Dr. Jocelyn Wittstein

And at the end of the arc of motion, they're not painful.

They're just still a little limited.

Then we do physical therapy and it's more helpful then.

And then rarely people need surgery for this.

I mean, I don't operate on many of these because it is a self-limited course and people do get better.

And most people don't need like what we call license of adhesions or manipulation, but some people do.

you know, I think certainly less than 10% of people.

So I think using physical therapy at the right time or phase is important so we don't exacerbate things.

And then the other thing I always do whenever I have a woman with frozen shoulder, I always take basically a perimenopausal or menopausal history.

I always ask them, are you having hot flushes?

Are you having night sweats?

You know, like what else is going on with you?

And I make a lot of referrals to women's health.

Probably

three to five per day in my orthopedic clinic to women's health because they're having these concomitant symptoms.

And do I have proof that initiating, you know, systemic estradiol reverses or makes your shoulder better or makes you not get on the other side?

No, but I'm studying that.

But does it make...

sense to me that it would it does make sense to me that it would and they need their other symptoms treated anyway and that your data so far suggests that hrt could be preventative is that a correct statement yeah our evolving data that i yeah i don't want to like i gotta get it out there in the right way but um yes that's what i'm seeing i i want to um do this the right way and get it accepted and reviewed and everything but yeah that's that is my feeling okay

I mean, I think...