What’s the best treatment for Frozen Shoulder

frozen shoulder muscles


When talking about Frozen Shoulder we have to consider two options:


True frozen shoulder, also called adhesive capsulitis, that involves the inflammation, thickening and tightening of the shoulder capsule (connective tissue that surrounds the joint). 


And everything else that gets diagnosed under this umbrella term. Most of the times involving the rotator cuff muscles. This is more common and it also has a better prognosis.


Clinical massage therapy has shown to produce very positive results in the treatment of both true frozen shoulder and other presentations with similar symptoms.


true frozen shoulder


While we don’t know very well why true frozen shoulder develops in certain people, there are some risk factors like:


Age and Sex: People 40 and over particularly women are more likely to develop frozen shoulder.


Inmobility or poor mobility of the shoulder for a prolonged time: This might be due to a rotator cuff injury, a broken arm, recovery from injury, a stroke or a computer job. 


Systemic diseases: cardiovascular disease, diabetes, tuberculosis hyper or hypothyroidism, Parkinson’s…




frozen shoulder muscles

Usually in frozen shoulder-like symptoms the Rotator Cuff muscles are involved.


The rotator cuff is a group of muscles and tendons in the shoulder that provide stability and movement and keep the head of the humerus (arm bone) inside the shoulder socket. This group of muscles are therefore very important for the correct functioning of the shoulder joint. 


Here’s a list of the rotator cuff muscles:


  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis

*These muscles can also trigger pain down the arm. If this is what you’re experiencing, click here for more information regarding treatment options.



Apart from acute injury and tendinopathy presentations, one of the most common presentations involving these muscles are Trigger Points and restrictions. These muscles tend to develop restrictions and trigger points overtime due to overuse, repetitive strain or weakness, which ultimately results in pain and the other symptoms mentioned above. 


Usually seen in clinic, people that come in for the treatment of frozen shoulder symptoms present trigger points and restrictions in several muscles and structures around the shoulder joint simultaneously, causing the joint to be stuck in that frozen state with limited range of motion and pain. The trigger points and restrictions usually develop overtime until the situation gets unbearable. 

shoulder impingement

Myofascial restrictions and trigger points around the shoulder joint as well as weakness in key structures can cause the shoulder to role upwards and forward out of its neutral functional position. This can cause shoulder impingement (impingement of the supraspinatus tendon and bursa in shoulder abduction – taking the arm up straight to the side).


Shoulder impingement usually happens between 60 and 120 degrees of the abduction movement, with its respective increase in pain.

frozen shoulder treatment

At INSIDE we successfully treat shoulder impingement by releasing the structures that pull the shoulder out of its neutral position and strengthening the weakened structures that are meant to hold it in its neutral position.


We treat frozen shoulder symptoms using a combination of advanced soft tissue release techniques executed using a whole body approach whereby the whole body is considered as one interrelated unit and included in the treatment as necessary. You can read more about the interrelated characteristics of the body here.


Using the Shoulder Girdle Protocol, the therapist’s focus is releasing and mobilising key muscles and structures that surround the shoulder joint as well as the release and mobilisation of secondary structures that might be contributing to the presentation or lack of mobility of the joint.


Once all structures are released around the joint, the pain usually subsides, but the work is not finished yet. These muscles are usually atrophied and weak and require strength based rehabilitation to recover their full functionality. We understand the importance of this last step towards a full rehabilitation and include it as part of our treatment process at INSIDE.