Frozen shoulder syndrome – clinically called adhesive capsulitis – is a painful and debilitating condition affecting the shoulder joint. It most often affects adults aged 40-60, with women and patients with certain medical conditions at higher risk. While frozen shoulder syndrome often, self-resolves over time. it can persist for months on end, severely impacting mobility and quality of life.

At NYDNRehab, advancements in rehabilitative medicine are revolutionizing the way frozen shoulder syndrome is treated, dramatically speeding up recovery and restoring full functional mobility, without drugs or surgery.

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Who is Dr. Lev Kalika?

What is frozen shoulder syndrome and what are its causes?

What is the role of fascia in adhesive capsulitis?

How is frozen shoulder syndrome diagnosed at NYDNRehab?

What advanced therapies are used to treat frozen shoulder at NYDNRehab?

What can I do to avoid frozen shoulder syndrome?

Frozen Shoulder Syndrome FAQs

Integrative Shoulder Specialist Dr. Lev Kalika

Dr. Lev Kalika

Clinical director & DC RMSK

Verified Expert Profiles

Dr. Lev Kalika, DC, RMSK, clinical director of NYDNRehab, has a successful track record of providing advanced holistic approaches that bring superior results to patients suffering from pain syndromes and movement disorders. Dr. Kalika has 20+ years of hands-on clinical experience in diagnostic ultrasonography, and is an esteemed member of the American Institute of Ultrasound in Medicine (AIUM).

In addition to operating his clinical practice in Manhattan, Dr. Kalika regularly publishes and presents peer-reviewed research on ultrasound-guided procedures, including dry needling and shockwave therapy. Dr. Kalika’s unique approach has helped numerous frozen shoulder patients to quickly restore pain-free shoulder function, without drugs or surgery.

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Dr. Yuri Brosgol

Orthobiologic specialist

Dr. Yuri Brosgol, MD is a neurologist with 25+ years of experience in treating myofascial ,orthopedic and chronic pain conditions. Working together with Dr. Kalika, Dr. Brosgol performs ultrasound-guided injection procedures to treat frozen shoulder cases with precision, for optimal results.

Together, Dr. Kalika and Dr. Brosgol are revolutionizing the way frozen shoulder syndrome is diagnosed and treated by leveraging the most advanced technologies and therapies currently available.

Frozen Shoulder Syndrome – aka Adhesive Capsulitis

Frozen shoulder syndrome (adhesive capsulitis) is a painful condition marked by stiffness, limited shoulder range of motion, pain that worsens with activity, and disrupted sleep. It arises when the connective tissue capsule surrounding the shoulder joint thickens, becomes inflamed, and tightens, forming adhesions that restrict movement.

Adhesive capsulitis typically progresses through three overlapping stages, and the condition can last from several months to 3 years or longer, depending on the individual and the treatment they receive.

Stages of frozen shoulder syndrome include:

Freezing stage

The most painful stage where pain gradually worsens and range of motion starts to decrease. This stage often lasts from 6 weeks to 9 months.

Frozen stage

Pain decreases slightly, but stiffness increases, interfering with daily activities. The frozen stage can last between 4-12 months.

Thawing stage

Range of motion slowly improves as pain continues to decrease. This phase can take from 5 months to 2 years or more.

While the specific causes of adhesive capsulitis remain unclear, we know that lack of physical activity can contribute to and worsen frozen shoulder symptoms. Prolonged immobilization after an injury or surgery is often a factor.

Key risk factors include:

Type 2 diabetes (highest prevalence)
Thyroid problems
Middle age (40-60)
Sedentary lifestyle
Poor posture
Female sex
Chronic systemic inflammation and metabolic disorders

The Role of Fascia in Frozen Shoulder Syndrome

Fascia, a type of connective tissue that forms a continuous, tension-transmitting network throughout the body, plays a key role in adhesive capsulitis. Frozen shoulder syndrome begins with inflammation, followed by fibrotic thickening and scarring of the glenohumeral capsule surrounding the shoulder joint. The capsule is made up of a specialized form of dense fascia that allows for smooth gliding and functional range of motion.

In frozen shoulder syndrome, an inflammatory process triggers excessive fibroblast activity, leading to overproduction of collagen, resulting in thickening, tightening, and adhesions within the shoulder capsule. The capsule shrinks in volume, restricting movement of the humeral head within the shoulder socket and causing pain.

At the same time, restrictions in surrounding fascia affecting the rotator cuff, trapezius, and/or the subscapularis can contribute to secondary tightness, muscle imbalances, and compensation patterns that further reduce shoulder function and worsen pain and stiffness. Dysfunctional fascia often develops myofascial trigger points – hard knots of tightly contracted fibers that cause pain and restrict muscle action.

Accurate Diagnosis is Key to Successful
Frozen Shoulder Treatment

Medical doctors rely on the patient’s health history, symptoms and clinical exam results to diagnose frozen shoulder syndrome, but that approach does not reveal the source and scope of the condition. At NYDNRehab, we use high-resolution diagnostic ultrasound to visualize the myofascial structures surrounding and affecting the shoulder joint.

Ultrasound enables us to:

Compare the affected and unaffected shoulders.
Identify densified fascial layers and trigger points.
Visualize nerves entrapped by fascial adhesions that intensify pain.
Examine the shoulder in motion, in real time.

Dr. Kalika has spent years developing his skills at ultrasonography and results interpretation. His in-depth grasp of human anatomy and myofascial dynamics has been recognized by his peers at the American Institute of Ultrasound in Medicine (AIUM). Dr. Kalika has been an early pioneer in using ultrasound to diagnose and treat musculoskeletal pain and dysfunction.

For frozen shoulder patients, our in-clinic ultrasound exam on your first visit puts you on the fast track toward resolving your shoulder pain and restoring functional shoulder range of motion.

New Advanced Therapies for Frozen Shoulder at NYDNRehab

If left untreated, frozen shoulder syndrome typically self-resolves within one to three years, but most patients are unwilling to
endure pain and reduced mobility for that long.
Even in the best of cases, it can take up to 18 months to fully restore shoulder function with conventional care.

Conventional treatment mainly focuses on pain relief, reducing inflammation, and restoring shoulder range of motion as quickly as possible. That typically involves NSAIDs like ibuprofen, physical therapy, and corticosteroid injections. Surgery is rare, and typically reserved for severe cases that don’t respond to treatment.

At NYDNRehab, we leverage the most advanced therapies and holistic treatment approaches to quickly eliminate pain and inflammation, and restore shoulder range of motion – all without drugs or surgery. Rather than focusing on pain management, we use ultrasound to identify the primary source of pain and then treat the dysfunctional tissues with advanced therapies.

Using our advanced, evidence-based techniques, we have achieved a 90% success rate in fully restoring pain-free shoulder function in as little as 3 months’ time. Our multifaceted approach to frozen shoulder syndrome dramatically speeds up the recovery process so you can get back to your daily activities without pain, stiffness, or limitations.

Ultrasound Guided
Hydrodilatation

Hydrodilation is an extremely effective, evidence-based procedure, presenting a breakthrough that supersedes all other existing treatments. The procedure involves injecting a water-based solution into the intra-articular space, causing the joint space to expand via hydraulic pressure, and relieving pain and stiffness.

We supplement the hydrodilation procedure with TECAR therapy to prolong the effect between the first and second injections, and follow up with one month of physical therapy. With this approach, we have been able to resolve 90% of our frozen shoulder cases, dramatically shortening recovery time.

Facial Layer
Hydrodissection

In more complicated cases where the shoulder has been frozen for an extended period of time, we perform 3 hydrodilation procedures, supplemented with TECAR therapy, and we then treat the fascia surrounding the joint capsule with hydrodissection. This procedure targets densified fascial layers that have lost their slippery and elastic properties. It uses a saline solution, injected into the fascia to free up its layers, releasing entrapped nerves, and restoring its gliding properties.

Radial Shockwave
Therapy

Shockwaves use acoustic energy pulses to reduce pain and inflammation and trigger a regenerative response. Radial shockwave therapy supports the hydrodilation and hydrodissection procedures and accelerates the healing process.

Ultrasound Guided
Dry Needling

Dry needling uses non-medicated (dry) filament-thin needles to target myofascial trigger points, a common feature of frozen shoulder syndrome. The needles are strategically inserted into the trigger points under ultrasound guidance, eliciting a twitch response in the hyper-contracted fibers that causes them to relax, quickly relieving pain and eliminating restrictions.

Stecco Fascial
Manipulation

Stecco is a specialized manual technique that helps to lubricate fascial layers, eliminate adhesions, and restore fascia’s functional properties. Dr. Kalika was mentored and certified in the Stecco approach directly from its creator, Dr. Carla Stecco, the world’s leading authority on facial tissue.

Customized Physical
Therapy

Once pain, inflammation, and stiffness have been addressed, one-on-one physical therapy puts the icing on the cake, helping to strengthen tissues, restore muscle balance, correct posture, and optimize shoulder range of motion. At NYDNRehab, we personalize your physical therapy protocol, based on your patient profile.

Avoiding Frozen Shoulder
Syndrome

Maintaining healthy shoulder function is key to avoiding adhesive capsulitis. Take the following steps to keep your shoulder joints stable, mobile, and free of pain or restrictions:

Stay physically active – your body is designed to move, and physical inactivity inevitably leads to reduced mobility and stability. Choose exercises that take your shoulders through their full range of movement, in all 3 planes of motion.
Stay hydrated – fascial tissue relies on water for lubrication and gliding action.
Avoid prolonged immobilization of the arm and shoulder, especially after injury or surgery. Work with a physical therapist to introduce appropriate gentle movement as soon as possible.
Manage metabolic disorders like diabetes and thyroid issues, where frozen shoulder syndrome is common.

Get Fast and Effective Frozen Shoulder Relief in
Manhattan NYC

Frozen shoulder syndrome typically arises between the ages of 40-60, when most people are at their professional prime. Symptoms of shoulder pain, stiffness, limited mobility, and disrupted sleep can take a toll on productivity and dramatically diminish quality of life. Conventional treatment may help manage symptoms, but it does little to speed up recovery.

At NYDNRehab, our integrative, personalized approach, combined with our advanced technologies and therapies, brings fast and effective relief from adhesive capsulitis, and quickly restores pain-free shoulder function, without drugs or surgery. Why spend months or even years dealing with frozen shoulder symptoms? Contact NYDNRehab today, and get the most effective therapy available at NYDNRehab in Midtown Manhattan

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Range of Available Unique Frozen Shoulder
Syndrome Treatment at Nydnrehab

What causes frozen shoulder syndrome?

The specific mechanisms behind frozen shoulder syndrome are not fully understood. We do know that lack of use and poor posture play a role, and it has been linked to metabolic disorders like diabetes and thyroid issues, where patients are 2-5 times at greater risk. Women between the ages of 40-60 are most commonly affected, and between 2-5% of the population is affected during their lifetime.

What are the main symptoms of frozen shoulder syndrome?

What are the different stages of frozen shoulder syndrome and how long do they last?

Can frozen shoulder syndrome occur in both shoulders?

When should I see a doctor if I notice symptoms of frozen shoulder?