If I could change one thing about 2024, it would be the number of injuries I had. I bounced from one annoying restriction to another; several varieties of hip pain, shoulder pain, a weird neck thing, forearm tendonitis, my old faithful achillies tendonitis, and currently, a knee that one minute was happy with pistol squats and but now really doesn’t like to bend at all.
Often, these ailments disappear as suddenly and as completely as they appeared (eventually). I’m grateful to have a terrific physiotherapist in my corner. She’s used to this conversation:
Physio: “So what did you do?”
Me: “Nothing I haven’t been doing for years.”
The pain is not chronic or debilitating, but it has been tiresome and it’s got in the way of my fun.
I respect and love my body, which I show by getting regular massages, prioritising nourishment and sleep, and modifying my activities. Running comes and goes, as do pull-ups and I’m currently on a squat ban. I’m reluctant to reduce my overall levels of activity because if you don’t use it, you lose it.
I’m fifty-one which means all of these complaints probably fall under the blanket term “musculoskeletal syndrome of menopause”, about which I would like to spread the word.
More than 70% of women will experience musculoskeletal symptoms around the menopause transition – and horrifyingly, 25% will be disabled by the symptoms.
40% of the ailments will have no ‘structural’ findings, meaning that MRIs or x-rays will not show deterioration of joints or muscle damage, and medics will be left shrugging their shoulders.
Of course, it’s all about estrogen.
Perimenopause is marked by the fluctuation and eventual loss of estrogen and this can be what’s responsible for joint pain, along with loss of muscle mass, loss of bone density, increased tendon and ligament injury, adhesive capsulitis (hello, frozen shoulder!), more fragile cartilage matrix, and the progression of osteoarthritis.
Estrogen is anti-inflammatory. For years you might feel like your menstrual cycle was calling the shots, but one of the good things estrogen does in our twenties and thirties is makes us more invincible. I believe that in my late thirties it was estrogen that made/allowed me to do Crossfit three times a week, but in my fifties, the very idea of it makes me shudder.
That my injuries take longer to heal than they might have done in the past, I can look to satellite cells – stem cells located on muscle fibres that promote plasticity and regeneration. Without estrogen to activate and proliferate satellite cells, muscle strength and recovery after injury are impaired.
Good news for me is that the pain peaks in early post menopause, so it needn’t be a lifelong symptom. In the meantime, unsurprisingly the advice is to eat plenty of protein, supplement with vitamin D, magnesium, vitamin K2 (a new one to me) and creatine, and (yay!) resistance training.
Poor news for my unspecific knee injury is that cartilage cell production is partly regulated by estrogen, but I might try to ignore that for a while yet and see if it, like many other of my injuries, disappears as mysteriously as it arrived.