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A Closer Look at the Different Stages of Frozen Shoulder

For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?

Frozen Shoulder Stages

A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.

Stage 1

Pre-Freezing – 1 month to 3 months

Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)

Root Cause

A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)

Stage 2

Freezing – 10 weeks to 8 months

The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)

Stage 3

Frozen – 4 months to 12 months

The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.

Stage 4

Thawing – 5 months to 2 years

In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.

Treatment

Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)

Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)

Prognosis

The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Motion Key To Healing


References

Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. https://doi.org/10.1067/j.cpradiol.2024.03.005

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107

Johns Hopkins Medicine. (2025). Frozen shoulder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder

UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. https://doi.org/10.5435/JAAOS-D-17-00606

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786

Mustard: A Low-Calorie Alternative Packed with Health Benefits

Can mustard be a low-calorie alternative to higher-fat condiments for individuals trying to reduce calorie intake?

Mustard

Prepared mustard is a common condiment used around the country. It is a low-calorie, highly flavored condiment that can replace more calorie-dense options. The familiar condiment combines mustard seeds with vinegar, salt, lemon, and other ingredients. There are also different varieties made from brown or black mustard seeds.

Health Benefits

Mustard is considered healthy because it contains antioxidants that provide various health benefits, including anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016) Although not associated with significant health benefits, mustard is a low-calorie alternative to many higher-fat condiments, like mayonnaise. Different types of mustard seeds are used for health purposes. For example, some herbalists use white mustard seeds to clear the throat when mixed with honey (Ewing, Sarah, 1999). Antioxidants include isothiocyanates and sinigrin.

  • Isothiocyanates, the oil that gives mustard its pungent taste, have anti-cancer properties for breast, lung, GI tract, and prostate cancers.
  • However, the mechanism remains unclear, and more research is needed to determine the efficacy of mustard’s health benefits for cancer.
  • Isothiocyanates may also help manage diabetes and reduce unhealthy cholesterol, providing cardiovascular protection and neurological benefits that may help autistic individuals. More research is needed. (Palliyaguru D. et al., 2018)
  • Sinigrin is another antioxidant. Research shows this antioxidant has anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016)

Nutrition

A single serving is usually about a teaspoon. A serving of prepared yellow and spicy mustard provides only about three calories. (U.S. Department of Agriculture, 2019) Its nutritional profile includes a rich supply of essential minerals, including calcium, iron, manganese, phosphorus, and zinc. It is also a good source of omega-3 fatty acids, tryptophan, phosphorus, iron, and protein. The seeds are also a very good source of selenium. Most calories come from carbohydrates, but because the calorie count is so low, these carbohydrates are not likely to significantly affect daily intake. Dijon mustard may provide more calories. A single serving of Dijon may contain up to 10 calories.

Preparation and Storage

Yellow mustard and Dijon are easy to find. Try course mustard varieties with distinct textures and seeds. Buy in small quantities, as mustard can lose flavor with time. Once opened, store in the refrigerator for up to one year. Mustard imparts a strong, spicy taste that pairs well with meat and seafood and can also be used to make salad dressings.

Side Effects

The U.S. Food and Drug Administration recognizes mustard as safe (GRAS). Eating too much can cause abdominal pain, diarrhea, and gut inflammation. However, mustard and mustard seed allergies are not uncommon. Symptoms may be mild or severe and generally appear shortly after consuming the product. Individuals may experience a rash or a tingly, itchy feeling in the mouth. Difficulty breathing is also possible. Other foods derived from the mustard plant, including leaves, seeds, and flowers, sprouted seeds, oil, and foods that contain these, are likely to cause reactions in those with mustard allergies.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.


Enhancing Health Together


References

Mazumder, A., Dwivedi, A., & du Plessis, J. (2016). Sinigrin and Its Therapeutic Benefits. Molecules (Basel, Switzerland), 21(4), 416. https://doi.org/10.3390/molecules21040416

Ewing, Sarah. (1999). Black Mustard (Brassica nigra). https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1421&context=ebl

Palliyaguru, D. L., Yuan, J. M., Kensler, T. W., & Fahey, J. W. (2018). Isothiocyanates: Translating the Power of Plants to People. Molecular nutrition & food research, 62(18), e1700965. https://doi.org/10.1002/mnfr.201700965

U.S. Department of Agriculture. (2019). Mustard, prepared, yellow. Retrieved from https://fdc.nal.usda.gov/food-details/326698/nutrients

Exploring the Different Types of Knee Braces and Their Uses

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

  • Sprain
  • Ligament injury
  • Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

  • Tendonitis
  • Patellar tendinopathy
  • Chondromalacia patellae
  • Patellofemoral stress syndrome
  • Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

Unloader

  • This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
  • A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

  • This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

  • This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
  • A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

  • A knee immobilizer keeps the knee in one position.
  • It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

  • Sitting
  • Walking
  • Driving
  • Sleeping
  • Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

  • Poor circulation
  • Superficial wounds on the knee
  • Psoriasis
  • Eczema
  • Arterial insufficiency
  • Severe varicose veins
  • A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Best Knee Injury Chiropractor


References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? https://familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. https://doi.org/10.1136/bmjopen-2020-048196

Wrist Sprain: Diagnosis and Treatment Options

Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program?

Wrist Sprain

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include:

  • Pain
  • Swelling
  • Bruising
  • Decreased range of motion
  • Weakness
  • Tingling

The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully.

Grades and Types

The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024)

Grade 1

  • Ligaments are stretched; this is considered a mild sprain.
  • The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)

Grade 2

  • Ligaments are partially torn; this is considered a moderate sprain.
  • It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)

Grade 3

  • Ligaments are torn completely or have pulled away from the bone.
  • Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
  • This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)

The wrist is made up of three joints (American Society for Surgery of the Hand, 2017)

Distal radioulnar

  • This joint is between the two forearm bones.
  • The radius on the thumb side.
  • The ulna on the pinky side.

Radiocarpal

  • This joint is between the radius and three small bones in the base of the hand.
  • The scaphoid
  • The triquetrum
  • The lunate

Ulnocarpal

  • This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.

Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist.

Symptoms

The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024)

  • Decreased range of motion
  • Swelling
  • Bruising
  • Feeling instability in the wrist 
  • Weakness
  • Numbness/tingling
  • Popping sensation
  • Warm skin

Causes

The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include:

  • Repetitive overuse work injuries.
  • Housework and tasks.
  • Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.

Diagnosis

A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include:

  • Magnetic resonance imaging – MRI
  • Computed tomography – CT scan
  • Arthrogram -X-rays with contrast dye

Treatment

Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024)

Rest

  • Minimize using the injured wrist for at least two days.
  • Wear a splint for support.
  • Avoid sudden movements.
  • Avoid placing too much pressure on the wrist.

Ice

  • Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.

Compression

  • Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.

Elevation

  • To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.
  1. Grade 1 sprains usually heal with basic care within a week or two.
  2. Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
  3. The removable brace or splint should be worn when using the arm.
  4. It can be taken off at rest at night and when bathing. (National Health Service, 2020)
  5. Individuals may need the brace for a week or more.

A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength.

Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020)

Healing Time

Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Path to Healing Personal Injury


References

National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf

American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains

Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain

American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints

National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html

American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist

Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050

American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament