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The Menopause Guide to Tendon, Joint and Connective Tissue Health

Once menopause enters the picture, it will likely be regarding hot flashes, mood adjustments or bone density. But many women are familiar with something else, before they think about osteoporosis. Knees start to hurt when climbing stairs, shoulders appear to be unexpectedly stiff, or a morning walk is not as easy as it used to be. These “changes” may be what are believed to be normal processes of aging, but hormones are causing subtle changes in the body tissues.

Tendons, ligaments, cartilage, and fascia make up the support system of the body, but they are rarely thought of until pain signals their presence. These tissues become progressively stiffer, more sluggish to heal and more likely to become stiff during menopause. It isn’t just aging, but hormones, which are implicated, and knowing that can be comforting.

How Estrogen Works: Connective Tissue Support

Hormonal changes can also influence connective tissue, although this is not always the case and is frequently overlooked. Estrogen receptors have also been detected in ligaments, cartilage, muscle and tendon, indicating that hormones are required for the normal structure and function of these tissues.

Collagen is the major constituent of ligaments and tendons. It is similar to the woven fibres used in a climbing rope, which offer strength and designated flexibility. As estrogen levels decline, collagen metabolism changes as well. Repair processes are slow, hydration of the tissue reduces, and its elasticity decreases gradually.

Estrogen’s role in collagen production and tendon adaptation has been suggested to benefit tendon health, and a review in Maturitas discusses how estrogen influences musculoskeletal health in general, also in tendon function and joint comfort. The changes occur over time, and not suddenly; in other words, movement will feel slightly different on a day-to-day basis.

Why Joint Pain Is Not Necessarily Arthritis

Joint pain is common during menopause, but it is not always caused by arthritis. Stiffness in the surrounding soft tissues may be as great as the stiffness in the joint.

As the collagen quality falls and the hydration of tissues decreases, the flow of movement reduces. There may be tightness in the fascia, the tendons may be less able to handle repetitive loading, and recovery from exercise may be slower.

Common changes include:

• Rigidity in the morning that gets better as they move around
• Any pain in the surrounding area of the shoulder, elbow, hip or heel.
• Inactivity even when they’re still moving around.Limited mobility, even while moving around.
• A longer period necessary to recover from exercise.Delayed recovery from exercise.
• Swelling after exercise is normal.
• Increased awareness of repetitive work activities such as gardening, typing, etc.
• Difficulty with joints that feel “rusty” (not as if they are severely painful)

Symptoms may also be different during the menopausal transition, as will hormones. Sometimes symptoms can be more pronounced for a few weeks before they get better.

Tendons Age More Slowly Than Muscles

Tendons take longer to remodel in response to exercise than muscles. There is less blood flow, slower collagen turnover and recovery is more gradual than with high intensity.

When muscles may feel strong enough for more, but the connective tissue cannot handle it, during menopause, intense exercise without proper recovery can put strain on connective tissue. Those are the reasons why sports medicine specialists say to gradually increase resistance training rather than maxing out the effort right away.

Slow, controlled strength training appears to be especially useful because it promotes collagen remodelling without excessively loading the tendons. If the tendon pain persists, then a complete medical evaluation may be warranted. The hormone test may be ordered in addition to other tests that are used to see if there are changes in the hormones that are causing ongoing symptoms, but not joint pain alone should be used as a way to diagnose menopause.

Everyday Habits That Help Protect Connective Tissue

While there is no way to prevent aging, the activities people engage in every day can affect their joints and tendons over time. There’s growing evidence that movement, nutrition and recovery is better than a single supplement.

Helpful strategies include:

• Progressive resistance training
• Balance and stability exercises
• Consuming sufficient amounts of protein throughout the day.
• The foods rich in vitamin C to help make collagen:
• Regular walking or other low impact exercise.
• Rest is essential between sets. Rest in between exercises.
• Quality sleep
• Stress management
• Staying well hydrated

Avoiding long periods of sitting or lying down.Preventing extended sitting or lying down.

In terms of intensity, many women already understand that consistency is more important. Regular moderate exercise may be more tolerable in the long-term, as opposed to one hard workout with extended recovery.

Strong Connections Last Longer Than Hormones

Chronic pain and loss of mobility are not a natural part of menopause, although it does cause changes in the connective tissue. Knowing that the stiffness, loss of flexibility and slow recovery are due to biological changes facilitates their acceptance and helps to manage them.

This is continued research that demonstrates that tendons, joints and connective tissue are still pliable well into adulthood. If they are moved regularly, strength trained appropriately and fed a well-balanced diet with proper rest and recovery, they can remain active well after menopause.

Photo Credit

Photo by: Abbat

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