The shoulder is a ball and socket joint, which means that the head of the arm bone fits into the shallow socket of the shoulder blade. Around this connection is a bundle of strong connective tissue that holds the arm bone and socket together. This is called the shoulder capsule. To ensure easy movement of the shoulder, there is synovial fluid that lubricates the joint. Mayo Clinic explains that when the shoulder capsule thickens and some of the synovial fluid is lost, it causes frozen shoulder, or adhesive capulitis. Frozen shoulder is most common in adults from forty to sixty and happens more frequently in women than in men. There is no definite cause of frozen shoulder, but there have been some links that have been found between frozen shoulder and diabetes. Another cause is immobilization of the shoulder for long periods of time.
Symptoms
Frozen shoulder symptoms are often described as gradually worsening. The two biggest indicators of frozen shoulder are pain and reduced range of motion within the shoulder. Stiffness and tightness of the joint are often symptoms that patients with frozen shoulder also experience. Symptoms are explained in three phases- freezing, frozen, and thawing. Freezing is the first stage of symptoms where the pain in the shoulder tends to get continually worse. According to Ortho Info, as the pain in the shoulder gets worse, the range of motion gradually deteriorates, as well. This phase can last anywhere from six weeks to nine months. The next stage, frozen, is when activities of daily living may be the most difficult. Although the pain may subside slightly during this time, the stiffness and tightness remain. This phase can last from four to six months. Thawing is the final stage and is described as the improvement phase. During this time, symptoms will decrease and activities will get easier and easier until the patient is able to return to a completely normal life. This process can take a long time- anywhere from six months to three years.
Treatment
There is no instant treatment for frozen shoulder. The process of recovering from this painful condition is long and hard. The treatment plan will mostly be focused on increasing the range of motion through many different methods. Physical therapy and massage therapy are the most common recommendations of doctors. Physical therapy is helpful in getting the shoulder to move in a slow process. There are many home exercises that are generally recommended to patients on top of regular physical therapy appointments. Massage therapy is helpful in breaking up some of the knots, adhesions, and tension within the soft tissue of the shoulder, which helps to open up the shoulder and increase range of motion. According to the RMT Education Project, another reason that massage can be extremely beneficial in the process of releasing a frozen shoulder is by increasing blood flow to the area. Decreased blood flow to the shoulder has been described as one of the possible contributing factors to frozen shoulder, so by increasing that flow, it helps the shoulder to heal faster and prevent future incidents of frozen shoulder. 
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