Frozen Shoulder: Navigating Causes, Treatment, and Self-Care with Massage Therapy

Frozen shoulder, or adhesive capsulitis, is characterized by a progressive tightening and inflammation of the glenohumeral joint capsule, leading to a significant reduction in joint volume. The average volume of a healthy shoulder joint can reach up to 35 ml; however, in cases of frozen shoulder, this volume may diminish to 10 ml or less.

Understanding these phases can aid healthcare professionals in diagnosing and developing appropriate therapeutic interventions for individuals with frozen shoulders, as indicated below:
The condition typically progresses through three distinct stages:

1. **Acute Stage (Freezing Phase)** Duration:** 2-9 months
This stage is marked by a gradual onset of pain and increased stiffness. Patients often experience severe nocturnal pain that disrupts sleep on the affected side, with discomfort localized primarily around the outer aspect of the shoulder and the deltoid insertion.

**Subacute Stage (Frozen Phase)** Duration:** 4-12 months<
Patients commonly report transitioning from pain as the primary complaint to emphasizing stiffness during this phase. Restriction in movement adheres to a specific capsular pattern: external rotation, followed by abduction and internal rotation. During this period, there is also potential for disuse atrophy of the deltoid and rotator cuff muscles.

3. **Chronic Stage (Thawing Phase)** Duration:** Variable; potentially lasting between 5-10 years
The chronic stage features a gradual improvement in motion and overall function. Pain may persist but typically becomes localized to the lateral arm and diminishes over time; however, patients might not consistently achieve full range of motion.
Arises following shoulder injuries or extended periods of inactivity.