Frozen Shoulder
Frozen shoulder (adhesive capsulitis) happens when the capsule around your shoulder joint thickens and tightens, slowly stealing your range of motion. You may not be able to reach behind your back, lift your arm overhead or sleep on that side. It often comes on without an obvious injury. At RehabOne Plus, we use a combination of manual therapy, mobilization, and progressive exercise to restore movement, usually without injections or surgery.
What Frozen Shoulder Feels Like
- Dull or aching pain deep in the shoulder, often radiating into the upper arm
- Stiffness that makes it hard to reach overhead, behind your back or out to the side
- Significantly decreased range of motion in all directions
- Pain that typically worsens at night and when trying to sleep on the affected shoulder
- A “stuck” feeling at the end of every movement
- Gradual onset over weeks or months without a clear cause
Common Causes of Frozen Shoulder
- Immobility following a recent injury or fracture (most common trigger)
- Recent shoulder surgery from rotator-cuff repair to clavicle pinning
- Cervical disc disease referring pain or limiting shoulder use
- Diabetes significantly raises the risk and prolongs the course
- Thyroid problems both hypo- and hyperthyroid states are linked
- Heart conditions or open-heart surgery requiring prolonged inactivity
- High cholesterol another metabolic risk factor
- Often idiopathic, no clear trigger identified
How We Treat Frozen Shoulder at RehabOne Plus
There is no single fix for frozen shoulder, recovery comes from combining the right treatments for your specific stage of the condition. Your practitioner will assess where you are in the cycle (freezing, frozen or thawing) and build a plan from these proven approaches:
Physiotherapy
Hands-on joint mobilization, progressive stretching, and a custom home-exercise program to restore range of motion
Chiropractic care
Adjustments to the cervical and thoracic spine where stiffness is contributing
Ultrasound therapy
Deep heating to soften the joint capsule and prepare it for stretching
Shoulder support
Compression sleeves with proprioceptive feedback during the active rehab phase
When to Come In
Book a consultation if your shoulder symptoms have lasted more than a week, are getting worse or are interfering with sleep, work or daily activities. Early intervention significantly shortens the total recovery timeline for frozen shoulder. We offer same-week appointments and direct-bill most insurers.
Stages of Frozen Shoulder
Frozen shoulder progresses through three predictable stages. Knowing where you are determines what treatment will help most.
Stage 1: Freezing (6 weeks to 9 months)
This is the painful phase. Pain comes on gradually, often without injury, and gets worse at night. Range of motion is starting to decrease but the loss is not yet severe. Treatment in this stage focuses on pain control, gentle mobilization, and preventing further loss of motion.
Stage 2: Frozen (4 to 12 months)
Pain decreases somewhat but stiffness is the dominant symptom. You cannot reach overhead, behind your back or out to the side without significant restriction. Manual therapy, progressive stretching, and mobilization work hard during this phase to restore motion.
Stage 3: Thawing (6 months to 2 years)
Motion gradually returns. The thawing phase responds well to a structured exercise program and targeted manual therapy. Most patients eventually regain near-full motion, though full recovery can take 1 to 3 years total without active treatment.
With early physiotherapy, the total recovery timeline shortens significantly. Most of our patients regain functional motion in 6 to 9 months rather than 1 to 3 years.
Risk Factors for Frozen Shoulder
Age 40 to 60
with the peak in women between 50 and 55
Diabetes
which raises the risk by 4 to 6 times and prolongs the course
Thyroid disorders
(both hyper and hypothyroid)
Recent shoulder injury or surgery
particularly with prolonged immobilization
Cardiovascular disease
or recent cardiac surgery
Parkinson’s disease
Female
with a 2:1 ratio compared to men
Previous frozen shoulder on the opposite side
in which case the second shoulder has a 20 to 30% chance of also developing it
Recovery Timeline With Treatment
The single biggest factor in recovery time is when treatment starts. Patients who come in during the freezing stage typically recover full motion in 6 to 9 months. Patients who wait until the frozen stage often take 9 to 14 months. Patients with diabetes typically take 1.5 to 2 times longer at any stage.
Expect 16 to 24 sessions over 4 to 6 months for a typical case. The plan layers in manual therapy, progressive stretching, home exercise, and where indicated, and ultrasound therapy to support healing.
When to See a Doctor in Addition to Physiotherapy
Frozen shoulder is usually managed conservatively. However, in a small number of cases, additional medical input helps.
- Severe night pain that does not respond to physiotherapy after 6 to 8 weeks (a corticosteroid injection can reset the pain cycle)
- No improvement in motion after 6 months of consistent physiotherapy (specialist consult)
- Suspicion of a rotator cuff tear masquerading as frozen shoulder (imaging may be needed)
- Frozen shoulder in someone with unmanaged diabetes (endocrinology referral)
Insurance Coverage for Frozen Shoulder
Frozen shoulder treatment is covered by most extended health plans for physiotherapy, chiropractic. If your frozen shoulder started after a motor vehicle accident or a workplace injury treatment is fully covered through SABS or WSIB respectively.
Visit Our Clinic in Thornhill
Located on Yonge Street near Steeles Avenue. Free parking available. Bring your insurance card on your first visit, we handle the rest.