The most frustrating problem I encounter when treating a patient with frozen shoulder is apathy. When the patient arrives for their first therapy session they are usually in desperation mode because of the sleepless nights they have encountered over the past 6 months due to shoulder stiffness and pain. They are willing to do just about anything short of cutting off their arm to get rid of the pain and return function… at least that’s what they say to my face during this all important first visit. “What’s the best frozen shoulder exercise?” is usually one of the first questions I get, and the patient’s apathetic expressions begins when I begin explaining that frozen shoulder treatment consists of a combination of exercise and rest, performed in multiple but brief sessions throughout the day. “Do you think going to a chiropractor would help me more?” has been another question on more than one occasion. “Not necessarily, sir” is the reply followed by “their are many techniques to treating your stiff shoulder, most of which are pretty good, but the important thing is that you are somewhere taking action”.
Now I’m not trying to sound like a “self-help” guru, but taking daily action is the absolute crucial first step someone with frozen shoulder can do to help speed recovery. Despite popular belief, just resting the shoulder only makes it more stiff and painful when you have to move it.
Now the next most important step is to avoid making it worse. Now as I just wrote the previous line, I can almost here the sarcasm laden reply of thousands of web surfers as they say “ya think?” However this is not as obviously simple as it seems. You see, in the world of injuries and recovery, my wife is known as a “tester”. If she happens to have an injury such as a painful shoulder, neck, etc… then everyday, no, several times a day she “tests” that injury to see if it still hurts. For instance if reaching overhead pinches or hurts her shoulder, she will repeat this movement throughout the day to see if “it’s getting any better”. The point of all of this is to emphasize that if you happen to be a type “A” personality, then bulling your way through the day using your painful shoulder is not the answer.
This is not to say that you will not feel pain throughout the day during specific frozen shoulder exercise, because you definitely will. The important concept here is to realize the difference between “damaging” pain and “non-damaging” pain. Now I can go into a whole section on the difference between the two (which is out of the scope of this article), but basically “damaging” pain is pain you feel when, obviously, damage is being done to soft tissue, ligament, or bone. Damaging pain is often described with words such as “sharp”, “tearing”, “nerve pain”, and “shooting”. Most people automatically stop when encountering damaging pain (although some low-pain-threshold people will push through damaging pain).
By contrast, non-damaging pain is is pain felt due to shortened muscles, ligaments, soft tissue, connective tissue, or tendons and is often described with words such as “achy”, “dull”, “pulling”, and “pressure”. Certainly there are many more words to describe these two types of pain, but these are the ones I have encountered over thousands of patient visits over the years. The point of all of this is that if you do exercise and do not push through non-damaging pain with frozen shoulder exercise, you WILL NOT improve your chances of recovery. A trained physical therapist can help give you the best combination of frozen shoulder exercise to maximize your recovery.