up in the lesser-known fourth phase, better known as chronic phase. Which could result in reduced shoulder function for the rest of your life.

- How were the four phases of frozen shoulder categorized?

Neviaser and Neviaser based their categorization on both arthroscopic (examination of the tissue with surgery) and clinical signs.

• 1 phase: The patient complains of shoulder pain, which is particularly worst at night. But the mobility itself is still good. Arthroscopic examination reveals signs of synovitis (synovial inflammation), but without signs of other damaged tissue.
• 2 phase: The patient complains of stiffness in the shoulder. Signs of synovial inflammation are seen, but also damage tissue formations and thickening of the joint capsule. This phase develops gradually, and mobility becomes significantly restricted and painful during passive testing (PROM).
• 3 phase: In this stage, the synovial inflammation has subsided, but there is extensive damage tissue, scar tissue, shortened connective tissue and joint capsule thickening – which causes persistent stiffness. The shoulder blades and shoulders are at this stage significantly weakened. Especially the shoulder stabilizers (rotator cuff), musculus latissimus dorsi and musculus teres major will need extensive rehabilitation training. Mobility increases again gradually.

– More extensive than just 'thaw'

As you understand from the extensive content of damaged tissue and tissue changes, the shoulder diagnosis, frozen shoulder, is far more than just a "shoulder that needs thawing«. It is important to be aware of these damage mechanisms. Here it is also important to emphasize again that the drive on with repeated cortisone injections entails a significant risk of long-term, chronic complaints - due to weakened tendon health. Breaking down the structural changes in the shoulder, in order to get to the level you were at before the diagnosis, will require targeted and dedicated training.

• 4 phase: The somewhat unknown little brother of the other three phases. In this phase there is persistent stiffness but minimal shoulder pain. Arthroscopically, there is significantly reduced space in the shoulder joint itself (narrower) and an extensive content of damaged tissue. This is a phase where very many patients can stay left hanging, without them ever recovering to the shoulder function they had before they were affected by frozen shoulder. That is why it is also called the chronic phase. With that said, many people get out of this phase too, but it will require discipline, time and self-effort.

2. VIDEO: 5 exercises against frozen shoulder (phase 1)

In the video below, chiropractor Alexander Andorff talks about what phase 1 of shoulder capsulitis entails, and also shows 5 recommended exercises. The exercises can be done daily. Aim for 10 repetitions per exercise and 3 sets. The five exercises for phase 1 are:

1. Codman's pendulum and circle exercise

2. Shrug

3. Contraction of the shoulder blades

4. Horizontal lateral arm guidance (with towel)

5. Push the towel forward on the floor

Explanation: Codman's pendulum and circle exercise

This is a great exercise to stimulate blood circulation and synovial fluid in the shoulder joint. The exercise provides movement in the shoulder joint and mobilizes the muscles in a gentle way. Let the arm affected by frozen shoulder hang down, while you support yourself on a table or similar with the healthy arm. Then let the shoulder move in circles, both clockwise and counterclockwise. Then make the pendulum movement back and forth, as well as side to side. Make sure to maintain a neutral curve in your back when doing the exercises. Do this for 30-45 seconds before taking a break. Repeat over 3-4 sets – 2 times a day.

Explanation: Shoulder raise and shoulder mobilization

Active review of the movement pattern of the shoulder without resistance. Raise your shoulders, then lower them back down. Roll your shoulders forward, then roll back. Turn the arm outwards (external rotation) while hanging down at the side. Lift your shoulders up and then lower them down. Light mobilization exercises that keep the movement going inside the shoulder joint. Can be done several times a day.

3. VIDEO: 6 exercises against frozen shoulder (phase 2)

We are now in phase 2 of shoulder capsulitis. The stiffness now limits mobility in the shoulder, and thus the exercises in this training program aim to stretch the joint capsule and maintain mobility in the shoulder joint. This can contribute to faster healing, less loss of shoulder mobility and reduction of damaged tissue. Due to the limited shoulder mobility, there is also a focus on isometric training in phase 2 (training of muscles without making them shorter or longer).  In the video below talking chiropractor Alexander Andorff about stage 2 of adhesive capsulitis, and then shows you 6 recommended exercises. You can hold stretches for 30 seconds. Other exercises you can aim to do 10 repetitions of each, with 3 sets of each. These 6 exercises are:

1. Sprain of the shoulder joint capsule (preferably with support under the head)

2. Stretching of the shoulder and shoulder blade

3. Finger climbing on a wall

4. Isometric outward rotation of the shoulder

5. Isometric abduction of the shoulder

6. Isometric extension of shoulder

Explanation: Stretching of shoulder (with elastic or broom handle)

Exercise that mobilizes and provides increased movement in the shoulder blades. This is done by using a rubber band, a towel or the handle of a broom and then holding it behind the body, with the left hand (or the opposite) behind the back and the right hand over the shoulder backwards. Remember to adapt in relation to your own shoulder problems. You should only stretch as much as you are comfortable with. The stiff shoulder should therefore be the lowest, since phase 2 entails clearly reduced abduction (side elevation movement) and flexion (front lift movement).

• A. Starting position (we emphasize again that the frozen shoulder should be in the lower position)
• B. execution: Pull calmly upwards - so that you feel the shoulder and shoulder blades move gently. Stop when it starts to hurt and then lower back to starting position.

Performed over 3 sets of 10 repetitions.

Our recommendation: A pilates band is very useful for frozen shoulder

A number of the exercises we show in this phase-specific exercise guide for frozen shoulder can be done with training socks. We often recommend the flat, elastic version, also known as a Pilates band. You can read more about our recommendation here .

Explanation: Isometric training of the shoulder

Isometric Training: Isometric training refers to exercises in which you train without shortening the muscle (concentric) or longer (eccentric), i.e. resistance-based only.

• A. Isometric outward rotation: Hold your elbow against your body and find a suitable place to perform the exercise. The pressure should be on the outside of the wrist. Press outwards for 10 seconds and then relax. Repeat 4 repetitions over 3 sets.
• B. Isometric inward rotation: Same design as A, but with pressure on the inside of the wrist and push inwards.

4. VIDEO: 7 exercises against frozen shoulder (phase 3)

Phase 3 is also known as the thawing phase. So now it's time to work purposefully to build up mobility in the shoulder joint, while also working to strengthen the weakened shoulder stabilizers (rotator cuff) and shoulder muscles. Part of the purpose here is also to break down much of the myofascial restrictions and damaged tissue that limit our mobility. In this video goes chiropractor Alexander Andorff through 7 recommended exercises against phase 3 of frozen shoulder. Note that we continue to stretch the joint capsule (as in phase 2), as these are effective exercises that hit the injured area. The 7 exercises include:

1. Stretching of the joint capsule

2. Stretching of the shoulder and shoulder blade

3. Forward transfer of the arms (shoulder flexion)

4. Side raises with arms (shoulder abduction)

5. Shoulder rotation: Inward

6. Shoulder rotation: Beyond

7. Stave ceiling (medium high starting point)

Explanation: Shoulder flexion, shoulder rotation and shoulder abduction

• A. Shoulder flexion: Hold a broomstick, bunting or towel at shoulder width. Then raise your arms together towards the ceiling in a gentle movement. Stop when you feel resistance. Repeat 10 repetitions over 3 sets. To be done daily.
• B. Overrotation: Lie on your back and hold a stick, knit or towel in shoulder width. Then lower your shoulder to the left side until you feel resistance. Repeat on the other side. 10 repetitions over 3 sets - daily. Alternatively, you can do as below - but only within the range of motion you can manage.
• C. Shoulder abduction: abduction means in good Norwegian Dumbell Lateral Raisen. So this exercise involves raising the relevant side out and up while holding onto a rubber band or a broom handle. Performed on both sides with 10 repetitions over 3 sets. Can be done daily or every other day (depending on your own medical history).

Bonus exercises: Stretching the pectoral muscles and biceps (exercises 19 and 20)

The pectoral muscles (musculus pectoralis) often become very tight and shortened with frozen shoulder. We therefore recommend that you actively stretch both them and the biceps during the diagnostic process.

• Pectoralis / chest muscle stretching: Feel free to use a doorway when performing this stretchy exercise. Put your arms up along the door frames and then gently lower your torso forward until you feel a stretch toward the front of the chest in the attachment to the front of the shoulder. Hold the stretch in 20-30 seconds and repeat 2-3 times.
• Biceps stretch: Place your hand calmly against a wall. Then gently turn the upper body towards the opposite side until you feel it stretch gently in the shoulder blade and shoulder. Keep the clothing position in 20-30 seconds and repeat over 3-4 sets.

5. Treatment for frozen shoulder (evidence-based)

Our clinic departments at Vondtklinikkene Interdisciplinary Health is keenly concerned that our patients should be well acquainted with what frozen shoulder actually entails, both physically and anatomically. It is also important that they are well informed about how important an active personal effort is (according to phase-specific shoulder exercises), and which treatment modalities may be useful for them. A holistic approach with a combination of several treatment techniques and rehabilitation exercises can result in shorter duration and significant improvements (including less pain and more shoulder mobility).

– Pressure wave treatment versus cortisone injection?

Recent studies have documented that pressure wave therapy can be more effective than the more invasive cortisone injection, but without the same risks.¹ A major research study published in the Journal of Shoulder and Elbow Surgery (2020), with 103 patient participants, compared four pressure wave treatments, with a week in between, versus an ultrasound-guided cortisone injection. The conclusion showed the following:

There was a significant improvement in shoulder mobility and range of motion (also known as the abbreviation ROM - range of motion) in both patient groups. However, in terms of pain and functionality, a significant improvement was seen in the group that had received pressure wave treatment. In fact, the latter reported a twice as good improvement over pain on the VAS (visual analogue scale).

Note in particular that the group receiving pressure wave therapy had twice as good an effect when it came to pain relief. These research results are also supported by previous larger research studies, which can also show a faster return to normal function and improved quality of life.²,³ With an evidence-based approach, all patients with frozen shoulder should first be recommended a treatment plan with pressure wave treatment consisting of 4-6 treatments (aggravated varieties, a few extra treatments can be expected), with a week in between.

Pressure wave treatment is combined with exercises for an even better effect

It is important to mention that in the above studies they have mainly looked at the isolated effect of only shock wave treatment. This means that the patients have only received this form of treatment (with good results to be sure). By combining this treatment method with specific rehabilitation exercises, according to the suspected phase, one can expect even better results. In addition to this, it can also be beneficial to implement dry needling, joint mobilization and muscular work. Feel free to contact us via social media or on the contact form directly to one of our clinic departments if you want to know more about how we can help you. We answer all questions and inquiries.

6. Self-measures and self-help against shoulder capsulitis

As mentioned earlier, certain more specific mobility exercises are particularly recommended, as these have shown a documented effect on range of motion and pain in systematic overview studies.⁴ And remember that these should be phase-specific (i.e. that you do exercises based on which phase of frozen shoulder you are in). In addition to rehabilitation exercises and physical treatment, there are also several good measures you can take on your own. This can help you to dissolve tense muscles and provide symptom relief. All product recommendations open in a new browser window.

Our recommendation: Self-massage with massage balls

A set of massage balls can be beneficial for self-massage against tense and tight muscles. This set contains two massage balls made of natural cork, which you can use to target muscle knots and trigger points. This can help you increase blood circulation and stimulate improved flexibility in the muscle tissue. Something the vast majority of us can benefit from. Read more about our recommended massage balls here . In addition to these, you can also benefit from one large foam roller for mobilizing joints and working against sore muscles.

Help for self-help: Large reusable heat pack with fastening strap

A heat pack that can be used again and again is something we are happy to recommend to everyone. There are far too many of these that can only be used once (disposable packaging), and in addition to being bad for the environment, this quickly becomes expensive if you want to use this regularly. Very practical to have lying around, as it can also be used as both a heat pack and a cold pack, i.e. what we call one reusable combination pack. This is of a large size and also comes with a practical fastening strap. You can read more about it here .

Summary: 20 exercises for frozen shoulder (a phase-specific exercise guide)

Being affected by frozen shoulder is very demanding. But as shown in this guide, there are a number of good exercises, self-measures and treatment methods that can help you. One of the most important things is that you understand the extent of having shoulder capsulitis, and that it is incredibly important that you take it seriously by doing what you can to achieve recovery.

The pain clinics: Your choice for modern treatment

Our clinicians and clinic departments always aim to be among the elite in the investigation, treatment and rehabilitation of pain and injuries in muscles, tendons, nerves and joints. By pressing the button below, you can see an overview of our clinics - including in Oslo (incl Lambert seats) and Akershus (Raw wood og Eidsvoll Sound). Feel free to contact us if you have any questions or are wondering about anything.

See clinic overview

Article: 20 exercises against frozen shoulder

Written by: Our publicly authorized chiropractors and physiotherapists at Vondtklinikkene Tverrfaglig Helse

Fact check: Our articles are always based on serious sources, research studies and research journals, such as PubMed and the Cochrane Library. Please contact us if you spot any errors or have comments.

- Feel free to follow the Vondtklinikkene Verrrfaglig Helse at YOUTUBE

- Feel free to follow the Vondtklinikkene Verrrfaglig Helse at FACEBOOK

Sources and research

1. El Naggar et al, 2020. Effectiveness of radial extracorporeal shock-wave therapy versus ultrasound-guided low-dose intra-articular steroid injection in improving shoulder pain, function, and range of motion in diabetic patients with shoulder adhesive capsulitis. J Shoulder Elbow Surg. 2020 Jul; 29 (7): 1300-1309.

2. Muthukrishnan et al, 2019. The effectiveness of extracorporeal shockwave therapy for frozen shoulder in patients with diabetes: randomized control trial. J Phys Ther Sci. 2019 Jul; 31 (7): 493-497.

3. Vahdatpour et al, 2014. Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder. Int J Prev Med. 2014 Jul; 5 (7): 875–881.

4. Nakandala et al, 2021. The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. J Back Musculoskeletal Rehabilitation. 2021; 34 (2): 195-205.

5. Le et al, 2017. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr; 9(2): 75–84.

6. Ramirez et al, 2014. Incidence of full-thickness rotator cuff tear after subacromial corticosteroid injection: a 12-week prospective study. Mod Rheumatol. 2014 Jul;24(4):667-70.

Photos: Wikimedia Commons 2.0, Creative Commons, Freestockphotos and submitted reader contributions.