Is your joint pain or Tennis Elbow (plantar faciitis, glute pain, frozen shoulder, tendinitis) all your menopause's fault? I am sure you have heard all about hot flashes, cold sweats, weight gain and psychological symptoms in menopause. As many as 22% of Chinese women have hot flashes, but did you know that musculoskeletal issues occur in 41%? (Yoon)
The reason why musculoskeletal issues are more common in the peri/ menopausal years is not totally clear. We do know that the hormone shifts of perimenopause and menopause ALSO can contribute to joint pain, frozen shoulder/ adhesive capsulitis and tendinopathies (like tendonitis type symptoms such as tennis elbow, golfer's elbow, runner's knee, plantar fasciitis and achilles tendinitis). What the heck?!
Menopause is defined as the final cessation of periods and occurs, on average, between 42 and 58 and reflects the end of the reproductive years. The time before menopause is considered perimenopause where periods can become irregular and symptoms can range from hot flashes, vaginal or sexual symptoms, sleep and mood changes
Estrogen has protective effects on joint pain and helps the metabolism and mechanical properties of tendons. So, if you are aged 40-60 and have felt persnickity joint stiffness and pain, tendinopathies like tennis elbow or shoulder pain, your hormones could be a factor. Exercise is so important for life long wellbeing. So, how do you continue to be a runner, tennis player, kid picker-uper or female athlete in mid-life?
Some Tips for Staying Well in Mid-Life
With aging and the menopause transition, fatigue, stiffness and decreased strength and muscular power occur. We lose type II (fast-twitch) muscle fibers as well. To combat this, we recommend:
Strength training
Appropriate protein intake
Flexibility exercise & Joint mobility work
Maximize recovery
Plyometrics (Vetrovsky)
Not only are skeletal muscles losing strength and power, so are the pelvic floor muscles. This may result in pelvic pain, urinary incontinence and fecal incontinence. We recommend
Pelvic floor examination and treatment (that is what we do!)
We also assess your vulvar tissues for signs of Genitourinary Syndrome of Menopause (and if we see signs, we communicate with your provider)
We also lose bone mass and bone density as we age. To decrease the risk of osteoporosis and bone injuries
Appropriate vitamin D intake
Strength training
We also have the following in-clinic
Class IV therapeutic laser: wonderful to use high powered photobiomodulation- light therapy - to stimulate repair of tendinopathies
Dry Needling: also shown to help tendinopathies and muscle pain and strains
Shockwave / Gainswave for Her: this innovative treatment helps tendinitis/ tendinopathies incredibly! It can also be used for female sexual health (such as pelvic pain and decreased orgasm)
Whole body assessment: we need to look at your entire kinetic chain to see where you can move better or get stronger. It is usually in the overworked links of the body that feel pain and our job is to figure out how to create balance in your movement, joint mobility and load so that injuries can go away for good.
We use a high-powered focus Shockwave unit at our West End office to help tendinopathies, pain and sexual health. Our Omniwave Shockwave unit uses high-velocity sound waves with deep tissue stimulation, activating your body's natural recovery processes, improving blood flow, targeting pain, inflammation, injury and age-related joint and muscle pain. It helps:
Chronic tendinopathies
Tendinopathy of the shoulder
Tennis elbow
Patellar tendinopathy/ runner’s knee
Golfer’s elbow
Plantar fasciitis
Achilles pain and tendinopathy
Greater trochanter pain and tendinopathy
Osteoarthritis
Carpal tunnel
Dequervains (mommy’s thumb)
Stress fractures
Shin splints
Pelvic floor conditions such as pelvic pain, erectile dysfunction in men and female sexual function disorders in women
Just understanding the underlying “why” of hormones as a contributing factor to muscle and joint pain in mid-life can be really helpful. While women may be familiar with some of the pelvic floor health shifts in peri/ menopause (or perhaps this is also new information to many), muscle and joint pains are often an unpleasant surprise.
At RVA Holistic PT, we believe in "controlling the controllables", making your movement more awesome (more efficient and balanced = less wear and tear on the painful areas), promoting health… along with looking at hormonal shifts holistically with great quality sleep, an antiinflammatory diet, low stress (🫣)
Rothschild, Carey E. PT, DPT1; Collingwood, Tara Gidus MS, RDN, CSSD, LDN, ASCM-CPT2. Maximizing Running Participation and Performance Through Menopause. Journal of Women's & Pelvic Health Physical Therapy 47(2):p 133-143, April/June 2023. | DOI: 10.1097/JWH.0000000000000276
Vetrovsky T, Steffl M, Stastny P, Tufano JJ. The Efficacy and Safety of Lower-Limb Plyometric Training in Older Adults: A Systematic Review. Sports Med. 2019 Jan;49(1):113-131. doi: 10.1007/s40279-018-1018-x. PMID: 30387072; PMCID: PMC6349785.
Yoon S, Lee D, Bang J. Perimenopausal arthralgia in the shoulder. Menopause. 2018; 25 (1): 98-101. doi: 10.1097/GME.0000000000000944.
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