Frozen Shoulder and Perimenopause – What to Watch For and How Physical Therapy Can Help

5-min read

If you’re in your 40s or early 50s and suddenly notice that your shoulder has become stiff, painful, or difficult to move, you’re not alone and it might not be a coincidence. Frozen shoulder (adhesive capsulitis) disproportionately affects women in the perimenopausal and postmenopausal years, and research is increasingly linking hormonal changes to this frustrating condition.

The good news? Physical therapy can significantly reduce pain, restore motion, and help you avoid surgery or long-term immobility.

Why Does Frozen Shoulder Happen?

Frozen shoulder occurs when the capsule of connective tissue around the shoulder joint thickens and tightens, limiting motion. While the exact cause isn’t always clear, it’s more common in:

• Women between the ages of 40 and 60

• People with diabetes, thyroid dysfunction, or autoimmune conditions

• Those recovering from an injury or surgery that limited shoulder movement

Hormonal changes during perimenopause and menopause—especially the drop in estrogen—may play a role in inflammation, collagen production, and joint health, which could help explain the increased incidence in midlife women.

Signs You Might Be Dealing with Frozen Shoulder

Frozen shoulder usually progresses through three stages:

1. Freezing Stage (6 weeks to 9 months)

   • Gradual onset of pain

   • Increasing stiffness

   • Pain worse at night or with sudden movement

2. Frozen Stage (4 to 12 months)

   • Pain may decrease

   • Significant stiffness remains

   • Daily tasks like dressing or reaching become difficult

3. Thawing Stage (6 months to 2 years)

   • Slow return of range of motion

   • Function gradually improves

If you’re in perimenopause and notice increasing shoulder discomfort and loss of movement, it’s worth talking to your physical therapist early as waiting often leads to longer recovery times.

How Physical Therapy Can Help

At Atomic Physical Therapy, we see a lot of active women frustrated by shoulder stiffness that interferes with exercise, work, or sleep. Our approach is rooted in education, movement, and hands-on care. Here's what to expect:

1. Pain Reduction Strategies

• Gentle manual therapy to reduce muscle guarding

• Modalities like laser or dry needling (if appropriate)

• Positioning education to help you sleep more comfortably

2. Targeted Range of Motion Exercises

• Safe, progressive stretching to restore shoulder mobility

• Home exercises to maintain progress between sessions

3. Strength and Stability

• Once movement improves, we introduce light resistance to regain control and prevent future injury

• Whole-body movement patterns are often involved especially if compensation patterns have developed

4. Education Around Hormonal Health

• If you're in perimenopause, we can also guide you on how hormonal shifts may be impacting your recovery, and refer you to trusted providers for additional support when needed

What If You Just “Wait It Out”?

While frozen shoulder can eventually improve on its own, research shows that early intervention with physical therapy leads to faster recovery, better outcomes, and reduced long-term stiffness. In some cases, waiting too long can mean dealing with months or even years of unnecessary pain and disability.

You don’t have to just live with it. If your shoulder has been stiff, painful, or hard to move and you’re in your 40s or 50s it’s worth getting it checked out. Our team at Atomic Physical Therapy specializes in helping women stay active and pain-free through all stages of life.

👉 Book a free discovery call today and let’s figure out what’s going on with your shoulder.