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Is there more to your shoulder pain?





At Empower Physical Therapy, we see people in the perimenopausal or menopausal phase start to come into us with shoulder pain as one of their chief complaints. I want to talk a little bit about that connection and how we can help address it in physical therapy. So first of all, when we're going through menopause or perimenopause, our estrogens are starting to decrease. We know that estrogen is supportive for all kinds of tissues in our musculoskeletal system, like tendons, ligaments, muscle, bone.


It becomes important to start paying attention to when your body is feeling a little more achy, maybe a little more joint pain as you transition through that phase of life. Potentially some of the same things that we can be doing to address things like brain fog, hot flashes, trouble sleeping, other things that might be going on during the menopausal period, might be some of the same things that can be supportive for the joint pain or aches that you might be experiencing in that phase of life as well. When it comes to the shoulder pain piece specifically, there is this shoulder condition called frozen shoulder that increasingly we're seeing linked to menopause in our clinical experience. Now, that's not really something that is being reflected in the research yet, although research is starting to be done to start helping us establish that connection. 


There was actually a study that was done at Duke where they looked at women in various age categories and they found that women who were postmenopausal who had been doing hormone replacement therapy were less likely to have this frozen shoulder condition, which shows us that there is some link between that decreasing estrogen and the shoulder pain that people are experiencing as they transition through that life phase. 


I want to just take a step back for a second and talk about what a frozen shoulder is. Frozen shoulder is a diagnosis that describes this pattern of shoulder pain where there's inflammation present in the joint and the actual tissue that seems to be inflamed is the tissue surrounding the joint itself. So it's not inside the shoulder, it's not the muscles or tendons around it, it's the actual fibrous, it's called a capsule that surrounds the joint. In the beginning what happens is at the ends of your range of motion like in shoulder flexion or in shoulder internal rotations like when you're reaching up behind your back, there is a little bit, not a little bit, shoulder internal rotation, like when you're reaching behind your back, there can be a lot of pain at those ends of range of motion. As time progresses, the range of motion that is available becomes less and less and less, and people feel like they cannot move their arm at a certain point. Eventually the pain starts to subside but the range of motion stays small and that is where being with a good physical therapist can be really helpful because it's important to be able to get all that range of motion back. 


So physical therapy can help with the pain management piece, the range of motion piece, and eventually, once it's appropriate, the strength piece of rehabbing a frozen shoulder. It can be really helpful to see a pelvic floor physical therapist because we understand that there is this relationship between what is going on with your menopausal transition and what is going on with the aches and pains that you might be experiencing in your body. From a shoulder pain specific standpoint.


Your shoulder is something really important for your day-to-day tasks. The more you start pulling back from what you're able to do day-to-day, the less range of motion you're going to have. Use it or lose it, sometimes people will say. At Empower PT we really want to make sure that we are getting people back to that prior level of function and then encouraging them to participate in a strength training program to help them maintain and even improve that available range of motion and strength. That's really important in the perimenopause and menopause period of life because like I said, estrogen really affects a lot of the musculoskeletal tissues in the body. Plus, in conjunction with some of the other things we can be doing to support those structures, we also want to have a really good comprehensive strength training program that can help maintain things like bone density, muscle mass, and the other stuff that is starting to be affected by those changes in hormones. At Empower Physical Therapy, it's really important to us that we take people all the way there in their care so that we're not just getting them back to being able to reach for a shelf and sending them on their way. 


I hope it helped you draw some connections. And if you have any questions, please feel free to reach out to us.

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