Showing posts with label rotator cuff. Show all posts
Showing posts with label rotator cuff. Show all posts

Friday, March 21, 2014

Frozen Shoulder - Over 40? Blame Menopause.





I have found that most people, including my doctor who primarily treats women, are NOT aware of the prevalence of frozen shoulder with women of "ahem" a certain age or the  connection between a frozen shoulder and menopause.

About 9 months ago, I started experiencing an ache in my shoulder which proceeded to get worse. So much so that I had trouble pulling shirts over my head; then it started to interfere with my sleep. In talking with one of my model friends who happens to be around my age, she told me she too was dealing with this and that her doctor was recommending to operate. 

First let's define what a "frozen shoulder" or adhesive capsullitis is; Unlike an injury to the shoulder or rotator cuff, this situation is not caused by any specific event and gradually builds resulting in pain and an inability to move your shoulder !

A girl who likes to know the why of everything I began to research and surprisingly found out that I fit precisely into 3 of the major risk factors. 

First of all I discovered that this affects primarily women (70%) around 40-60 years old, who are menopausal or perimenopausal. My physical therapist said that in his 10 years of treating frozen shoulder only once has he treated a man for this. In Japan this is so common that is called "Fifties Shoulder". Science thinks this might be due to a hormonal shift; possibly because estrogen has anti-inflammatory properties that are now deficient.

Secondly, 10-30 percent of people with diabetes (type 1 or type 2) develop frozen shoulder according to the American Academay of Orthopaedic Surgeons. Diabetes can damage the blood vessels affecting circulation and result in scarring of the body's elastic tissue - triggering a frozen shoulder. 

The good news that I uncovered was that most people THAW out and recover from a frozen shoulder within 2 years - even if they do nothing! Plus it rarely reoccurs again. Just today I spoke to my girlfriend who was suffering from this and she told me that it seems to have gone away! Proof positive. I myself am just about "thawed" and moving better now too - time, Pilates and physical therapy have helped tremendously.

Today my therapist did a technique called "dry needling". He said it alone has been the single best game changer for helping frozen shoulders he has learned. Using an acupuncture needle (the ones you don't feel) inserted into "trigger point". 

Orthopaedic surgeons have long done this, but they usually do it to deliver some sort of anti-inflammatory med or steroid. My physical therapist told me that what they have found is that just the process of inserting the needle, not necessarily the medicine, produces pain relief and improves the range of motion. Today was my first go with it - he went straight through one of the rotator cuff muscles to the shoulder bone with a needle. I could feel the pressure against my bone, a little discomfort, but no pain. When he was finished I immediately had more range of motion and the achey feeling was gone.

Regarding surgery ... unless you are wrenching in pain, my non-professional opinion is to try all other options first since the literature suggests that even after surgery, this capsulitis can reoccur and it will go away on it's own in time although you can speed the process up a bit. Here are a few things to try first that worked for me:

  • Sleeping with a pillow under my elbow to help rest the painful shoulder. 
  • Doorway stretches and lots of other stretching exercises, including targeted Pilates.
  • Conscious posture improvement - rounding shoulders reduces range of motion. When I am walking I make sure to pull my shoulder back and down. When sitting, I pull my arm behind my back into my waistband and hold the stretch.
  • Ibuprofren
  • Heat
  • Massage