Frozen shoulder, medically known as adhesive capsulitis, causes stiffness and pain in the shoulder joint. It develops when the shoulder capsule, the connective tissue surrounding the joint, thickens and tightens due to inflammation and the formation of scar-like tissues called adhesions. The condition progresses through distinct stages, beginning with pain and loss of motion. Understanding the condition’s progression is important, especially the transition from the restrictive “frozen” state to the final recovery phase, known as “thawing.”
Understanding the Thawing Phase
The thawing phase, or Phase 3, represents the period of gradual recovery for the shoulder joint. This transition occurs as the adhesions and scar tissue within the shoulder capsule slowly begin to break down and loosen, allowing for increased flexibility. The primary characteristic of this stage is the slow return of mobility, contrasting with the preceding “frozen” phase where stiffness was at its maximum.
While pain significantly decreases compared to the initial “freezing” phase, the main focus shifts entirely to regaining lost range of motion. This phase is typically the longest of the three stages, often lasting anywhere from six months up to two years before a full or near-full recovery is achieved. The improvement is a measured process of the joint capsule returning to its normal, pliable state.
Key Physical Indicators of Recovery
One of the first signs that the shoulder is entering the thawing phase is a distinct shift in the nature of the pain. The constant, severe ache and sharp, movement-induced pain characteristic of the early stages begin to fade significantly. Severe night pain, which often disrupted sleep in the freezing phase, becomes less frequent and much more manageable.
Pain does not vanish instantly, but it changes from a pervasive, debilitating sensation to more of an intermittent ache, often felt only at the end range of a movement. This reduction in baseline pain indicates that the underlying inflammation in the joint capsule is resolving. The overall stiffness of the joint also feels less absolute, suggesting the tight capsule is beginning to yield.
The most noticeable indicator of thawing is the subtle but measurable improvement in the shoulder’s range of motion. Movements that were completely blocked in the frozen stage start to become possible again, though the progress is slow and often measured in small increments. External rotation, the ability to rotate the arm away from the body, is typically one of the first movements to show improvement.
Specific movements like reaching across the body to buckle a seatbelt or reaching into a back pocket begin to require less strain. The ability to perform simple overhead tasks, such as washing one’s hair or reaching for a high shelf, slowly returns. This gradual return of function confirms that the restrictive capsule is loosening its grip on the joint.
Managing the Thawing Phase
Once the signs of thawing are present, the focus of management shifts toward cautiously maximizing the recovery of motion and strength. Consistent, gentle physical therapy and stretching exercises become a central part of the daily routine. The goal is to encourage the joint capsule to stretch and remodel without re-injuring the recovering tissues.
Physical therapists often introduce targeted exercises, such as the pendulum stretch or finger walks up a wall, to safely push the boundaries of the improving range of motion. It is important to find the balance between performing exercises that cause a tolerable stretch and pushing too hard, which can trigger a painful inflammatory flare-up. Strengthening exercises are also gradually incorporated to rebuild the muscle strength lost due to months of limited movement.
Patience is a necessary component of managing this phase, given its long duration, which can span many months. Regular consultation with a doctor or physical therapist is important to ensure the recovery plan is appropriate for the current level of mobility and pain. They can adjust the intensity of exercises to continually challenge the joint safely and provide guidance on how to avoid setbacks during this final stage of recovery.