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Changing Hormones and Bursitis?


#1

Hi all,

I've continued to lift twice a week but had to stop doing o-lifting because my shoulder was really killing me. Did some trigger point therapy sessions which reduced the quality of pain quite a bit but still not enough to feel like I should get back to explosive lifting.

I was still doing heavy front/back squats but it was sometimes quite tough to get the arm into the back squat position. Wider grip and lots of slow arm circles made it possible but it took extra effort.

So, off to the sports med doc I go. He does a bunch of those bilateral tests..."lift up, resist, hold at 90 degrees, resist, etc. etc." Then he has me lift both arms up about 45 degrees off straight ahead, rotate thumbs down and resist... wow, the left side has no ability to resist being pulled down but the right is fine. This, he says, is bursitis sign.

So I get a shot of cortisone in the left bursa of my shoulder. Repeats the test after a few minutes and, voila, I can resist equal. Pain much better but still a bit of hitching. No lifting anything heavy with the shoulders for 2 weeks... no squats, etc. Fortunately, I'd just finished back squats at 65kg for 3x5 that morning so I'm good with that. Now its weighted vest lunges and step ups in the meantime.

Here's the interesting thing... while he's doing all the different tests I mention I've been having hot flashes and other signs of perimenopause... how could I not as I have a flaming flash right then. He nods, finishes, diagnoses.

He says that bursitis often occurs when women's hormone levels change at perimenopause. Bursitis is very common in the 40-60 age group for women, he says. I have never heard of this.

Anybody ever hear something about this (bursitis w/ changing hormone levels)? Any experience with this? What did you do?

I'll be doing a bunch of scapular retraction strengthening stuff when I can start weighting my shoulder again. Face pulls, etc. Increase fish oils (thank goodness I just got a Flameout order in) and chrondroitin/glucosomine/MSM. I've got my list of Cressey articles lined up for exercise choices after the 2 weeks.


#2

That is very interesting. I've never heard of that connection before. Did he say why chaning hormone levels affect the female body like that?

I hope you are successful in working through this, it's got to be pretty annoying/frustrating.


#3

I've never heard of that either. I always thought bursitis can affect anyone at any age. I also don't buy his "hormonal" theory, but I do have one of my own, that is obvious, and just makes more sense to me.

I think it's due to more laxity in women's shoulders. Since our shoulder joints are looser than men's, the joint itself and the surrounding structures of tendon and muscle have a lot more "wiggle room". So we really have to work harder to maintain proper form and alignment in all shoulder exercises, and throughout all planes of force and motion (overhead, lateral, etc.) This stress causes inflammation, which is what bursitis is. So take whopping loads of Flameout.

Men blame EVERYTHING on a woman's hormones.


#4

Thanks Sic and Yo Momma, I spent a bit of time on scholar.google.com looking for a connection and found nothing there either. Your final sentence probably put the right perspective on it, Yo Momma. The sports doc said the changing hormones changed the lubrication level of the joints. I couldn't find anything to support his statement so to heck with him.

The last trigger point therapy session removed the last bit of pain that would pop up with certain motions in the shoulder socket. I'm still moving weirdly through some ranges so I've decided not to lift explosively until both arms are moving freely through all ranges at speed. I want to lift indefinitely longer so a 2 month layoff of o-lifting is OK. I think I'll do at least an 8 week cycle of squat strengthening and shoulder retraction strengthening and try to be ready to start again end of March.

Thanks again for sharing your views.
Best
Stand Up


#5

Well I know changing hormones changes the lubrication in other places... but we're not talking about sex, we're talking about joints. I'm not sure that the same phenomen would occur.


#6

Who knew... there are estrogen receptors in bursa and synovial fluid generating cells:

http://edrv.endojournals.org/cgi/reprint/17/4/369.pdf

osteoporosis and declining synovial fluid appear correlated to declining estrogen levels.


#7

I don't think this 'splains your dilemma, though. This was looking at the development discrepancy of autoimmune disease in women. The "bursa" they were referring to was a study done in quails, and it is an organ that only birds have. It's called "the bursa of Fabricius", and it is at the junction of their gut and cloaca. It is lymphoid tissue that gives rise to progenitor B cells, which can begin the whose cascade of immune response.

Sounds pretty good, though. But human men get lots of bursitis, and hopefully have lots less estrogen receptors than we do. It really has to do more with our inflammatory response to repetitive stress, which differs from individual to individual.

But what do I know? I'm just the bass player.


#8

Lol, I did the same internet research and learned lots about hormonal/bursa interactions... before realizing it was unique to birds. Dammit.


#9

Agree that searching the paper for bursa talks about the quail. Searching on synovial reveals the estrogen receptors in humans aspect.

I've been trying to find a reason the sports doc would have said what he said (other than his being sexist). I wasn't aware that there are estrogen receptors in synovial fluid generating areas. I wasn't aware that rheumatoid arthritis has such a strong female leaning. So maybe his observation is based on bursitis as an early symptom to RA? Maybe his aging female athletes are showing these symptoms more than his aging male athletes.

I found another book that is focused on the literature concerning aging female athletes but I'd have to shell out the bucks to get the details.

I take my 10 yr old daughter to a female sports med doc on Thursday for follow-up on her buckle fracture. This doc specializes in female athletes at the other change of life: menarche and adolescence. Perhaps I'll get a chance to ask her about books on the topic.

I'd like to understand this a bit more to know if there is anything else I can do to be an aging female athlete instead of just an aging female :slight_smile:

Best, Stand Up


#10

If you find out, let me know. I'm older than you are and fading fast.


#11

Took my daughter to a female sports medicine doctor today for her buckle fracture follow-up... all's well with her.

I got a chance to ask the woman doc about "something I've heard" about women beginning menopause and increased injuries with shoulders due to changing hormones. She thinks for a bit and says she's never heard of it. She relates that the bone health issues aren't very likely at the start of menopause... it's more of a years of low estrogen exposure problem. Otherwise, she's not heard of it.

I didn't tell her I heard it from her colleague, male sports doc, as doctors will never disagree with each other in front of patients.

So... never mind on the subject of this thread.

However, the question has got me started researching things I can do to be a successfully aging athlete, irrespective of gender. But that's a topic for another thread.


#12

Heavy sigh...I'm flopping back again. There is a recently published book called "The Active Female Health Issues Through-out the Lifespan" by J. Robert-McComb, R. Norman and M. Zumwalt. Published in December 2007. You can search it via Amazon.

If you search on "shoulder based sex differences" (an item shown in the index), this is what it says:

"Finally, women between the ages of 40 and 60 are more predisposed to developing secondary idiopathic capsulitis(78). This condition is associated with increased thickening of the anterior superior joint capsule at the coracohumeral ligament (79), along with a noninflammatory synovial reaction in the proximity of the subscapularis tendon (80). These changes demonstrate active fibroblastic proliferation accompanied by tissue transformation into a smooth muscle-like phenotype that is similar to Dupuytren's disease (81)."

This description reads exactly like what I am currently experiencing in my left shoulder.

So, I guess original doc was sort of right although this summary doesn't say anything about changing hormones as the cause. The implication is there because this is the time frame that the onset of menopause usually occurs.

Following up on the statement "women between the ages of 40 and 60...(78)." where (78) is this paper:
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1010343&blobtype=pdf
This link is to the full paper published in 1996. The title is:
"Shoulder capsulitis in Type I and II diabetics:..." which seemed like a real stretch to get the "women between the ages of 40 and 60..." statement. So, I read the whole paper. Most of the paper discusses detailed data about diabetics. The introduction references several papers including this one:
http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1582928&pageindex=1 published in 1959. This paper is the one that states that shoulder capsulitis is more prevalent in women between the ages of 40 and 60.

After reading these papers through though, I don't see actual data being collected by the author of the 1959 paper.

So I searched on some terms gleaned from the papers above. The search term used is "periarthritis of the shoulder" which got this paper with actual data:


and party-line papers such as:
http://www.aafp.org/afp/990401ap/1843.html
I was able to trace down 10 references that supported the statement of the book that those who developed idiopathic capsulitis were predominately "women between the ages of 40 and 60".

So what does that mean for me and other women of a certain age? I find this information comforting in that I've had two instances of shoulder pain (one in each shoulder) in the last 2.5 years I've been doing o-lifting. Both occurrences started with out an acute cause (i.e. I cannot point to an event which created pain during the event). The latest instance, in fact, started during a two week lay-off from lifting. "Idiopathic" means unknown cause. The predominance of idiopathic capsulitis with women of my age group strongly suggests to me that my o-lifting may not be causing my shoulder problem and thus, I should not conclude that I should stop doing o-lifting.

Have I just gone through a long and complicated analysis to rationalize continuing to do something I really enjoy doing?


#13

Maybe, but you are sure thorough with your rationalization.

I kinda go through a similar process when I have questions/doubts about stuff, but I'm far too lazy to delve into it deeply. I tend to just do it, if that's what I wanted in the first place. If whatever it is doesn't work out, c'est la vie.
Have you been able to lift at all since this became an issue?

Since I only just started OL and I'm 41 next month, I often wonder if anything more than personal satisfaction will ever come out of all this training. If not, then whatever, it's all good.

I can totally relate to why you want to keep up with the OL, and I hope you are able to continue. If not, you can still train and maybe coach if that suits you.
Let us know what happens.
db


#14

Every athlete wants to avoid injury. But so far, there is nothing that can be done to avoid aging, and the different stresses we place on our bodies. But no matter what age, it all comes down to risk assessment associated with our sport, and what we are willing to do to continue playing.

As for me, the injuries I suffered in my youth sometimes come back to haunt me now, as far as pain and stiffness, especially where I have broken bones. My fingers have some arthritis from pulling on the steel strings of my bass for 30 years. It's a very small price to pay for a lifetime of doing what I really enjoy. But I'm one of those "all or nothing" types, you know, whose last words are "Hey, watch this!!" I don't recommend my lifestyle to anyone, though.


#15

Yes I have been able to get back to lifting as of this week. During the two weeks of no shoulder involvement I did weighted vest work. Three sets of 50 squats with a 20 pound weighted vest definitely kept the legs fired up. I felt every single muscle fiber in my hams and glutes after 150 squats!

I've started gentle and light-ish overhead work this week, too. The good thing about this problem is my posture the other 23 hours of the day has significantly improved. I'm finding it very easy to keep my scapula down and back. Started doing up-right rows, military press and incline push-ups with focused attention on what's going on with my scapula position while doing them. These actually make my shoulder feel normal.

I'm going to take it slow though on getting back to explosive with the shoulder. I want my left shoulder to be totally twinge free when I move it before getting back to cleans. So, I'll work on increasing my squats including OHS and strengthening the scapular retraction muscles. Tentatively target end of March to get back to o-lifting. This will give me two months before a meet I'd like to participate in.

Agree, dianab, I'm happy with just doing the lifting. Personal enjoyment of the activity along with feeling powerful and strong in my other hours of the day is what I expect from o-lifting. Anything else would be gravy.

Good job on your improvements in squatting, dianab. Gotta love it.


#16

So you are definitely on the mend, I'm glad to hear that. Those squats with a vest sound hard, but I bet you enjoyed every minute of it.
Keep us up to date, it's very helpful for me to see what you are doing. And I am loving the squats and the overall feeling of getting stronger.
db


#17

I was reading your post about change if life menopause it is a true fact to it I have been suffering with this every since menopause if you look up 34 symptoms if menopause you will see along with the other horrible symptoms hot flashes body aches anxiety feeling off balance it’s so much but the tendinitis is definitely one of the major symptoms if you look up patient. Info you will find many women around the world experience this well hope your getting better and stronger