It’s been #MenopauseAwareness week (isn’t every week?!) and there’s been a plethora of people giving advice about what women should and shouldn’t be doing especially when it comes to exercise. One thing is for certain though, at menopause, movement is non negotiable.
When we first wrote the 3rdAge course, five looooong years ago, when it came to bone health, our focus was primarily on osteoporosis – of course its management and prevention strategies, but in hindsight, there was almost an air of inevitability about it. Fast forward five years, and in its new incarnation, I knew we needed to broaden the focus of 3rdAge health – to expand not only nutrition, lifestyle shifts and mindset hacks to to truly deepen and widen the exercise research, recommendations and examples – so now there’s a much enlarged module that looks at a variety of musculoskeletal issues facing women at midlife – from shoulders/ tendon issues, women and back pain, cervicogenic headaches/ TMJ issues, the menopausal athlete, foot and ankle function (why do so many perimenopausal women get plantar fasciitis?!) and of course bone health (Spoiler Alert: we look at research at exercising and it turns out the BOTH low load/high reps AND high load exercise = beneficial for bone health at midlife and beyond!)
One issue that I thought it was necessary to talk about was hip pain at midlife. I’ve been following the work of Alison Grimaldi and her work on gluteal tendinopathy. Gluteal tendinopathy is a common and frequently disabling condition. Research suggest it affects 1 in 4 women over 50 and has similar effects on quality of life as severe hip arthritis. Current management of tendinopathy centres around education and progressive loading exercises but there have been no high quality studies of this approach in gluteal tendinopathy to date…until the LEAP trial by Mellor et al in 2018
Until the LEAP trial, the standard treatment for this lateral hip pain syndrome was a combination of corticosteroid injection and rest…which of course is not a great strategy for the bone density of a perimenopausal women. So this report showed some interesting strategies for the treatment, including a specific exercise strategy with a focus on decreasing pain/compression followed by progressive and specific gluteal strengthening strategies.
So if we know that specific exercise strategies are beneficial for lateral hip pain in menopausal women and we know that the hip (specifically the neck of femur) is a high risk region for osteoporotic changes AND we know from the research that gluteal/ deep hip rotator strengthening is supportive for pelvic floor muscle functioning, particularly bladder support….(more on that in an upcoming blogpost…)
Creating space and strength and balance around the hips is an essential skill for menopausal women – 20% of women who fracture their hip after the age of 60 are dead within one year
The only question becomes – why aren’t more women prescribed exercise strategies with the same ease they’re given antidepressants? (I’ll leave the sermon on the mental health benefits of exercise for another day…)
How’s your movement prescription toolbox?
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Until next time
Onwards & Upwards