Physiotherapy · Frozen shoulder
Frozen shoulder physio in Phuket
Frozen shoulder is slow, but it is not a mystery. Our physios grade how irritable it is, measure your range, and match the exercise to it. We refer you to a doctor when an injection is worth discussing.
For shoulders getting stiffer every week, people offered an injection, and shoulders stuck for months.
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What the research says
It improves, but not always fully
Frozen shoulder brings pain, especially at night, and stiffness, especially turning the arm outwards.1 The old promise that it always clears by itself within a year or two does not match the research.2
59%
had a normal or near normal shoulder about four years after symptoms began, in one UK study. Most of the rest had mild symptoms.3
30%
of people with frozen shoulder had diabetes in pooled studies. If you have not been tested, ask your doctor.4
503
people in a UK trial where physio with an injection and two surgical options gave similar results at 12 months.5
Recovery takes time. A measured plan helps you use that time well and know when to change course.
How we work
Grade it, measure it, then load it
We grade how irritable your shoulder is, measure it in degrees, and match the exercise to that grade.1 We track every change.
Grade before you stretch
High irritability means pain before the end of a movement and night pain. Then exercise stays gentle. Stretches get firmer only as the shoulder settles.1
No forcing into pain
In one study, people who exercised within pain limits did better at two years than those given intensive stretching.6 Forcing it did not help in that study.
Injection is a doctor’s call
Our physios do not inject. When pain is the main problem, we refer you to a doctor, who decides with you. Injections ease pain sooner on average, and the effect fades over months.7
Your recovery
Four phases, set by your shoulder
Times are rough guides and vary between people. Your physio moves you on by milestones, not dates.
- 01
While pain is high
Calm the pain
Pain arrives before the end of a movement and wakes you at night. Goals are sleep, comfort and gentle movement: stick-assisted movements within comfort, gentle holds, a pillow under the arm at night, and a decision with a doctor about an injection.
Move on whenNight pain wakes you 3 nights a week or fewer, average pain is 6 out of 10 or less, and pain comes at the end of a movement, not before.
- 02
As pain settles
Win back movement
Range work moves into mild tension with 20 to 30 second holds, and light band strength work starts: rotations, side raises and wall slides.
Move on whenPain 3 out of 10 or less on most days, no night pain for two weeks, and turning out improved by 10 degrees since your first test.
- 03
Once night pain has gone
Stretch and strengthen
Longer, firmer end-range stretches, weighted rotation, raises above shoulder height, rows, pulldowns and push-up progressions.
The handover checkNo night pain for four weeks, turning out at least 75% of your other arm, and a clearly better shoulder score.9 Your physio signs it off.
- 04
After physio sign-off
Back to full strength
Your coach builds strength, power and sport skills: overhead pressing and pulling, rotation for golf and padel, then a step-by-step return to swings, serves and swimming.
Ready for full sport whenStrength at 90% of your other arm, sport tasks green the next morning, and a written flare plan.
A US review suggests a surgeon’s opinion if symptoms are hard to live with after 6 to 12 weeks of non-surgical care.10 Frozen shoulder can start in the other shoulder later, in 6% to 17% of people within 5 years.11
Between sessions
Set your daily dose by the response
Check after each session and again the next morning. These rules are expert advice, not trial-tested.
Check three things: pain during exercise, how many nights it woke you this week, and your reach the next morning.
Green: progress
Pain 3 out of 10 or less that settles within an hour or two, no extra night waking, same or better reach. Progress slowly.
Amber: hold
Pain 4 to 5 out of 10, soreness gone by lunchtime next day, or one extra night waking. Repeat the same dose for a few days.
Red: step back
Pain 6 out of 10 or more, a flare lasting over a day, or lost range next morning. Go back one phase and contact your physio.
Get medical help today if
- A locked shoulder after a fall, seizure or electric shock
- A hot, red, swollen shoulder, or fever and feeling unwell
- Fever, heat or redness after an injection
- A new lump or swelling around the shoulder
- Past breast or shoulder radiotherapy, with new shoulder pain
- Chest pain or breathlessness with arm pain: call 1669
See a doctor within days for past cancer, weight loss, night sweats, a lasting cough or hand weakness. With diabetes, check blood sugar closely after any steroid injection.12
Offered a steroid injection?
What an injection can do
A steroid injection into the shoulder joint, given by a doctor, eases pain sooner on average. Across pooled trials, injections reduced pain by about 1 point out of 10 more than placebo or physio at 8 to 12 weeks. By 6 months the differences were small.7
It may be worth asking a doctor if pain, not just stiffness, is your main problem, night pain wakes you several nights a week, or pain stops you doing your home exercises. With diabetes, blood sugar can rise for hours to days after an injection, so check it closely.12
Patient reviews
What our patients say
Rated 5.0 from 57 Google reviews
“I had an impingement in my shoulder an Karim solved it within three sessions! Really amazing! I can only recommend going there.”
Julian BarthGoogle review “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”
Catlin McCrackenGoogle review “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”
Unfiltered OpinionsGoogle review “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”
Jamie AllworkGoogle review “Meaw has been incredible. She helped me recover from long term neck and lower back pain and gave me personalized exercises that I now do daily. These have made a huge difference in my strength, mobility, and overall well-being. I’m so grateful for her expertise and highly recommend her to anyone looking for real, lasting results!”
Jeff CraigGoogle review “I have been seeing Karim for long term issues with my neck and the results have been fantastic. I have attended several physios in the past and none compare to Karim. His skills and knowledge helped to pinpoint the exact cause of the issues and the treatment plan has made massive improvements.”
joyce billingtonGoogle review “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”
Michelle LawlorGoogle review
Questions
Frozen shoulder questions
Does it always thaw by itself within two years?
Do I have to stretch through the pain?
No. In one study, exercising within pain limits did better than intensive stretching at two years.6 Stretches get firmer as pain settles, guided by the traffic light.
Will one injection fix it for good?
Injections ease pain sooner on average, but the effect fades over months.7 They work best alongside home exercise, and the decision is between you and a doctor.
If it stays stuck, is surgery the answer?
In a trial of 503 people, physio with an injection gave similar results at 12 months to two surgical options. Serious complications happened only after surgery.5
Does diabetes have anything to do with it?
What happens at the free physio assessment?
Your physio confirms the diagnosis, grades how irritable it is and measures your range. You leave with a clear plan, and a referral to a doctor if useful. It’s free, with no obligation.
Physio team
Your physio team
Meaw leads our clinical standards and checks every handover to your coach.
How physiotherapy works here
Meaw
Head Physiotherapist
Karim
Physiotherapist
Also on the team Sukanya, Physiotherapist
Next step
Find out where your shoulder stands
Message us on WhatsApp to book your free physio assessment. You leave with your irritability grade, your measured range and a clear plan.
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Questions first? WhatsApp +66 65 914 1604
Sources (12)
- Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1-A31.
- Wong CK, Levine WN, Deo K, et al. Natural history of frozen shoulder: fact or fiction? A systematic review. Physiotherapy. 2017;103(1):40-47.
- Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg. 2008;17(2):231-236.
- Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J. 2016;6(1):26-34.
- Rangan A, Brealey SD, Keding A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. Lancet. 2020;396(10256):977-989.
- Diercks RL, Stevens M. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg. 2004;13(5):499-502.
- Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581.
- Martin SD, Dean MC, Eberlin CT, et al. Watchful waiting provides higher value with similar functional outcomes to physical therapy for frozen shoulder: a prospective randomized controlled trial. J Shoulder Elbow Surg. 2025;34(6):e455-e467.
- Tveitå EK, Ekeberg OM, Juel NG, Bautz-Holter E. Responsiveness of the shoulder pain and disability index in patients with adhesive capsulitis. BMC Musculoskelet Disord. 2008;9:161.
- Ramirez J. Adhesive capsulitis: diagnosis and management. Am Fam Physician. 2019;99(5):297-300.
- Rupani N, Gwilym SE; BESS Frozen Shoulder Working Group. British Elbow and Shoulder Society patient care pathway: frozen shoulder. Shoulder Elbow. 2025;17(4):351-363.
- Deck JW, Cavanagh L, Wines T, et al. Effect of steroid injections on blood glucose level. Am Fam Physician. 2023;108(3):307-308.
This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.