Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
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Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Frozen Shoulder Release - Arthroscopic Release of the Coraco-Humeral Ligament
Frozen shoulder (adhesive capsulitis) is a painful and disabling condition that leads to progressive stiffness, loss of motion, and significant functional limitation. It affects around 3% of the population, with women more commonly affected than men. Surgery, such as arthroscopic release of the coraco-humeral ligament, is usually considered only in severe cases when conservative treatments such as physiotherapy, medication, or injections have failed.
Understanding Frozen Shoulder
The shoulder joint is formed by the humerus (arm bone), scapula (shoulder blade), and clavicle (collarbone). This joint is surrounded by a capsule — a flexible, elastic structure that allows wide mobility. Stability and movement are further supported by ligaments and muscles.
In frozen shoulder, the capsule and surrounding ligaments become inflamed, thickened, and less elastic, leading to stiffness and pain. The exact cause is not fully understood, but frozen shoulder is classified into two types:
- Primary (Idiopathic) Frozen Shoulder: Global limitation of movement without a clear underlying cause, often linked to decreased compliance of the posterior capsule.
- Secondary Frozen Shoulder: Occurs after trauma, surgery, or prolonged immobility, and may be associated with other conditions such as impingement or rotator cuff tears.
Stages of Frozen Shoulder
Frozen shoulder typically progresses through three clinical stages, which together may last up to three years. However, spontaneous resolution is not guaranteed:
- Freezing Stage (0–3 months): Gradual onset of pain, increasing stiffness, and progressive loss of movement.
- Frozen Stage (3–9 months): Pain slowly decreases but stiffness worsens, with marked restriction in shoulder motion.
- Thawing Stage (up to 3 years): Pain becomes minimal, and shoulder mobility gradually returns toward normal.
Role of the Coraco-Humeral Ligament
The coraco-humeral ligament runs from the coracoid process of the scapula to the upper humerus, helping stabilise the shoulder joint. In frozen shoulder, this ligament can become inflamed and thickened, contributing to restriction of movement.
Arthroscopic Release Surgery
When conservative measures such as physiotherapy, medications, or injections do not improve symptoms, surgery may be indicated. Arthroscopic (keyhole) release of the coraco-humeral ligament is performed to cut and release the tightened ligament and capsule. This procedure reduces shoulder tightness, restores mobility, and allows more effective post-operative physiotherapy.
Physiotherapy Before Arthroscopic Release of the Coraco-Humeral Ligament
Engaging in physiotherapy before surgery is strongly recommended and plays a key role in improving outcomes. At Acephysiosports.com, physiotherapy is often used as a conservative treatment for frozen shoulder, offering guidance, reducing joint stiffness, and enhancing shoulder mobility. When surgery becomes necessary, pre-surgical physiotherapy helps resolve initial issues and prepares the shoulder for smoother recovery afterward. Pre-operative care may include:
- Heat application
- Pain relief strategies
- Gentle joint mobilisations
- Stretching exercises
- Myofascial release techniques
- Targeted strengthening of shoulder muscles
- Education on surgery and recovery management
Post-Surgical Symptoms After Arthroscopic Release
After surgery, your arm will be supported in a protective sling, and you will be advised to begin physiotherapy as early as possible. Starting physiotherapy immediately with Acephysiosports.com helps accelerate recovery, reduce complications, and restore function sooner. Typical symptoms after arthroscopic release of the coraco-humeral ligament include:
- Discomfort or pain
- Shoulder stiffness
- Swelling around the joint
Physiotherapy After Arthroscopic Release of the Coraco-Humeral Ligament
Once the procedure is complete, physiotherapy becomes central to regaining full function. Physio.co.uk will carry out a detailed assessment and create a tailored treatment plan based on your daily, occupational, and sporting needs. Clear goals will be set, and a structured rehabilitation programme will be developed to restore mobility and strength. Early sessions will focus on pain control and safe movement, gradually progressing to exercises that rebuild strength, restore mobility, and return you to normal activity.
Weeks 1–3: Early Post-Operative Care
During the first three weeks, the primary goal is to minimise complications and control acute symptoms. Early mobilisation of the shoulder is essential for surgical success, and care is taken to begin safe movements. Treatment may involve:
- Cryotherapy for swelling and pain relief
- Sling management and postural guidance
- Pain control strategies
- Heat therapy when appropriate
- Pendulum exercises to encourage gentle motion
- Passive and active-assisted range of movement (ROM) exercises
- Early active ROM exercises
- Hand, wrist, and elbow exercises to prevent stiffness
- Scapular setting techniques
- Massage and stretching
- Electrotherapy for pain relief and healing
- Supportive taping
- Education and self-management advice
Weeks 4–6: Restoring Movement and Stability
From weeks 4 to 6, rehabilitation focuses on improving and maintaining shoulder mobility while preventing regression into stiffness. Attention is given to retraining normal biomechanics and introducing stability work. Treatment may include:
- Joint mobilisations to enhance mobility
- Progressed passive and active ROM exercises
- Rotator cuff strengthening to support the joint
- Scapular stabilisation exercises
- Soft tissue release and stretching
- Supportive taping
- Biomechanical assessment and retraining of movement patterns
Weeks 7–12: Strengthening and Functional Progression
From the seventh week onwards, physiotherapy is advanced to focus on strength, endurance, and return to functional activities. The programme becomes more task-specific, tailored to occupational or sporting goals. Interventions may include:
- Advanced joint mobilisations
- Progressive strengthening of the shoulder and rotator cuff
- Muscular endurance training
- Functional and sport-related exercises
- Proprioceptive training for joint stability
- Continued soft tissue release and stretching
Weeks 12+: Long-Term Recovery and Return to Function
Beyond 12 weeks, most patients will have regained significant strength and mobility, though full recovery can take up to six months. Physiotherapy at this stage ensures long-term shoulder health, preventing recurrence and enabling return to full activity. The focus includes:
- Achieving full, pain-free range of movement
- Advanced strengthening of the rotator cuff and surrounding shoulder muscles
- High-level proprioceptive and control exercises
- Functional and sports-specific training
- Ongoing management and self-care strategies for long-term shoulder health
Summary
Frozen shoulder (adhesive capsulitis) is a painful and disabling condition marked by stiffness, loss of motion, and reduced shoulder function. While some cases resolve naturally over years, surgery may be required if pain and immobility persist despite conservative care. Arthroscopic release of the coraco-humeral ligament restores joint mobility by releasing scarred and contracted tissue. Following surgery, a comprehensive rehabilitation programme with Physio.co.uk is essential to regain shoulder movement, strength, and pain-free function while reducing the risk of recurrence.
To arrange an assessment with AcephysioSports.com, please contact us or call +65 8153 5374. Alternatively, you can book an appointment online today!
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