Most yogis have dealt with shoulder stiffness. Maybe you carry stress and tension in your shoulders, spent hours sitting on a long flight, or just slept in an awkward position. But if the pain has come on gradually, gets worse at night, and is coupled with a limited range of motion, you might have a condition known as frozen shoulder syndrome.
See also: 7 Yoga Poses to Release Tight Shoulders
What is frozen shoulder syndrome?
Frozen shoulder syndrome has many names: adhesive capsulitis, painful stiff shoulder, and periarthritis. But for those who suffer from it, its only real name is “ouch.” According to the American Academy of Orthopedic Surgeons, frozen shoulder can vary in severity, but people who suffer from it are limited in both active (think: lifting your arm over your head) and passive (someone else moves your arm) shoulder motion.
Experts don’t fully understand what causes frozen shoulder. Their best hypothesis: inflammation (sometimes caused by injury) sets into the shoulder joint first. Over time, the tissues surrounding the joint thicken and tighten. The connective tissues develop adhesions (bands of stiff tissue) and scarring. The result: your shoulder joint lacks the space to rotate through its full range of motion.
Who is at risk for frozen shoulder syndrome?
Anyone can develop frozen shoulder but the condition is most common in people between the ages of 40 and 60. Individuals with diabetes (type 1 and 2) and thyroid disease are at higher risk of developing frozen shoulder. In fact, thyroid disorders may increase the risk for frozen shoulder as much as 2.7 times, though experts aren’t entirely sure why.
You might also develop frozen shoulder syndrome after an injury such as a torn rotator cuff or broken humerus (the upper arm bone that connects the elbow and shoulder). It’s also more common after shoulder surgery such as rotator cuff or soft tissue repairs. This is why doctors suggest keeping the shoulder joint moving after surgery to stave off the condition.
What does frozen shoulder feel like?
Frozen shoulder syndrome progresses through three phases:
- The initial freezing stage. Along with less mobility and range of motion, you’ll feel diffuse, severe pain that is worse at night. This increased stiffness typically lasts between 2 and 9 months.
- The frozen stage. Pain starts to lessen, though the shoulder joint is still stiff and movement is restricted. This phase generally lasts 4 to 12 months.
- The thawing stage. Your range of motion progressively increases over 5 to 24 months. Pain eases, though some people have longer-lasting effects, such as chronic restriction of motion and pain that require surgery or physical therapy.
Doing yoga with frozen shoulder
During the painful stages of frozen shoulder, movement limitations make some poses difficult. It can be painful to reach the arm overhead, out to the side, or across the chest. Even “gentle” postures like Extended Child’s Pose may be difficult for yogis with frozen shoulder. Off the mat, you may find it hard to scratch your back, hook your bra, or put on a coat.
Before doing any yoga with a frozen shoulder, first make sure you actually have frozen shoulder syndrome. Symptoms of frozen shoulder can often be confused with rotator cuff disorders or nerve impingement. A medical professional can confirm that you have a frozen shoulder and suggest the best treatment options—typically rest, combined with gentle range of motion exercises. They can also offer guidance to make sure a yoga program won’t further harm the area.
Remember that frozen shoulder syndrome is typically a self-limiting disease, so it will always help the healing process to call upon the Yoga Sutras to remind us that patience pays off while recovering. Overly aggressive movement can increase pain while providing little improvement in shoulder function. Sudden, pulling or jerking movements may be harmful, especially if they are painful. So, as always, to improve strength and mobility in the joint, let pain be the guide when practicing these yoga postures. Working within a range of tolerance is paramount for healing.
Yoga postures for frozen shoulder syndrome
Bhastrika Pranayama (Bellows Breath)
Lifting the arm provides gentle abduction of the shoulder joint and stretches the lower portion of the shoulder capsule (the membrane around your shoulder joint).
Interlace your fingers under your chin. With an inhale, press your elbows up and out to the height of your chin, while mindfully activating your back and shoulder muscles. Reach your elbows up only as high as you can without pain.
Exhale, and draw the elbows back toward each other to touch in front of the chest. Repeat 5-10 times.
Salabhasana (Locust Pose) variation with elbows bent
This posture actively stretches the front of the shoulder capsule.
Lie on your belly. Bend your elbows at a 90-degree angle so that your hands are in line with your waist and your elbows hug in toward the body. As you inhale, lift your chest, hands, and feet away from the mat while keeping your elbows actively drawn in toward your waist. Repeat 5–8 times, rising on the inhale and relaxing on the exhale.
Makarasana (Crocodile Pose)
This is another external rotator-strengthening pose for the shoulder joint. It can be practiced gently or more actively, depending on where you are in your recovery.
Lie on your belly. Bend your elbows and cup your chin in your palms. Place your elbows a comfortable distance apart, about shoulder distance. The further you separate the elbows, the more external rotation and stretch in the shoulder joint will occur during the active portion of this pose.
With an inhale, imagine dragging your elbows together, but keep them stationary. This is an isometric contraction that utilizes the internal rotator muscles. You will feel a stretch in the external rotators (infraspinatus and teres minor).
As you exhale, relax your chest and walk the elbows further away from one another. Continue by using your inhalations to isometrically contract the elbows toward one another, and exhalations to relax the chest and walk the elbows further apart. Practice for 5–8 breath cycles. Makarasana puts the shoulder joint into moderate flexion, so you may want to consider skipping this pose if it provokes shoulder pain.
Malasana (Garland Pose) variation
This posture adds some resistance to shoulder strengthening while in external rotation.
Come into Malasana, lightly pressing your triceps into the inside of your knees. Place your hands in Anjali Mudra (Prayer). Exhale and press your triceps deeper into your knees. Press your knees back into your triceps for more resistance. Inhale to relax. Repeat this cycle 5–10 times. Sit on a block or two if needed for support, as the posture should be focused on the shoulder exercise.
Ardha Baddha Hastasana (Half Bound Hands)
If you have restricted shoulder mobility, full Gomukhasana (Cow-Face Pose) may not be an accessible arm position. This variation of the pose puts the shoulder in gentle internal rotation and stretches the posterior portion of the shoulder capsule. Additionally, it focuses on range of motion in the rotator cuff. This posture can be practiced seated or standing.
Start with your unaffected arm relaxed alongside your body. Reach the hand of your affected shoulder behind you to clasp the forearm or elbow of the straight arm. Activate the muscles of your affected shoulder by drawing the front of the shoulder back into its natural alignment. Play with the stretch by drawing the straight arm back or out and away from your body. Hold for 5 breaths.
Savasana variation with cactus arms
This posture can help improve both the abduction and external rotation limitations typical of frozen shoulder syndrome.
Lie on your back and place your arms into a cactus position. Use a bolster, block, or pillow under the affected arm as needed. Gently press the back of the arms into the floor or the prop, focusing your weight on your elbow to isolate the shoulder joint.
As your shoulder begins to improve with the above yoga poses, you can add two more poses to your routine, again, only if they are accessible and can be practiced without pain.
Utthita Tadasana (Five-Pointed Star)
This pose focuses on abduction and adduction of the shoulder. The goal is to move in and out of the position with the arms rather than holding the pose statically. You can stand with your back against a wall for support.
Begin in Tadasana (Mountain Pose) with your feet together. With palms facing forward, extend your arms out to the sides only up to the height of your shoulders. Step your feet 2–3 feet apart (or closer for better balance). Bring your arms down and step your feet back together. Keep your neck muscles relaxed—overactive neck muscles often compensate for painful shoulders. As you improve your range of motion without pain, work on gradually raising the arms up higher. Repeat 6–10 times, alternating the foot you step out with halfway through your repetitions.
This pose offers active flexion and extension for frozen shoulder syndrome.
Begin with your arms alongside the body. Inhale and gently reach your arms overhead as far as is comfortable. Stop before you feel pain.
Exhale, reaching your arms back alongside your body. This motion puts the shoulder into extension. As you improve range of motion with this exercise, you can lift the arms higher behind you in shoulder extension. If reaching the arms overhead feels limiting, keep the elbows bent and arms wider than shoulder distance to decrease strain on the shoulder. Repeat 4–8 cycles on each leg.
The ideas offered in this article are for informational purposes only. They are not intended as medical advice, professional diagnoses, opinions, treatments, or medical services to you, or any other individual. It should not substitute for the advice of your physician or healthcare provider. If you have any concerns or questions about your health, you should always consult your physician directly.
About the Author
Ingrid Yang MD, JD, C-IAYT, E-RYT500 is a physician, yoga therapist, freelance writer and published author. She has been teaching yoga for over 20 years and is the author of the books Adaptive Yoga and Hatha Yoga Asanas. Dr. Yang leads trainings and retreats all over the world, with a special focus on kinesthetic physiology and healing through breathwork, meditation and mind-body connection. Find out more at ingridyang.com or on Instagram @ingridyangyogamd.