Our articles aren’t designed to switch medical recommendation. When you have an harm we advocate seeing a professional well being skilled. For extra info please see our Phrases and Circumstances.
I do know I stated this in our final put up however it’s a message that’s price repeating – practically half of leisure feminine runners are of menopausal age. What we cowl as we speak may have implications for many sufferers you see in clinic.
I typically get requested for extra details about menopause transition as a result of I cowl tendinopathy in my educating, so I’ve achieved some analysis and wished to share what I’ve discovered with you. I’ve to confess, I’m not I’m knowledgeable on this matter so I’ve teamed up with Claire Callaghan who’s!
Claire lately recorded a superb Perimenopause Masterclass the place she offered with an excellent dietician to debate protein, calcium, Vitamin D, strengthening and plenty extra! It’s primarily aimed on the public, however well being and train professionals are very welcome to come back and sometimes do attend. Go to this hyperlink to seek out out extra.
As well as, this current overview has plenty of nice info particular to runners and athletes – Maximizing Operating Participation and Efficiency Via Menopause (Rothschild and Collingwood 2023).
They state that menopause sometimes happens between the ages of 42 and 58 years. It’s preceded by the perimenopause (or menopause transition) which on common lasts round 4 years however it might probably vary from just a few months to over a decade.
There are a number of physiological results of menopause transition and falling oestrogen ranges which we’ve summarised with urged options for runners from Rothschild and Collingwood (2023) within the desk beneath:
I might use this as a fast reference and concentrate on discussing particular person choices with a affected person somewhat than sharing the graphic with them as in any other case it might probably appear fairly daunting.
A key constructive is that working and common train has the potential to assist in many of those areas so we wish to help and encourage this if it’s a part of somebody’s objectives.
How may we adapt rehab and working?
As a result of modifications in oestrogen ranges, tendon, muscle and bone well being, it’s essential to make sure development of each rehab and working is tailored to swimsuit particular person wants. In lots of instances, a extra gradual development is required with a concentrate on consistency somewhat than pace.
Coaching could must be tailored, particularly depth. We have to guarantee there may be enough restoration so embody relaxation days after longer/ tougher runs and plan a restoration week into the schedule roughly each fourth week (or as wanted). Sleep impairment is quite common throughout menopause transition and coaching could must be lowered consequently.
Vitality availability and dietary wants must be thought of. That is coated in additional element in Rothschild and Collingwood (2023) however I might advocate referring to a Registered Dietician or Sports activities Nutritionist for his or her knowledgeable enter. That is particularly essential for a runner with osteopenia/ osteoporosis or a historical past of stress fracture.
Progressive energy work and plyometrics can enhance muscle, tendon and bone well being and help continued working. Sadly, they are often provocative for tendinopathy, particularly when signs are irritable.
In these instances, it’s typically greatest to focus first on what’s tolerable when it comes to signs after which steadily construct to a stage that may obtain the affected person’s rehab objectives. I typically discover beginning with isometrics will be useful:
What about Hormone Alternative Remedy (HRT)?
Hormone Alternative Remedy could assist enhance high quality of life and signs throughout menopause, together with sleep (Cintron et al. 2017). There may be some proof to counsel that HRT can also enhance outcomes for some ladies with Gluteal Tendinopathy:
“Menopausal Hormone Remedy with any train plus training was related to larger enhancements in ache and dysfunction as in contrast with placebo cream in a subgroup of contributors (BMI <25)” Cowan et al. (2021)
Raiser et al. (2024) counsel that there’s proof to help utilizing HRT for prevention and therapy of low bone mineral density. Nevertheless, additionally they level out that proof particular to runners is proscribed and there are considerations about opposed results akin to elevated breast most cancers danger.
As well as there are contraindications to HRT together with earlier breast most cancers, historical past of DVT, Pulmonary Embolism or blood clotting dysfunction, liver illness and migraine (Harper- Harrison and Shanahan 2023)
Lobo (2016) state, “In youthful wholesome ladies (aged 50–60 years), the danger–profit stability is constructive for utilizing HRT, with dangers thought of uncommon”
Like all interventions HRT must be thought of on a person foundation with the affected person being conscious of potential dangers and advantages. It’s an emotive matter that may divide opinions which may trigger confusion for sufferers. For extra on kinds of HRT, advantages and dangers see the NHS HRT Steering. The Girls’s Well being Concern pages on HRT are additionally a superb useful resource for clinicians and sufferers in search of extra detailed info.
