I currently have three perimenopausal clients as a personal trainer and all are managing a frozen shoulder, among other symptoms.
According to menopause expert Dr Louise Newson this is fairly common, and thought to be caused by inflamed tissue around the shoulder joint. “This tissue then gets tighter and shrinks,” says Newson, founder of the Balance menopause app and host of The Doctor Louise Newson Podcast.
“It tends to first affect external rotation of your shoulder—when you turn your arm away from your body—and abduction of your shoulder, when you move it out to the side.
“If you have frozen shoulder, you’ll often experience pain—usually worse at night—and stiffness, which can restrict movement.
“Many women find it difficult to reach for things, particularly overhead or to the side, like hanging clothes or fastening their seatbelt. Some people may find it difficult to get dressed or brush their hair.
“The hormones estradiol, progesterone and testosterone work to reduce inflammation, support joint health and lubrication, and promote connective tissue integrity (keeping the body’s various connective tissues healthy and working well). During perimenopause and menopause, levels of these hormones fluctuate and reduce.”
Depending on which stage you’re in, Newson says exercise can help.
“During the early inflammation stages, it’s important not to push on through regardless, as the shoulder can get more inflamed—physiotherapy will focus on restoring shoulder mobility.
“During the developed stage, physiotherapy may be more intensive. You can also try putting a heat pack or hot water bottle on your shoulder for up to 20 minutes at a time.
“Many women find that taking the right dose and type of Hormone Replacement Therapy (HRT) and testosterone improves symptoms associated with frozen shoulder, as well as improving other symptoms, including muscle and joint pains.”
How exercise can help frozen shoulder
I also enlisted the help of physical therapist Regie Tiu, owner of Restore Plus PT, who has compiled some exercises to help manage a frozen shoulder.
Tiu has created exercises for the early inflammation stages of frozen shoulder, with demonstrations on how to perform them safely and effectively.
“Frozen shoulder, also called adhesive capsulitis, happens when the shoulder joint capsule becomes thick, tight and inflamed,” says Tiu. “This causes pain, stiffness and a gradual loss of movement. It feels like your shoulder is frozen in place, which explains the name. It often develops slowly and goes through stages: freezing, frozen, thawing and resolution.
“During peri-and menopause, estrogen levels drop, which can affect collagen levels and joint tissue elasticity. This hormonal shift makes joints—especially the shoulder—more prone to inflammation and stiffness. Stress, poor sleep, poor posture and less physical activity increase the risk of frozen shoulder.
“But gentle and consistent movement is the key. Exercise increases blood flow, helps lubricate the shoulder joint and slowly stretches the tight capsule. Over time, this reduces pain, restores movement and prevents the shoulder from getting stiffer. Even little daily stretches make a big difference when done correctly and consistently.”
How to do the exercises for frozen shoulder
Tiu recommends doing the exercises two to three times a day for the best results.
1. Pendulum exercise
Reps: 15-20 each direction
2. Wand exercise
Reps: 10 each direction
3. Wall slide
Reps: 3 each direction
4. External rotation stretch
Reps: 3
5. Posterior capsule stretch
Reps: 3
6. Towel stretch
Reps: 3
What should people do to avoid aggravating frozen shoulder?
“Avoid pushing through sharp pain or forcing your arm into positions that it is not yet capable of,” says Tiu. “Recovery from frozen shoulder takes time so stick with gentle stretches.
“Do keep in mind that the stretches can be a little painful, but it should not be excruciating pain. Applying heat before exercising can help loosen the shoulder up, and ice after to calm the inflammation down. Also, avoid long periods of immobility like sleeping on the same side or keeping the arm in a sling, unless prescribed.
“Move as much as you can as often as you can. Most people start to notice small improvements within a couple of weeks of consistent exercise. Full recovery can take several months depending on the stage of frozen shoulder. The key is consistency: exercising a few minutes three times a day every day is far better than pushing too hard once in a while.
“Even though it can take a while to recover from frozen shoulder, it’s not permanent and does not require surgery. The most important thing is to be patient, stay consistent, keep moving and get professional help if the pain doesn’t improve or if the stiffness worsens. Working with a physical therapist can help tailor exercises to your stage and accelerate your recovery.”
