Introduction to Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder, or adhesive capsulitis, is a frustrating condition that causes pain, stiffness, and a loss of mobility in the shoulder. It creeps in slowly—sometimes over months or even years—and can make everyday things like putting on a jacket or reaching for something off of a shelf feel impossible. I know this all too well because I’ve had it... twice!—once in each shoulder. Let me tell you, it’s a strange mix of numbness and searing pain that’s hard to describe and even harder still to live with.
This condition moves through three stages:
Freezing: Things start to tighten up, and the pain sets in, which can be painfully long (I'm talking months and months!).
Frozen: The stiffness remains, but strangely enough, the pain might ease up—at least that happened to me, unless I was trying to move my arm through its normal range of motion and beyond the debilitatingly reduced one.
Thawing: Slowly but surely, things start loosening up again, but this part was painstakingly slow. My range of motion was severely limited, and before I started therapy, I could barely climb a ladder.
When the pain in my shoulder vanished overnight, I thought I was in the clear. But getting my shoulder moving again was just the start of the real battle. And recovery wasn’t as simple as waiting it out. I had to work with two incredible pros—Pascal Séguin and Dr. Michael Wexel—through physiotherapy and chiropractics to restore mobility. Without their help, I’d probably still be dealing with limited movement and extreme discomfort.
What’s weird about frozen shoulder is that it can strike seemingly out of nowhere, though it’s more likely if you’ve had injuries, surgery, or periods of inactivity. Adding to the challenge, people with diabetes are far more likely to develop it. Why? That’s what we’ll dive into next, along with how both overdoing it in the gym and being sedentary can trigger this condition. Plus, I’ll share practical tips to combat it and regain strength and mobility.
Frozen Shoulder and Diabetes: The Surprising Link
People with diabetes are significantly more likely to develop frozen shoulder. Studies suggest that up to 20% of individuals with diabetes experience this condition, compared to just 2-5% in the general population.
According to a systematic review by Dyer et al., the odds of developing frozen shoulder are nearly 3.7 times higher for diabetics than for non-diabetics (source).
And, it’s not just statistics for me—it’s personal. I’ve experienced frozen shoulder twice, once in each arm, and both times were for completely different reasons. The first hit me hard after I pushed myself to the limit in the gym, chasing personal records without listening to my body. I was working out nine times a week, dividing my time between Brazilian Jiu-Jitsu, heavy weights, and calisthenics. But when the pain and stiffness set in like a brick wall, it left me sidelined.
Why Are Diabetics More Prone?
Glycation of Collagen
Chronic high blood sugar promotes glycation, where sugar molecules bind to collagen, making connective tissues stiff and less elastic (source).
Chronic Inflammation
Diabetes triggers inflammation in joints, making movement feel heavy, like trying to wade through molasses.
Delayed Healing
Diabetics often experience slower recovery times. I remember wondering why my shoulder wasn’t improving, even after weeks of therapy. Every small improvement felt like a huge win.
What Triggers Frozen Shoulder? Overdoing It vs. Doing Too Little
Frozen shoulder doesn’t play fair—it can hit whether you’re pushing too hard or doing too little. I learned this the hard way when both of my shoulders locked up for opposite reasons, one triggering the other.
Overtraining as a Trigger
My first frozen shoulder came after grinding through nine intense workouts a week. Repetitive, high-intensity movements and mechanical overload can lead to inflammation, scar tissue formation, and capsular fibrosis (when the protective tissue around your shoulder joint tightens up and stiffens with scar-like tissue, making it hard and painful to move)—a recipe for frozen shoulder. I thought I could push through the stiffness, but I hit that brick wall fast.
The Impact of Inactivity
When my first shoulder started freezing up, I stopped working out entirely, overwhelmed by the pain and loss of movement. Sedentary behavior can also trigger chronic hypoxia, when parts of your body don't get enough oxygen, both slowing down healing and causing tissues to weaken or get damaged over time, and lead to AGE accumulation, when sugars in your body latch onto proteins or fats, creating sticky byproducts that make tissues stiff and less flexible over time. As I finally began making progress with my first frozen shoulder, the inactivity took its toll, and my other shoulder started locking up.
Research shows that low-grade inflammation caused by inactivity further impairs recovery and worsens frozen shoulder over time (source).
Looking back, it’s clear that the sudden switch from intense workouts to complete inactivity played a major role. Both experiences taught me a critical lesson—balance is everything, especially for those managing diabetes.
How to Manage and Prevent Frozen Shoulder
Managing frozen shoulder is about staying proactive—balancing rest and activity to avoid further complications. In the next part of this series, I’ll dive deeper into practical tips for regaining mobility, sharing insights from my own recovery. I'll be trying to get interviews with Pascal Séguin and Dr. Michael Wexel, so stay tuned for expert advice on preventing future flare-ups and finding the sweet spot between activity and rest. In the next blog we'll be looking directly at various ways you can manage your frozen shoulder, and I'll give you some personal insights into the frustrations of my journey. Maybe, you'll be able to avoid the same mistakes I made.
Sources
Dyer et al. (2023). Increased prevalence of frozen shoulder among diabetics: A systematic review and meta-analysis. BMJ Open. Link
The role of glycation in connective tissue stiffness: Mechanisms and impact. ScienceDirect. Link
Frozen shoulder and diabetes: Exploring inflammatory and connective tissue responses. Frontiers in Medicine. Link
Dr. Craig Best Interventional Spine & Sports clinic. Link
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