How does Focused Shockwave Therapy help Frozen Shoulder?

Focused Shockwave (FSWT) is used to reach the deep joint capsule. It helps break down chronic scarring and inflammation associated with adhesive capsulitis, stimulating neovascularisation to accelerate the transition from the 'frozen' to the 'thawing' stage.

What are the three stages of Frozen Shoulder?

Frozen shoulder typically progresses through the Freezing stage (increasing pain and loss of motion), the Frozen stage (decreased pain but maximum stiffness), and the Thawing stage (gradual return of mobility). Treatment at Bodytonic Clinic aims to reduce the duration of these stages.

Is treatment for Frozen Shoulder covered by AXA or Bupa?

Yes, we accept AXA Health and Bupa insurance for frozen shoulder treatments at our Canada Water and Stratford clinics. As recognised healthcare providers, we can often facilitate direct billing once you have your authorisation code.

Understanding frozen shoulder, the ultimate guide

Written by: James Gill BOst GOsC 6039. Registered Osteopath, Founder & Clinic Director

Medically Reviewed Shibin Vinod BPT, HCPC PH124277, CSP 111177, MSc Sport and Exercise Medicine | MSK Physiotherapist

What is Frozen Shoulder?

Frozen shoulder (adhesive capsulitis) is a debilitating condition that can stop you from sleeping and working. At Bodytonic Clinic, our multidisciplinary team of Osteopaths, Physiotherapists, and Chiropractors see frozen shoulder cases every week. By combining manual therapy with advanced technology like Focused Shockwave Therapy, we aim to reduce your pain and shorten the ‘thawing’ process significantly.

What are the symptoms of Frozen Shoulder?

Frozen shoulder typically develops slowly, and it develops in three stages. Each stage can last for several months.

Are you in the ‘Freezing’ stage and struggling with nighttime pain? Early clinical intervention is key to preventing long-term stiffness. Our specialists use a combination of Manual Therapy and Focused Shockwave Therapy to manage pain and improve range of motion. Book a Frozen Shoulder Assessment in Stratford or Canada Water.

What are the common causes of Frozen Shoulder?

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

The causes of frozen shoulder are not well understood. There is no clear connection to arm dominance or occupation. Below are a few factors that may put you at more risk of developing frozen shoulder:

Age and sex: People 40 and older, particularly women, are more likely to suffer from frozen shoulder.
Immobility or reduced mobility: People who’ve had prolonged immobility or reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Several factors promote the development of frozen shoulder including:

Major diseases: People who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk of frozen shoulder include:

How is Frozen Shoulder diagnosed?

During your consultation your physical therapist / healthcare professional (osteopath, chiropractor or physiotherapist) will take a precise case history taking of your symptoms and thorough physical examination will be taken to help diagnose and understand the cause of your shoulder pain.

During the case history the practitioner may ask you questions such as;

During the physical assessment the practitioner may carry out a series of tests for frozen shoulder including a postural assessment. They will also observe the range or motion of your shoulder and carry out some orthopedic tests. In some cases and depending on the severity of the symptoms, imaging such as X-rays, MRI’s or ultrasound scans might be needed to understand the exact cause of the shoulder pain.

What are the treatment options for Frozen Shoulder?

Your best ally in the battle against frozen shoulder is timing, having a treatment early may reduce the duration of your symptoms.

While rest and anti-inflammatories are common first steps, clinical results at our London clinics show that ‘active’ recovery yields faster results.

Manual Therapy: Our Osteopaths and Chiropractors use specific stretching techniques to release the tight joint capsule.
Advanced Tech: We are one of the few clinics in London offering Focused Shockwave Therapy alongside Radial Shockwave. Focused shockwave is superior for frozen shoulder because it reaches the deeper tissues of the shoulder socket without losing energy.
Rehabilitation: Our Physiotherapists provide bespoke exercise plans to prevent muscle atrophy while the joint is restricted.

Manual therapy: is one of the first conservative approaches that you may use for frozen shoulder. There are different manual therapies available so a combination of different practitioners (physiotherapists, chiropractors, osteopaths, massage therapists) may be the best option for your condition. Your manual practitioner will work together with you to improve the functionality and the mobility of your shoulder.

During the treatment your practitioner may gently move your shoulder to relieve your pain, work on the areas of your body to improve your posture and use techniques to relieve muscle tension.

Your practitioner will show you exercises that you can do at home to help increase the range of motion of the shoulder and decrease the pain. These may involve stretching, strengthening and improvement of your shoulder flexibility.

Medication: If you decide to visit your GP, depending on the severity of your pain they may prescribe you with some oral medications to help with relieving your symptoms. Over the counter painkillers and anti inflammatory medications are prescribed as they can help with the pain and inflammation experienced during frozen shoulder.

Movement modification: During the early stage, your GP or your manual practitioner (such as physiotherapy, osteopath, chiropractor, massage therapist) may advise you not to move your shoulder in any way that causes you pain. For this reason you may end up ceasing doing some physical activities that are increasing your pain such as sports or going to the gym.

However, clinical studies show that absolute inactivity can actually worsen the thickening of the joint capsule. Our practitioners specialise in finding your ‘therapeutic window’-the balance between movement and pain relief.

For any doubts you can contact your GP or your manual practitioner for any suggestions about daily changes in your life like using a pillow or a towel to support your arm when you’re in your bed.

Shockwave Therapy: For chronic and highly painful cases of Frozen Shoulder, where stiffness persists for many months, advanced treatments can help break the pain cycle. Extracorporeal Shockwave Therapy (ESWT) is used as a powerful non-invasive tool to reduce chronic inflammation and aid in tissue remodelling. We utilize the versatility of Radial Shockwave (ESWT) to release tension in the large shoulder muscles, and the deep-reaching precision of Focused Shockwave (FSWT) to target the chronic scarring and inflammation in the joint capsule, accelerating your progress through the “thawing” phase of recovery.

Corticosteroid Injection: If your frozen shoulder condition is getting worse and you are not getting any results with manual therapy treatment then your GP may offer you a corticosteroid injection. This is a strong anti inflammatory drug that is injected into the shoulder. It is used to help ease the pain and can make manual therapy such as osteopathy and physiotherapy more comfortable for you.

Surgical Intervention: most people with frozen shoulder, notice an improvement of their symptoms with self-treatment and conservative treatments. Sometimes pain remains severe even after multiple approaches. In this case your GP may refer you to a consultant (an orthopaedic doctor who specializes in bones and joints). Usually the orthopaedic consultant will carry out further examination and prescribe you more tests to confirm the frozen shoulder diagnosis. Your consultant my suggest one of the following procedures:

Shoulder manipulation: this procedure is done while you are under the effect of a general anaesthetic. Your surgeon will move your shoulder around to stretch the tightened capsule and improve the flexibility of any scar tissues. Typically it is combined with a steroid injection to ease any painful symptomatology.
Arthroscopic capsular release: arthroscopy is a type of surgery widely used to look inside and treat a joint. Your surgeon will look inside your shoulder joint and use special instruments to cut through the connective tissue in your capsule joint to loosen it and make it able to move freely. This is done under the effect of a general anesthetic.
Arthroscopic distension therapy: in this procedure your surgeon fills your shoulder joint with fluid to break up scar tissue and free up the joint. This completely blocks pain from your shoulder area and you will stay awake during the procedure, but the surgeon will inject some local anesthetic into your shoulder.

Can Frozen Shoulder be prevented?

The exact cause for frozen shoulder is not known therefore it is difficult to ascertain whether there is much we can do to prevent frozen shoulder from happening. However, among all of the risk factors mentioned above, one of the most common causes of frozen shoulder remains the lack of mobility. This may result during recovery from a shoulder injury or a stroke. If you’ve had an injury that makes it difficult to move your shoulder, talk to your doctor or physical therapist about exercises you can do to maintain the motion of your shoulder joint at a certain level.

Meet Our Shoulder Specialists

If you are suffering from Adhesive Capsulitis, you don’t have to wait years for recovery. Meet some of our practitioners, who specialise in complex shoulder pathologies and provide hands-on care at our London Clinics.

Georgie Mabbs Osteopath London Bodytonic Clinic SE16 E15 E14 SE8 E1W

Georgie Mabbs M.Ost, BSc

Livia Battafarano Registered Osteopath London Canada Water se16 Stratford E15 e20 bodytonic

Livia Battafarano MOst

Yvan Loneux Registered Osteopath London SE16 E20 E15 E14 SE1 SE8 SE10

Yvan Loneux M.Ost ND

Ele Bray MSK Physiotherapist at bodytonic clinic London Canada Water SE16 Stratford E15

Ele Bray MSc, BSc

Courtney Innis Osteopath London bodytonic clinic London SE16 E15 E20 Featured Image

Mr Courtney Innis BSc (Hons) Ost

What are the best exercises for Frozen Shoulder?

Pendulum stretch: Do this exercise first. Let your arm hang down like a pendulum, and then gently swing it back and forth or in circles. Perform 10 reps in each direction (clockwise and anticlockwise), once a day. As your pain reduces, increase the diameter of your swing, but never force it. When you’re ready for more, increase the stretch by holding a light weight in the swinging arm.

Finger wall walking: Pretend your fingers are your feet and walk your fingers up a wall. Hold for a few seconds. Then walk your fingers back down. Repeat 3 times. Move closer to the wall as you repeat.

Towel Stretch: In standing position, place the back of your hand on the side you want to stretch attached to your lower back. Throw one end of a towel over your shoulder. Grab it behind your back with your other hand. Pull down slowly on the towel with your front arm. Let your back arm slide up. You will feel a stretch in your shoulder. Hold the stretch for a few seconds. Do this 3-5 times a day. Build up to holding each stretch for 20 to 40 seconds.

Why Choose Bodytonic Clinic for Shoulder Pain?

We don’t just treat the symptoms; we treat the person. Whether you visit our Canada Water or Stratford clinic, you gain access to a full suite of recovery tools, from Medical Acupuncture to the latest in Shockwave technology.

Stop waiting for the pain to go away. Schedule a consultation with a Bodytonic specialist today.