Anatomy Lower Limb

 Frozen shoulder rehab protocol

0 ‐ 2 Weeks: 

•  Sling allowed as needed for comfort only, first 5 - 7 days, taking arm out often 5 - 7 times a day for elbow ROM 
•   Posture education and postural exercises 
•   Ball or putty squeezing throughout the day 
•   Icing every two hours for 15 - 20 minutes first 5 - 7 days, 3 times a day thereafter 
•   CPM (continuous passive motion) machine 4 - 6 hours per day for 1 - 4 weeks
•   Soft tissue mobilization focused on periscapular musculature, cervical spine, and rotator cuff 
•   Scapular mobilization 
•   Passive and active assisted ROM manually and using pulley at home going for full motion as soon as able without increased irritability 
•   Cardiovascular training program can include bike, treadmill, versa climber, UBE 
•   Core stabilization program

2 ‐ 4 Weeks:

•  Full passive range of motion should be achieved by 2 - 4 weeks 
•  Scapular and glenohumeral joint mobilization as indicated 
•  Begin rotator cuff retraining and strengthening, focus on restoring proper  biomechanics 
•  Integration of involved shoulder through bilateral UE activity and total motion  training (full body movements using both upper and lower extremities) 
•  Continued cardiovascular and core strength training 
•  Continued icing 3 times per day 

4 ‐ 8 Weeks:

•  Progressive strength training contingent upon perfect biomechanics 
•  Development of independent home and gym program 
•  Okay to return to swimming with good mechanics after 6 weeks 

8 ‐ 10 Weeks:

•  Progression into normal activity and exercise program 
•  Patient discharged with life-long home maintenance program to include daily  ROM exercises, rotator cuff program, and cardiovascular program

Home Exercises for the Stiff or Frozen Shoulder

Stiff or frozen shoulders are usually uncomfortable, even if the degree of stiffness is not great. That's the 

bad news. The good news is that most stiff shoulders can be managed successfully by a simple exercise 

program conducted by the patient in the home. 

Getting the shoulder moving

It is basically a question of gently and progressively getting the shoulder moving again. This program is 

the safest of all treatments for frozen shoulders. Although months of these specific exercises may be 

required, persistence almost always pays off. Even if arthritis is present, this program may help preserve 

and even improve the shoulder's range and comfort. Before beginning these exercises you should 

consult with your physician. 

There are two components to the home program for stiff shoulders. The first is a series of stretching 

exercises and the second relates to regular participation in a fitness program. 

Your opposite arm is a great therapist for your stiff shoulder. Your "therapist arm" is always available to 

apply a gentle stretch in any direction of tightness. Each of these gentle stretches needs to be held up to 

a count of 100. 

Stretching Exercises for the Frozen or Stiff Shoulder

Photo Gallery 

The basic program includes the exercises illustrated below.  Click any image below to enlarge and view 

in our photo gallery. 

Instructions for Shoulder Stretching Exercises

 If other directions of stiffness are identified, they can be stretched with a similar approach. An important  principle of the stretching exercises is to allow your muscles to relax so that the stretch can be applied  to the soft tissues without muscle interference. Tissues of a tight shoulder do not like to be stretched  suddenly, roughly, or with a lot of force. Thus the strategy is to apply a gentle stretch so that at most  minimal soreness results. Any soreness should go away within 15 minutes after you stop the exercises.  You should carry out this shoulder stretching sequence three times a day. As much as possible, these  sessions should be performed after the shoulder has been relaxed by a hot shower, bath, or aerobic  exercise. For each stretch, make a note of the maximum range obtained with each session. Try to  establish a new "bench mark" each time you do them, so that you can see your progress each time.  The beauty of this exercise program is that you are in control. You can adjust the vigor of the stretching  to do what is most easily tolerated by your shoulder. The exercise program is totally portable and can be  performed in your home, office, car, the bus, the airplane, or wherever you happen to be. This is  important because consistency in this exercise program pays off. If pain results from the exercise  program, do not stop or change the frequency of your exercise sessions, just reduce the vigor of the  stretches so that they become comfortable.  Regular fitness exercise helps keep your joints supple. This "lubricating" effect is optimized if you  perform a half‐hour of aerobic exercise each day.