Patient Spotlight: Dr. Jill Javahery, MD

Jill first came to see me several months ago with severe right shoulder pain and limited mobility. As an avid tennis player, this simply wasn’t going to work for her.

Jill is 47, a dermatologist running a busy practice, a mom to three very active high-school boys, and married to a very busy neurosurgeon. Tennis is essential to her wellbeing, so getting her back on the court mattered.

During our first few visits, we focused on her shoulder and spine. We were making decent progress, but we both felt there might be something more going on. So we expanded the bodywork to include her full spine, hips, and feet. Through the connective tissue system, restrictions in one part of the body can contribute to pain somewhere else, including a stiff, painful shoulder. We also moved into my new 75-minute integrated sessions, incorporating Active Release Therapy and focused breathwork and now were making deeper progress.  Still, we both agreed it was worth taking an even broader look at her overall health. One of the things I love about working with medical doctors is that they’re open to exploring every aspect of what might be contributing to an issue in a holistic way. At 47, Jill had recently entered perimenopause and was beginning to experience some of the subjective symptoms of this phase of her life as a woman. 

We decided it would be helpful for her to see her OB-GYN and check her hormone levels. Fluctuating hormones can directly affect connective tissue health and may contribute to pain and limited mobility. In fact, research suggests the shoulders, neck, and jaw may have a higher density of estrogen receptors, which can make these areas particularly sensitive to hormonal changes during perimenopause and menopause. In fact, it's now understood that the shoulders, neck and jaw may have a higher density of estrogen receptors making these areas more susceptible to peri-menopause and menopause symptoms.  Following the blood work, Jill began  a hormone replacement regime and almost immediately she experienced a deeper relief of shoulder pain. 

With a better understanding of how hormones influence connective tissue, it becomes clear that the body isn’t “breaking down.” Rather, it’s adapting. Hormonal signals that once supported tissue recovery, sleep patterns, and nervous system balance simply become more variable.

Recently, this is something I’ve been paying closer attention to in my own work with women especially for those entering this phase of life. Recovery after intense workouts may take longer. Sleep becomes more important. Nervous system regulation matters more than ever. And of course, intentional, skilled tissue work can play an important role.

For Jill this has meant adding a recovery day in between hard matches, improving her sleep hygiene, and incorporating breathwork into both our sessions and her daily routine. Combined with continued bodywork, Jill is happily back on the tennis court,  playing regularly without pain.

As my understanding of the unique needs of women in all phases of life, but, particularly those entering menopause, continues to deepen, I look forward to further refining and improving the care I provide.