Frozen Shoulder: When the shoulder freezes and the nights become agony

The Three Phases of Frozen Shoulder: Where Are You?

Frozen shoulder typically progresses through three overlapping stages that can last up to two years in total.

• Phase 1: Freezing. The inflammation in the joint capsule is acute. The cardinal symptom: Shoulder pain at night and an extreme, stabbing pain with almost every movement. The joint is beginning to stiffen.

• Phase 2: The Frozen Phase. The pain is slowly subsiding, but the shoulder is now massively stiff. Movements above shoulder height are often impossible.

• Phase 3: Thawing. The inflammation has subsided, the capsule is gradually loosening, and the range of motion is returning month by month.

Why aggressive stretching in phase 1 is harmful

In the first phase, your central nervous system is on extreme alert due to the inflammation. The brain sends a clear signal: „Danger! Do not move!“ Anyone who tries to forcefully stretch the shoulder in this phase is literally adding fuel to the fire. The nervous system reacts with even more muscle guarding.

Here in physical therapy, we initially focus on unloading, gentle manual techniques, and a holistic perspective. When the shoulder hurts, the cervical spine or rib cage often compensates. We release tension in the neck and torso to take the stress off the shoulder. Only in the „frozen“ and „thawing“ phases do we begin with targeted neurocentric training, specific stimuli, and the so-called Nerve gliding (neurodynamics), to rid the brain of the fear of movement and to regain mobility.

Self-help: Everyday practical tips for a quieter night

• The correct sleeping position: Lie on your healthy side and hug a thick cushion with the affected arm. This prevents the shoulder from dropping forward and putting the joint capsule under tension.

• The gentle swinging: Lean on a table with your healthy arm, bend your upper body forward slightly, and let the affected arm hang completely relaxed. Now swing it gently back and forth without any muscle power (like an elephant's trunk). This gently relaxes the joint capsule and relieves acute pain.

When should you have a medical or physical therapy consultation?

Have the shoulder examined promptly if mobility rapidly and noticeably decreases, severe pain persists even at night or at rest, or the symptoms occurred after a fall or injury – in these cases, a structural injury must first be ruled out.

In addition to individual therapy, our Manual therapy aiming specifically to restore mobility in a gentle way.

Your way out of the pain spiral in Zurich Do you suspect you are suffering from adhesive capsulitis? Do not wait until the pain becomes unbearable. The team at Physiotherapy Waidfuss in Zurich (near Wipkingen and Höngg), we will guide you through all stages of the disease. Contact us online for a thorough assessment and your individual treatment plan!