Shoulder Rehabilitation Facts for Impingement and Frozen Shoulder Syndromes

Shoulder discomfort

Shoulder rehabilitation for impingement syndrome and frozen shoulder is remarkably similar even though the shoulder conditions are not exactly the same.

The two goals of shoulder rehabilitation planned by the physical therapist are (1) increase movement and (2) managing the pain.

The problem with these ailments is that the pain and decreased mobility does not respond quickly. Often it takes more than a year and usually gets worse before it gets any better. The most difficult factor for many physical therapists and patients alike is that there is no direct cause. However, that does not mean that the pain cannot be alleviated through therapy and mobility cannot be increased.

Early Phase of Shoulder Rehabilitation

shoulder-pain-treatmentThe first stage of both syndromes is that there is long-term stiffening and pain in the shoulder area. This usually manifests when performing regular tasks, varying from a dull ache all the time to sharp pain when the injured shoulder is being utilized.

The aspect that sets this apart from regular shoulder pain is that there is severe pain when you move the shoulder away from the body. During this phase physical therapy should be started with weekly visits to an office and a daily home exercise program.

Middle Phase of Shoulder Rehabilitation

During the middle stages of impingement syndrome and frozen shoulder, the involved shoulder will have a tremendous decrease in mobility as well as a sharp increase of acute pain. This phase can last from three months of  onset of symptoms to almost a year, which is the typical period of the worst symptoms.

The role of a physical therapist during this time is to implement shoulder rehabilitation in an aggressive manner. While this will cause discomfort for the patient, it is proven that being proactive during this time period will result in an easier time acclimating to the healing phase of the syndrome. Most patients will tend to guard and immobilize the involved upper extremity to prevent pain, but it is necessary to keep moving the arm.

Healing Phase

shoulder-rehabilitation-ROMThe final phase of shoulder rehabilitation for both of these different ailments involves returning the shoulder to normal usage. This usually occurs approximately eight to twelve months after the onset of pain and rigidity in the shoulder. Correcting the mechanical uses of the arm is the most important part of this healing phase, followed by complete pain relief.

The physical therapist must continue to be aggressive with increasing motion and work on strengthening the arm back to pre condition levels. If the patients opts for quicker healing, then the patient could get an anti-inflammatory injection and begin more intense therapy.


By following this rough outline for physical therapy and pain management, both impingement syndrome and frozen shoulder may be treated successfully and produce a positive outcome.