The Musculoskeletal Syndrome of menopause; It’s not all in your head
Menopause is a natural phase in a woman’s life, yet it brings with it unwanted changes that our health and well being. Recently an article was brought to my attention discussing what is now being called “the musculoskeletal syndrome of menopause”. This a collection of symptoms including musculoskeletal pain, joint pain, loss of lean muscle mass, decreasing bone density, tendon and ligament injuries, adhesive capsulitis (frozen shoulder) and the progression of osteoarthritis due to changes in the make up of cartilage. The good news is that with the right approach, these symptoms can be managed. I am choosing to believe that we can continue to feel strong, agile and confident in our bodies so we stay connected and keep up with our friends and family. Quality of life matters.
I would like to explore how physical therapy and yoga, following recommendations from the Bone Health and Osteoporosis Foundation, can offer a tailored approach to maintaining muscle mass, improving balance and posture, enhancing pelvic floor function, and preserving bone density during menopause. These strategies not only help combat the physical symptoms of menopause but also support overall well-being, maintaining vitality as we age.
The Impact of Menopause on the Musculoskeletal System
The decline in estrogen levels during menopause affects various systems in the body, including the musculoskeletal system. Estrogen plays a vital role in maintaining bone density, muscle mass, and the health of connective tissues. When estrogen levels drop, several changes occur:
Loss of Muscle Mass: Sarcopenia, or the gradual loss of lean muscle mass, is common during menopause. This can lead to weakness, reduced mobility, and an increased risk of falls.
Decreased Bone Density: Osteoporosis becomes a significant concern, as bone resorption accelerates, increasing the risk of fractures, especially in the spine, hips, and wrists.
Joint Pain and Stiffness: Arthralgia, or joint pain, often develops or worsens during menopause, as the joints lose some of their natural lubrication and flexibility.
Increased Injury Risk: Tendons and ligaments become more prone to injury, and conditions like adhesive capsulitis (frozen shoulder) can develop due to reduced flexibility and connective tissue health.
Pelvic Floor Dysfunction: Bladder issues, pelvic pain, and prolapse can occur or worsen during menopause due to changes in connective tissues and muscle weakness in the pelvic floor.
Addressing these issues may benefit from a multifaceted approach that includes strengthening muscles, maintaining bone health, improving flexibility, and supporting joint function—all of which can be achieved through physical therapy and yoga.
In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.
Strengthening Muscle Mass: Preventing Falls and Enhancing Mobility
Muscle loss during menopause can lead to decreased strength, balance issues, and an increased risk of falls. The Bone Health and Osteoporosis Foundation recommend that to counteract this, it is crucial to incorporate resistance training into your exercise routine. Both physical therapy and yoga can help women build and maintain muscle mass, which is vital for overall mobility and fall prevention.
Resistance Training: Physical therapy programs often focus on resistance training, which can help rebuild muscle strength. This includes exercises that target major muscle groups, including the legs, core, and upper body. Resistance training can involve weights, resistance bands, or body weight exercises.
Yoga also provides a unique form of resistance training by using body weight to build strength. Standing poses and even seated chair poses with intention and focus on the leg muscles are excellent for building lower body and core strength, which are essential for preventing falls and maintaining balance.
Improving Balance and Coordination: Balance is another key component of fall prevention. Many women experience a decline in balance during menopause due to changes in muscle mass and joint function. Anecdotally, as we lose our butt and gain a belly we seem to see a decrease in outer hip strength. Physical therapists often include balance exercises such as standing on one leg, walking heel to toe, or using balance boards to help improve coordination and stability.
Yoga is particularly effective in enhancing balance, as many poses require focused attention and stability. Almost all the standing poses from tree pose to warrior II or warrior III challenge balance and proprioception (the sense of where you are in space), helping to strengthen the muscles and improve coordination.
Bone Density: Protecting Against Fractures
The Brilliant Bones Program through Body in Tune, LLC offers a comprehensive approach to exercise for osteoporosis.
Maintaining bone density is an important aspect of staying healthy as we age. Estrogen plays a key role in regulating bone turnover, and its decline can lead to a slowing of building new bone and increased bone resorption or breakdown, resulting in osteoporosis. Women have an increased risk of fractures with osteoporosis, particularly in the spine, hips, and wrists.
The Bone Health and Osteoporosis Foundation emphasizes the importance of weight-bearing exercises, resistance training, and cardiovascular exercise to maintain bone health. Physical therapy and yoga can address these needs through targeted, bone-friendly exercises.
Weight-Bearing and Resistance Exercises: The goal is to stimulate bone formation which we do by putting forces through the bones, imparting torsion to the bones or by pulling on the bones by activating muscles. Examples of weight-bearing activities are walking, climbing stairs, and dancing. Resistance exercises could be using weights or resistance bands, and yoga. Dr. Loren Fishman has studied a series of yoga poses showing improved bone density, strength, balance, coordination, flexibility, and stress management. These poses also improve posture and spinal alignment, which are crucial for reducing the risk of vertebral fractures.
Spinal Alignment and Posture: Maintaining proper spinal alignment is critical for preventing vertebral fractures, which are common in women with osteoporosis. Physical therapists will teach you posture correction and spinal alignment exercises to prevent spinal deformities like kyphosis (a rounded upper back).
In yoga, we repeatedly focus on alignment in poses that lengthen and strengthen the spine teaching our bodies what it feels like to stand and move with better posture. Yoga can help maintain spinal flexibility and alignment, reducing the risk of compression fractures in the vertebrae.
Pelvic Floor Health: Addressing Bladder and Pain Issues
Menopause can significantly impact the pelvic floor muscles, leading to bladder control issues, pelvic pain, and discomfort during intercourse. Estrogen plays a role in maintaining a healthy pelvic floor with coordinated contraction. Both specialized physical therapy and yoga offer effective solutions for improving pelvic floor coordination, improving bladder control and alleviating pain.
Pelvic Floor Physical Therapy: A specialized area of physical therapy focuses on rehabilitating the pelvic floor muscles. Through targeted exercises, stretching and posture education, women can regain confidence in their pelvic floor, reducing symptoms like urinary incontinence, urgency and pelvic pain.
Yoga for Pelvic Floor Health: A yoga practice incorporating sustained postures, breathing to encourage relaxation and spinal support and proper muscle recruitment during movements or with energy locks can help ease pelvic floor muscles tightness and tension and discomfort in the lower abdomen and pelvic area. Bringing awareness to the pelvic floor throughout your yoga practice can gently engage and release the pelvic floor, promoting strength and flexibility.
Good news! Body in Tune would love to collaborate with you to teach you this precise yoga practice and to support your lifestyle so you can enjoy your life off the mat with confidence.
Cardiovascular Health: The Importance of Staying Active
Cardiovascular exercise is essential during and after menopause, not only for bone health but also for overall heart health and weight management.
The yoga practices I design with my clients covers the Bone Health and Osteoporosis Foundation recommendations of balance, posture/upper back strengthening, practicing good spinal alignment, and resistance training with the use of gravity resisted postures. Menopause brings with it a variety of musculoskeletal challenges that are real and not in our heads. By creating and movement practice that fits your life, women can minimize the impact of menopause on their musculoskeletal system and can manage the keep our bodies and pelvic floors strong, flexible, agile so we can reconnect and keep up with our friends.
Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.
I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.
