Diagnosis Explanation:

Frozen shoulder (adhesive capsulitis) is a stiff and painful shoulder condition caused by inflammation and thickening of the joint capsule. It typically develops in three stages over several months to years:

1. Freezing Stage (Painful Phase, 2-9 months) – Gradual increase in shoulder pain and stiffness, worse at night.
2. Frozen Stage (Stiff Phase, 4-12 months) – Pain may decrease, but range of motion is severely limited.
3. Thawing Stage (Recovery Phase, 6 months-2 years) – Gradual return of mobility and strength.

Specific Work Modifications:

• If your job requires standing or walking: Avoid repetitive overhead reaching, and take breaks to stretch the shoulder gently.
• If your job involves lifting: Avoid lifting objects above shoulder height or sudden jerky movements.
• If your job is desk-based: Keep the shoulder supported, adjust your monitor to eye level, and take breaks every 30 minutes to move the arm.
• Avoid: Repetitive overhead activities, prolonged immobilization, and sudden forceful movements.

Specific Activity Modifications:

• If you play sports: Avoid throwing, swimming strokes, and overhead movements until motion improves.
• If you do weightlifting: Avoid overhead presses, pull-ups, dips, and heavy resistance exercises.
• If you do yoga or Pilates: Modify poses to avoid deep shoulder extension and weight-bearing on the arms.
• Avoid: Overhead movements, sudden jerky arm motions, and excessive stretching that causes pain.

Recommended Supplements:

• Collagen Peptides – 10g daily for joint and tendon support.
• Vitamin C – 500mg daily to promote collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support joint and muscle healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce joint stiffness.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue flexibility.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep the joints lubricated.

Home Exercise Prescription (Rehabilitation for Frozen Shoulder)

Early Phase (Freezing Stage, Reducing Pain & Improving Motion):

• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Wall Walk (Forward) – Face a wall, use fingers to "walk" the arm up as high as comfortable, hold 5 seconds, repeat 10 reps, 2x/day.
• Cross-Body Stretch – Use the opposite hand to pull the arm across the chest, hold 20 seconds, 3x/day.

Strengthening Phase (Frozen Stage, Restoring Function):

• External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.
• Wall Slides (Lateral Movement) – Stand sideways to a wall, slide affected arm up and down, 10 reps, 2x/day.

Advanced Phase (Thawing Stage, Preventing Recurrence):

• Overhead Pulley Stretch – Use a pulley or resistance band to gently assist arm overhead, 10 reps, 2x/day.
• Light Resistance Shoulder Press – Press arms upward without pain, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.

Helpful Books:

1. Overcoming Frozen Shoulder: A Proven Step-by-Step Guide to Recovery – Dr. Angela Moore.
2. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.

Click here for more orthopedic patient information.
Contact a Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.