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Menopausal Frozen Shoulder – Osteopathic Approach

Frozen Shoulder or Adhesive Capsultis is a common disorder in general orthopaedic practice, characterized by pain and limitation of the shoulder joint [1]. The prevalence of frozen shoulder is 2 to 3 percent in the general population [2]. The underlying cause remains unknown and the lack of consistency in the published literature also reflects a lack of understanding of causation.

Frozen shoulder mostly affects women (70% of patients presenting with adhesive capsulitis are women) over the age of 50. In Japan, the term “goju-kata” (50-year-old-shoulder) has been used among the general public since the eighteenth century [3].

In Osteopathy, we think there is a close link between hormonal imbalance and the development of frozen shoulder.

There are a lot of origins that can cause frozen shoulder, and it is always over-simplistic to write a general article because each person is unique. The aim of this article is to explain one potential triggering mechanism of frozen shoulder and how an Osteopath can help you.

What is the physiological link between frozen shoulder and menopause?

During menopause, the secretion of estrogen decreases significantly with undesirable consequences on the flexibility of some of your tissues like skin, the uterus, but also the capsule of your shoulder. The capsule is the sac enclosing your shoulder joint. The decreased estrogen hormone is associated with an increase of the secretion of the growth hormone called IGF-1. This hormone is responsible for an abnormal proliferation of collagen [4], which is a structural protein of the shoulder capsule.

How can an Osteopath help you?

The Osteopath’s goal is to put your hormonal system (glands, blood flow…) in the best condition possible and to release the joint mobility restriction, which can change the biomechanics of the upper body.

  • To do this, the Osteopath will check the organ mobility because organs play an important role in hormonal secretion; in particular the kidney, pancreas, thyroid, liver, and ovaries. Also the abdominal organ is an important blood reservoir. For example, the liver contains 10% of total blood volume. Osteopaths emphasize improving circulation and avoiding congestion because hormones circulate in the bloodstream. It’s always difficult for people to understand that an organ is mobile. The mobility of an organ is minimal compared to the hip joint or the shoulder joint and represents only a few millimeters to a centimeter. To illustrate this, during breathing, when the diaphragm descends, the kidney moves up and down 3 cm [5]. In one day, your kidneys travel 600 meters!
  • Your Osteopath will use a cranio-sacral technique to have an action on your pituitary gland (to work on hormonal balance). This gland needs to be free of all stress to function correctly.
  • Another way to work on the balance of your hormonal system is by vertebral adjustment (structural technique or soft manipulation), which acts on the balance of your automatic nervous system (neurovegetative system). This system regulates different functions like venous and blood circulation and secretion/excretion. The regulating centers of this system are in the spinal cord and brain. This is the basis of the importance of adjusting the spine and practicing cranio-sacral therapy.
  • Your Osteopath will also ensure that there is no joint mobility restriction, which can affect the biomechanics and the blood flow of the shoulder. We will focus on the joints of the upper body but also other joints on the spine and lower limb, which can have an effect on the shoulder.

Osteopathy complements a physiotherapy approach to the treatment of frozen shoulder.

Menopausal Frozen Shoulder and Prevention 

It is not necessary to wait for menopause to appear to consult an osteopath. I recommend two treatments per year to allow your body to adapt to this important hormonal change.

Advice

A healthy lifestyle (including physical activity and a healthy diet) is essential to live well during this particular stage in a woman’s life.


[1] Tamai K1, Akutsu M, Yano Y. Primary frozen shoulder: brief review of pathology and imaging abnormalities. J Orthop Sci. 2014 Jan;19(1):1-5.

[2] Huang SW, Lin JW, Wang WT, Wu CW, Liou TH, Lin HW. Hyperthyroidism is a risk factor for developing adhesive capsulitis of the shoulder: a nationwide longitudinal population-based study. Sci Rep. 2014 Feb 25;4:4183.

[3] Tamai K, Akutsu M, Yano Y. Primary frozen shoulder: brief review of pathology and imaging abnormalities. J Orthop Sci. 2014 Jan;19(1):1-5.

[4] Kilian O, Pfeil U, Wenisch S, Heiss C, Kraus R, Schnettler R. Enhanced alpha 1(I) mRNA expression in frozen shoulder and dupuytren tissue. Eur J Med Res. 2007 Dec 14;12(12):585-90.

[5] Barral JP, Mercier P. Manipulations viscérales : Tome 1. 2004 juin. Elsevier Masson


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