Support for your lifestyle

Claire Callaghan

Exercise

Are you suffering from more joint and muscle pains or are injuries taking longer to resolve? Changing hormones and the passing of time affect bone, muscle tendon and ligament strength, as well as how quickly and effectively your body can repair. There are steps, big and small, that you can take to counteract this and to ‘future proof’ yourself.

How perimenopause and menopause can affect your bones, joint and muscles

Your bones are living tissue, they constantly undergoing turnover and change. Oestrogen and testosterone help to regulate this process, so falling hormone levels impact your skeleton and pelvic floor too.  Without preventative steps (such as weight bearing and resistance exercises and lifestyle measures) then:

• You can lose up to 20% of your bone density in the first 5-7 years post menopause (1). This in turn can result in an increased risk of fracture. Worst affected areas are the thoracic and lumbar spine and in long bones, such as the femur (thigh bone) and the forearm. Sadly, fractures are not only painful, but they can also lead to altered posture and potentially a loss of independence. If you’re concerned about bone thinning or have a family history of osteoporosis, you can find out your bone density with a DEXA Scan.
• Muscle mass decreases from the age of 30 at a rate of 3-8% per decade (2,3). It’s not known exactly how oestrogen affects this, but it seems the quality of muscle, rather than its mass, is reduced during menopause.
• Muscle power (the ability to produce force quickly and repeatedly) and the vertical jump height (height you can jump and elevate yourself to) drops along with your hormones (4). This means it’s harder to lift something heavy, run up the stairs and to step down quickly.
• The quality of our collagen changes. Collagen is found in the skin, ligaments, tendons, pelvic floor muscles and connective tissue. It acts like scaffolding, giving it strength and structure. A lack of hormones makes this become thicker and stiffer. As a result, these tissues don’t have the same ‘spring’ and support and they don’t heal as quickly either.

Common ailments in perimenopause and menopause

If you suffer pain in the outer hip, back of the heel and calf or along the inner shin into the foot, you’re not alone. These are common ailments, often linked to tendon problems. These problems can disturb sleep, change how you walk and make it hard to exercise.

There’s some evidence that there’s a connection between falling oestrogen and pelvic floor problems too.  If you’re leaking urine or needing to go to the toilet more frequently, this could be part of the problem.

Insomnia, anxiety, ‘brain fog’ and musculo-skeletal pain also seem to go hand in hand too. Those who have disturbed sleep tend to suffer from more pain in joints and muscles, resulting in a reduced quality of life (5).

The good news – you can do something about this and get support from others.

Ideally you would do weight bearing exercises and balance exercises twice a week, alongside regular moderate exercise.

Overall, exercise not only improves overall fitness and helps to manage weight, but it also boosts your mood and aids concentration. When done safely, it also helps reduce joint and tendon pain. If you’re unsure what’s right for you, seek help from a physio or exercise professional.

When the going gets tough

• Some days and weeks it might just be too tough to exercise, for all sorts of reasons (including menopausal symptoms!) Check out the list of ‘quick wins’ below for times like this. You can fit them into your day, either while doing other tasks or in a brief spare moment.
• Doing a little, often, and consistently is the key. Establish a routine.
• Aches, pains and motivation will come and go.
• Be patient. Healing can be slower if you do get injured.
• Try and stay optimistic and enlist help from others – family, friends, physios, and health and exercise professionals

Written by Claire Callaghan B Pty MSc

Chartered Physiotherapist, Sport and Exercise.

You can follow Claire at @PhysioClaireCal

Reference list:

• NHS Website: https://www.nhs.uk/conditions/osteoporosis/
• UK Chief Medical Officers Physical Activity Guidelines, September 2019. https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report
• Lowe et al. Mechanisms behind oestrogen’s beneficial effect on muscle strength in females. Exercise Sport Sci Rev. 2010. April 38 (2): 61-67.  doi:1097/JES.0b013e3181d496bc
• Bondarev et al. Physical Performance in relation to menopause status and Physical Activity. Menopause 25 (12): 1432 – 1441. Dec 2018.doi: 1097/GME.0000000000001137
• Frange et al. Insomnia with Musculoskeletal Pain in Post Menopause: Associations with Symptoms, Mood, and Quality of Life. J Menopausal Med. 2018 Apr;24(1):17-28. doi: 6118/jmm.2018.24.1.17.