The 50-year-old Shoulder
As we reach mid-life there is a tendency to blame every ache and pain on the menopause. So, is the menopausal shoulder a thing?
Shoulder complaints are the third most common musculoskeletal problem after back and neck disorders. Women are certainly at an increased risk of shoulder dysfunction with connections to thyroid dysfunction and hormonal fluctuations associated with perimenopause.
The two most common presented issues are injury to the rotator cuff muscles a general term for a strain, tear or tendinopathy to one of four main muscles in the shoulder girdle group and adhesive capsulitis or frozen shoulder as it’s more commonly known.
Other than an injury/trauma additional contributing factors are:
Age – with both issues peaking around the 50-year-old women
Collagen – collagen fibers keep the skeletal system flexible, but levels in the body start to decline around the age of 25. These declines can cause loss of flexibility in ligaments tendons bones and cartilage
Diabetes – causing compromise to the blood flow to the tendon and its ability to heal
Change – sudden increase or decrease in activity
Repeating the same shoulder movements, for example, throwing or lifting
Although symptoms may vary between the two conditions they can include:
Inflammation
Pain at night, particularly when sleeping on the affected side
Weakness or pain in the shoulder when the arm is lifted or rotated.
Limited range of motion, especially placing arm behind back
The pain may come on gradually if it is a tendinopathy, but pain may be severe and sudden if a muscle is partially or completely torn
Tendinopathy’ is an umbrella term for inflammation/degeneration/tearing/impingement of the tendon of the supraspinatus muscle.
There are many tests that can be done to assess the tissues and the cause of pain and therefore what treatment strategy is best. Some shoulder issues will respond positively and quickly to treatment; however, realistically, true frozen shoulder can take between 24 – 36 months to resolve. Therefore, it is also important to have a positive mindset around the condition to be empowered and involved in self-care through the stages of recovery.
TRUE adhesive capsulitis = loss of ROM in this order (capsular pattern):
Lateral/external rotation (most affected)
Abduction (next affected)
Medial/internal rotation (least affected)
One thing to note is that the presence of injury or degeneration does not necessarily equal pain and pain does not always equate to injury.
So yes, the menopausal shoulder does exist however, as with most things in the body, nothing happens in isolation. Being in the best health through regular exercise, stress management, healthy eating and hydration and good sleep hygiene will certainly mitigate some of the risk factors associated with it.
Rotator cuff injuries are likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that require repeated overhead lifting or work at or above shoulder height also increase the risk of rotator cuff impingement.
As always, the information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case.
