Frozen Shoulder Protocol
**Phase 1: Pain Control & Early Mobility (Freezing Stage, 0-6 weeks)** - Reduce pain - Minimize inflammation - Maintain available ROM - Prevent further stiffness **Interventions:** - Pendulum (Codman) Exercise: 3-5 min, 2-3x/day - Table Slide (Flexion): 10-15 reps, 2-3x/day - Wand Assisted Flexion (Supine): 10-15 reps, 2-3x/day - Scapular Setting: 10 reps, 2-3x/day (5 sec hold) - Pain Relief Modalities: Ice / TENS / Ultrasound / Moist heat, as per need **Precautions:** - Avoid pushing through pain - No heavy activities - Avoid lifting overhead - Sleep with support under arm if needed **Phase 2: Improve ROM & Flexibility (Frozen Stage, 6-12 weeks)** - Improve ROM (especially ER, Abduction) - Reduce stiffness - Improve joint mobility **Interventions:** - Wand Assisted External Rotation: 10-15 reps, 2-3x/day - Cross Body Stretch: 20-30 sec hold, 3 reps, 2-3x/day - Sleeper Stretch (ER): 20-30 sec hold, 3 reps, 2-3x/day - Wall Slide (Abduction): 10-15 reps, 2-3x/day - Joint Mobilization (Physiotherapist): Grade II-IV, 3-4 sets, as tolerated **Precautions:** - Stretch till mild discomfort (not sharp pain) - Avoid ballistic movements - Maintain good posture **Phase 3: Strength & Function (Thawing Stage, 12-10 weeks)** - Restore full ROM - Improve strength - Enhance functional use - Return to activities **Interventions:** - Theraband – External Rotation: 10-15 reps, 2-3 sets, 3-4x/week - Theraband – Internal Rotation: 10-15 reps, 2-3 sets, 3-4x/week - Shoulder Flexion with Dumbbell: 10-15 reps, 2-3 sets, 3-4x/week - Scaption Raise: 10-15 reps, 2-3 sets, 3-4x/week - Functional Training: Functional progression, 3-4x/week **Precautions:** - Progress gradually - Stop if pain increases > 2/10 - Focus on quality of movement **Phase 4: Maintenance & Prevention (20+ weeks, Ongoing)** - Maintain ROM & strength - Prevent recurrence - Promote shoulder health **Interventions:** - Regular Stretching Routine: Ongoing program - Strength Training: 2-3x/week, 2-3x/week minimum - Posture & Ergonomics - Active Lifestyle **Precautions:** - Listen to your shoulder - Avoid long periods of inactivity - Maintain overall fitness
