Massage Therapy for Frozen Shoulder

If you’ve been having trouble lifting your arm over your head because your shoulder is too stiff or painful, you may have a condition called adhesive capsulitis, commonly known as “frozen shoulder.”

Frozen shoulder is a general term used to describe a restricted range of motion or stiffness in the shoulder. Adhesive capsulitis is a specific condition characterized by a gradual onset of stiffness and pain in one shoulder caused by inflammation and tightening of the joint capsule (ligaments that attach the shoulder bones). Often, the terms frozen shoulder and adhesive capsulitis are used interchangeably.

Regular massage treatments can help manage shoulder pain and loosen stiff shoulder muscles. The standard treatment for frozen shoulder also includes regular physical therapy, home exercises, heat therapy, nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Prompt treatment aids recovery, although it may take from 12 to 18 months to nearly or fully restore range of motion. Conservative treatments are generally successful in treating frozen shoulder, although in some cases surgery may be needed to release the contracted joint capsule in the shoulder.

How Can Massage Therapy Help with Frozen Shoulder?

Massage therapy is a helpful treatment for frozen shoulder because it increases blood flow to the injured area and helps to reduce scar tissue. Regular massage treatments are needed to reduce muscle stiffness, and you may not start to feel relief until after several massage treatments.

A combination of techniques, performed by an experienced massage therapist, will provide shoulder pain relief and help your recovery during the “thawing,” or recovery stage of the condition. Deep-tissue massage is a common technique used to treat frozen shoulder. With this technique, the therapist applies steady pressure to the muscles to release adhesions or scar tissue that may be contributing to shoulder pain. A Japanese form of deep-tissue massage, called shiatsu, involves deep pressure on specific areas of the body, called acupressure points, to adjust energy flow (“Ki” in Japanese) through the body, thereby reducing pain. Deep-tissue massage techniques should be avoided during times of acute shoulder pain, inflammation, or swelling.

Other massage techniques for frozen shoulder include trigger point therapy, in which steady pressure is applied to targeted points within muscles to relieve muscle spasms, and Swedish massage, which involves gentle kneading and long strokes applied to surface muscle tissues to reduce stress and tension.

Heat therapy, applied immediately before or after massage, is also very beneficial in treating frozen shoulder.

What is Massage Therapy?

Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage treats the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic, and nervous systems.

What Causes Frozen Shoulder?

Frozen shoulder most commonly affects people from 40 to 60 years old and typically affects one shoulder, but can also develop in both shoulders. Frozen shoulder can occur after a fall or motor vehicle accident or may be related to an underlying condition, such as arthritis, a shoulder injury, rotator cuff tendonitis, or resulting from shoulder surgery. The use of a sling, splint, or cast may cause joint stiffness and contribute to frozen shoulder due to limited use and immobility. Diabetes increases the risk of developing frozen shoulder. Often there is no known underlying cause for frozen shoulder.

A gradual onset of pain is the initial symptom of frozen shoulder (phase one or the “freezing” stage), which leads the person into developing stiffness due to lack of movement (second phase of the condition or the “frozen” stage). Although pain decreases gradually in the second phase, stiffness remains. The “thawing,” or third phase of the condition, occurs when shoulder function and range of motion gradually improve and the pain subsides.

If you develop shoulder pain that limits range of motion for an extended period of time, your doctor should perform a thorough medical examination. X-rays and MRIs can help your doctor rule out arthritis or other underlying conditions and plan the best course of treatment. Arthroscopy (also called arthroscopic surgery), a type of minimally invasive procedure in which a contrast material is injected into the joint space, also may be used to allow the physician to examine the extent of scarring or inflammation.

It is important to seek immediate medical attention if your shoulder pain is severe or if fever, dizziness, weakness, or any unusual symptoms occur along with shoulder pain.

Helpful Tips for Shoulder Pain

  • Perform the stretching and strengthening exercises recommended by your doctor or physical therapist: If you are experiencing shoulder pain, don’t stop moving your shoulder completely; continue to perform gentle exercises to maintain your mobility, as advised. Resting the injured area for prolonged periods may increase muscle stiffness and reduce range of motion.
  • Warm up properly before any activity, and don’t neglect your “good” shoulder —exercising both shoulders is equally important: A physical therapist can recommend specific stretching and strengthening exercises to loosen the shoulder joint, decrease your pain, and help speed your recovery.
  • Seek treatment from an experienced therapist: A specially trained physical therapist or a certified massage therapist who has experience treating frozen shoulder and other shoulder conditions should provide treatment so you can achieve maximum benefits.

Additional Resources

The American Academy of Family Physicians provides some rotator cuff exercises that may be helpful to strengthen the shoulder muscles and maintain mobility; however, use caution when performing these exercises and ask your doctor or therapist if these exercises are right for you before you attempt to do them.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) provides a publication, “Fast Facts about Shoulder Problems,” November 2006.

Several organizations specialize in providing information about managing pain, including the American Chronic Pain Association, National Pain Foundation, American Pain Society, and American Pain Foundation.

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