The 4 Stages of Frozen Shoulder: What to Expect and How to Exercise Safely

Frozen Shoulder Recovery Starts With Understanding

 You try to reach your back pocket or raise your arm—and it's stiff, painful, and just won’t move. The frustrating, slow-burn condition known as frozen shoulder can feel like a mystery with no end in sight.

 At Exercise Matters, we help clients understand what stage of frozen shoulder they’re in—and guide them with the right exercises at the right time. Here's what the research says about the 4 stages of frozen shoulder and the best way to manage each one.

What Is Frozen Shoulder?

Frozen Shoulder (also called Adhesive Capsulitis) is a condition where the connective tissue surrounding the shoulder joint becomes inflamed and stiff, limiting movement and causing pain. It progresses in 4 distinct stages, each requiring a different rehab approach.

Stage 1: The Pre-Freezing Stage 

What’s Happening:

• Shoulder pain starts subtly and gradually worsens

• Movement is still possible but increasingly painful

• Often misdiagnosed at this stage

  
  

Exercise Advice:

• Gentle range-of-motion exercises

• Pain-free pendulum swings

• Postural awareness and scapular setting

Goal: Minimise pain and maintain as much mobility as possible without irritation

Stage 2: Freezing Stage 

What’s Happening:

• Significant pain, especially at night and with movement

• Stiffness progressively increases

• Loss of external rotation and overhead movement

  
  

Exercise Advice:

• Passive and active-assisted mobility work (e.g. pulleys, stick exercises)

• Heat therapy before exercise to reduce joint stiffness

• Isometric shoulder activation (within pain-free range)

Goal: Reduce pain, prevent further stiffness, and maintain gentle movement

Stage 3: Frozen Stage 

What’s Happening:

• Pain begins to reduce

• Movement remains restricted—especially rotation and abduction

• Functional limitations continue (e.g. dressing, reaching)

  
  

Exercise Advice:

• Gradual introduction of resistance training

• Stretching to end range (within tolerable limits)

• Joint mobilisations (performed by clinicians)

• Wall walks, isometric holds, scapular retraction drills

Goal: Restore range of motion and begin rebuilding shoulder strength

Stage 4: Thawing Stage 

What’s Happening:

• Movement begins to return

• Pain significantly reduces

• Shoulder gradually regains full or near-full function

  
  

Exercise Advice:

• Full range strengthening (light dumbbells, bands)

• Functional training (reaching, lifting, pushing)

• End-range mobility stretches (sleeper stretch, cross-body reach)

• Continue postural and scapular training

Goal: Restore functional movement and build strength for long-term resilience

Case Study: Alan, 56, Office Worker with Frozen Shoulder

Alan presented in the freezing stage with severe night pain and limited mobility. Our phased program included:

• Stage 2: Pendulums and heat-assisted stretching

• Stage 3: Isometric holds and wall slides

• Stage 4: Resisted theraband work and overhead mobility drills

After 12 months:

• Alan regained 95% of shoulder mobility

• Pain-free overhead motion was restored

• He returned to recreational golf

Frequently Asked Questions

1. How long does frozen shoulder last?

Typically 12–24 months, but early intervention can reduce duration and severity.

2. Can I speed up the stages?

Not exactly—but targeted rehab can make each stage more manageable and help restore function sooner.

3. Should I push into pain?

No. Gentle stretching is good—but sharp or intense pain can cause more inflammation. Work within a tolerable range.

4. Is cortisone helpful?

It may reduce inflammation and pain, especially in the freezing stage. Discuss with your GP or specialist.

Move Through It, One Phase at a Time

Frozen shoulder recovery is a process—but with the right plan, it doesn't have to be a setback. Let us guide your progress with clinical rehab that matches your stage, goals, and capacity.

📞 Book a shoulder rehab consult at (07) 5448 3532 🌐 www.exercisematters.healthcare

References:

• Kelley MJ et al. (2013). Frozen shoulder: evidence and a proposed model. Phys Ther.

• Lewis J. (2015). Frozen shoulder contracture syndrome: review of pathology and evidence-based management. Br J Sports Med.

• Maund E et al. (2012). Management of frozen shoulder: a systematic review. Health Technol Assess.