Frozen Shoulder Explained

Written By : Dr. Evan Steinke, B.Sc, DC

Frozen shoulder, also known as adhesive capsulitis, is characterized by pain and a progressive loss of motion in your shoulder joint. You may have experienced this as beginning with shoulder pain from an unknown cause that made your sleep difficult and became increasingly painful over the coming weeks. Frozen shoulder is caused by inflammation of the shoulder joint resulting in adhesions and stiffening of the surrounding structures. As a result, the shoulder begins to become painful and lose its mobility. This is more commonly seen in people over the age of 40 and is slightly more common among women with both diabetes and thyroid disease being known risk factors.

Frozen shoulder is known to have a particularly long recovery time without treatment of 18-24 months. Due to the long duration of the condition is often divided into three phases. 

Phase 1 – Freezing: Pain in the shoulder as it begins to tighten over several months. It may be particularly noticeable at night and progress to being painful at rest.

Phase 2 – Frozen: The structures around the shoulder are now adhered to each other and mobility is limited in most or all directions, however, pain may begin to diminish in this phase. This phase can last for up to a year.

Phase 3 – Thawing: The structures around the shoulder begin to loosen and allow for a gradual return of shoulder mobility over 6+ months.

Your doctor will be able to determine which phase you are in with a physical examination, there is no need for x-rays or other forms of imaging. Management of frozen shoulder depends on the phase you are currently in but will often include a wide range of physical therapy approaches aiming to improve your range of motion and providing relief. These can include the following:

Muscle release techniques: These techniques aim to help ease pain in the surrounding shoulder muscles and reduce muscle tension to allow for improved movement. 

Exercises and Stretches: A variety of programs can be performed at home that aim to improve muscle strength, improve flexibility, and provide improved joint stability. 

Mobilization: Working with the shoulder joint directly your therapist will help mobilize the joint to improve range of motion.

Activity Modification: Depending on your specific needs your doctor may also make modifications to your daily routines and activities to ease the load and stress on your shoulder joint.

In severe cases that do not respond to conservative care your therapist will be able to evaluate and direct you for a shoulder injection or discuss other options for your particular situation. 

If you think that you have frozen shoulder symptoms suffer now longer and book with Dr. Evan Steinke at AST Westman Village today!

Frozen Shoulder

Perimenopause is the Cause

Written by: Dr. Fiona Lovely, Chiropractor, Functional Medicine Practitioner and Menopause Doula at AST


Many times, I am asked by women feeling the impending menopause experience, “What can I do now to help myself” for those years?  It’s a great question and there is much you can do.  

First, let’s talk terms.  Menopause is the time when you have been 12 months without a menstrual period.  The 10-ish years before that are what is now referred to as perimenopause.  As the typical age for menopause is 52, it is likely you have entered perimenopause by the time you are in your early 40s.  For some women, it’s at 35. Let the math be fluid on this, as every woman is different.  

How do you know you are in perimenopause?  The early signs are the change in quality and length of sleep and a change in moods.  You may not be easily able to elevate your mood to match the environment.  Anxiety can show up or worsen.  Same with depression.   Perimenopause is a neuroendocrine transition which means the brain is signalling the hormones to create a new normal.  This transition can be long, so its helpful to know you can expect change. 

For many women in their late thirties and early forties, you may be in your child-birthing years and brush these early symptoms off as a lack of sleep, or the baby-blues or stress.  These things may in fact be caused by the hormonal shifts of perimenopause. Your levels of testosterone and progesterone do a slow decline towards menopause.  Estrogen levels can be quite high or low and can swing wildly.  You can feel moody, sleepy, less strong, less sharp mentally and your cycle can get shorter, meaning you can bleed every 25 or 26 days instead of 28-30 days.  

In the forties, women can experience the more classic signs of menopause like hot flashes, dryness, lack of libido, deepening insomnia, feelings of low self worth, low confidence, anxiety and/depression.  This is a delicate time for a woman as she can easily be misdiagnosed with a mental health disorder instead of being treated for perimenopause.   You may not have even had a hot flash or a skipped period at this point.  

On a list of the top ten most common symptoms of perimenopause, hot flashes are number 10.  Many women never have a hot flash, so please don’t wait to assume you are in perimenopause only when your periods change or you experience a hot flash! 

Reducing stress, recognizing your symptoms are a result of changing hormone levels, getting enough rest, nutritious food, outside light and daily enjoyable movement are important for preparing yourself for a gentle perimenopause.  Eating enough daily protein and strength training for maintaining muscle health is important too. 

In short, if you are a woman between 35-55 years of age and something recently has changed with your health, it’s likely related to perimenopause!   It begins long before you miss a period.  Look for great practitioners who can coach you through this transition.  Perimenopause can be a chaotic time where the help is thin on the ground. 

Have you considered speaking with a Menopause Doula?  We can help guide the way forward to better sleep, a peaceful mind and a calm and cool physical self.  

Contact AST Willow Park to schedule an appointment with Dr. Fiona Lovely today.

Not ready to make an appointment but want to learn more, head to Not Your Mothers Menopause Podcast. Hosted by Dr. Fiona Lovely.