Understanding the Link Between Perimenopause and Musculoskeletal Health

/

In my last blog post about frozen shoulders, I touched on the increasing recognition of a link between perimenopause and the risk of developing adhesive capsulitis. But what is it about this life stage that makes us more susceptible? In this post, I want to explore the ‘why’ behind this connection — how hormonal changes during perimenopause affect our musculoskeletal system, what this means for us as women, and what other conditions we might be at greater risk for. I’ll also share how physiotherapy can play a vital role in both prevention and recovery.

What Happens to Our Hormones During Perimenopause?

Perimenopause is the transitional phase leading up to menopause, marked by fluctuating levels of estrogen and progesterone. These hormonal shifts can have widespread effects on various systems in the body, particularly the musculoskeletal system. Estrogen plays a key role in maintaining connective tissue health, bone density, and inflammation regulation. As levels begin to decline:

  • Collagen production decreases, affecting the elasticity and strength of tendons and ligaments. This can lead to joint laxity, making joints less stable and more prone to injuries e.g. ankle sprains and possibly ACL tears.

  • As oestrogen drops so does our bone density, meaning conditions like osteopenia or osteoporosis may develop, increasing the risk of stress fractures.

  • Changes in estrogen and progesterone may affect the elasticity and hydration of tendons and ligaments, increasing the risk of tendonitis or tears, especially in high-load areas like the Achilles or rotator cuff.

  • Perimenopausal women may experience slower recovery and increased chronic inflammation, heightening injury risks during repetitive activities or insufficient rest periods.

Why Perimenopause Increases the Risk of Frozen Shoulder

Women between the ages of 40 and 60 are disproportionately affected by frozen shoulder, and the hormonal changes of perimenopause are a likely contributor. The decline in estrogen can lead to:

  • Increased joint and soft tissue stiffness.

  • Higher likelihood of inflammation around the shoulder capsule.

  • Reduced healing capacity of connective tissues.

Additionally, perimenopausal women may experience changes in posture, reduced physical activity, or increased stress, all of which can contribute to shoulder dysfunction and pain.

Other Conditions More Common During Perimenopause

Perimenopause doesn't only increase the risk of frozen shoulder. Women may also be more prone to:

  • Osteopenia and Osteoporosis: Due to decreased bone density from lower estrogen levels.

  • Tendinopathies: Such as rotator cuff or Achilles tendinitis.

  • Osteoarthritis: Particularly in weight-bearing joints.

  • Carpal Tunnel Syndrome: Linked to fluid retention and hormonal changes.

  • Pelvic Floor Dysfunction: Resulting from weakened support tissues.

  • Falls and Balance Issues: Stemming from muscle loss and changes in proprioception.

How Physiotherapy Can Help

At Balance in Motion, we understand that you're not just your shoulder, your joints, or your symptoms — you're a whole person, with a unique history and lifestyle that influence your health. Our approach is about truly listening, understanding your goals, and tailoring support around your needs, not just your diagnosis. It is therefore important that we know what phase of life you are in!

·       Early Intervention: We use gentle mobilisation and movement strategies to support your body during the early stages of stiffness or discomfort.

·       Pain Management: Through hands-on techniques, dry needling, and customised exercises, we help reduce pain and restore confidence in movement.

·       Postural and Functional Support: We look at how you move in your everyday life and help improve posture, strength, and mobility so your body can work better for you.

·       Preventative and Strength-Building Programs: Designed with you in mind, our sessions aim to build resilience, improve balance, and reduce your future injury risk.

·       Education and Empowerment: We walk with you on this journey, providing the tools and knowledge to help you feel informed, in control, and capable throughout perimenopause and beyond.

Final Thoughts

Perimenopause brings significant physical changes and understanding them is the first step in staying healthy and resilient. With the right support, including physiotherapy, women can continue to move well, feel strong, and maintain their quality of life throughout this transition and beyond. So book in now with one of the team here at BIM Physio!

 

Jess Rose