Tip #1 - Support the affected arm during activities of daily living.

This includes driving, typing at the computer, sitting in a chair and relaxing in your lazy boy at home. Gravity pulls the arm down when it is unsupported, and this increases strain on the rotator cuff. It is best to use a soft pillow or cushion when available.

By reducing the pull of gravity throughout the day, you will naturally lessen the pain and inflammation in your shoulder. While it will take effort on your part to not violate this rule, I promise you it will make a difference.

Tip #2 - Use ice and heat accordingly to relieve pain and decrease stiffness.

Heat is a great way to start the day and reduce stiffness. Your best bet is a warm shower. Another method is applying a heating pack. Regardless, this will feel good, reduce stiffness and better prepare you to move the arm in your morning routine.

With regard to ice, I always suggest a frozen bag of veggies or professional soft wrap that conforms to the shape of the shoulder. Be sure to support the arm as mentioned previously while icing. Keep the ice on for 15-20 minutes and then off for an hour. You may ice more than once per day if desired based on pain. I usually suggest icing before bed to improve sleep.

I know you are asking yourself why put ice on a stiff shoulder. Ice really is helpful because it reduces inflammation. Heat feels good, but does not dramatically affect the inflammation. Ice should be used after periods of increased activity (e.g. work or play). So, if you have not been icing, begin using it daily to reduce pain and aid healing.

Tip #3 - Avoid forcing the arm to move in painful ranges of motion unless absolutely necessary.

With a stiff frozen shoulder, the rotator cuff gets compressed when the arm is elevated, rotated or extended beyond the point of joint mobility due to abnormal joint mechanics and this often further aggravates the symptoms. This is problematic with getting dressed, fastening the seat belt or placing carry-on baggage in a plane.

Depending on your pain state (acute, sub-acute or chronic) you may have pain in different parts of the range of motion. Any significant pain with movement is a bad thing and you should try to minimize or avoid it altogether. Rest from this abusive motion is absolutely critical to resolving your inflammation and returning to pre-injury levels.

However, this does not mean you should stop moving the arm in those directions at all as that can cause you to lose even more mobility. Use moderation as your guide and pay attention to the pain levels day to day!

Tip #4 - Do not perform single arm or overhead heavy lifting during periods of inflammation.

This position coupled with external loads will prolong your pain and slow the recovery process. It is common for people to unknowingly abuse their shoulder with daily activities including overhead lifting, carrying laptops, hauling briefcases and even lifting luggage (especially overhead).

I know you are asking how to avoid these positions. The best answer is to switch arms or use both arms to execute lifting maneuvers when possible. Believe it or not, even small loads and movements can significantly increase pain and inflammation. Minimizing the number of such activities is necessary to allow the injured tissue to heal.

Use pain as your guide with daily tasks, but be careful to avoid pushing, pulling or lifting heavy objects with the affected arm. Try to use both arms and keep them as close to the body as possible. This measure alone will accelerate healing and reduce your pain.

Tip #5 - Perform arm pendulums (clockwise and counterclockwise circles) daily.

This gentle motion stimulates receptors in the shoulder joint and helps to increase joint space and reduce pain. This is also a good warm-up activity prior to shoulder exercises. You can eventually add a small weight or soup can to increase the effect.

It is important to let the motion of the body direct the shoulder and not to forcefully move the shoulder in circles. The arm should hang as though it were limp and follow the lead of the body.

I generally recommend doing 20-30 repetitions of this exercise 1-2 times per day. If it causes pain, then reduce the radius of the circles or simply wait until it can be done pain free. This is even more effective if you perform it after a warm shower or applying moist heat to the shoulder for 10-15 minutes.

Tip #6 - Use a pillow under the arm at night to better support the injured arm.

Propping the arm up as opposed to letting it hang down against the bed will actually reduce pull and tension on the shoulder and rotator cuff itself. Proper positioning will keep the shoulder in a neutral position in line with the body and should feel very comfortable.

I also recommend trying to sleep on the unaffected side if possible, as lying on the sore side compresses the shoulder and will typically increase pain and wake you.

I know you are thinking it is impossible to stay in one position at night. You are probably right. But, I encourage you to at least try these options when you are in significant pain, as I know for sure that compression of the shoulder will make your symptoms worse. That also equals more pain and less sleep.

So, use a small to moderate sized pillow that achieves the optimal position described above. Even if you move during sleep, a little break from the bad positions should still aid in your recovery.

Tip #7 - Perform daily stretching and range of motion exercises.

What if your shoulder is really sore? How does exercise aid healing? Exercise will increase blood flow to the tissues and doing specific exercises will not only prevent further motion loss and stiffness, but actually help you recover lost function and mobility in your shoulder.

It is not acceptable to do just any exercises. They need to be specific to the problem you have and target the tight tissue in your shoulder. They must also be done at a certain frequency, intensity and volume to reduce your pain. I have determined a clinically proven formula for doing just this.

Lower intensity and longer duration stretches coupled with specific cane range of motion exercises are essential to promote healing, reduce inflammation and return you to pre-injury activity levels again. More importantly, effective rehab exercises will prevent future injuries and more pain and suffering. While there is no magic pill or quick fix for a frozen shoulder, these exercises are guaranteed to help you get better.

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