In Perimenopause, declining estrogen levels affect collagen production, tendon elasticity, and joint lubrication, increasing the risk of tendinopathy (tendon irritation or degeneration). Women often experience chronic tendon pain in specific areas due to repetitive stress, reduced recovery capacity, and muscle imbalances. Read on to see what our Physical Therapists say on how to manage and prevent tendon degradation.
Why Perimenopause Increases Risk of Tendinopathy
Perimenopause increases the risk of tendinopathy due to several physiological changes in a woman's body. A decline in estrogen levels leads to weaker tendons and slower repair, making them more susceptible to injury. Additionally, the loss of muscle mass places greater strain on the tendons, further contributing to potential damage. Joint stiffness and reduced flexibility can result in poor movement mechanics, increasing stress on connective tissues. Higher levels of inflammation during this stage also heighten pain sensitivity, making tendon issues more pronounced and challenging to manage.
How our Physical Therapists suggest to Manage and Treat Tendinopathy
Strength training, particularly progressive loading, is essential for building tendon resilience. Incorporating eccentric exercises, such as slow and controlled lengthening movements like heel drops for the Achilles, helps strengthen tendons and improve their capacity to handle stress. Mobility work, including dynamic stretching and foam rolling, enhances flexibility and reduces stiffness, promoting better movement mechanics. Additionally, proper recovery through adequate nutrition and rest supports tendon repair and overall musculoskeletal health.
Common Tendinopathy Areas Seen in Women
Lower Body
Weight-Bearing & High-Impact Areas
• Achilles Tendon (Achilles Tendinopathy) – Often due to running, tight calves, or improper footwear.
• Patellar Tendon (Jumper’s Knee) – Pain just below the kneecap, worsened by squatting or stairs.
• Gluteal Tendons (Gluteal Tendinopathy/Trochanteric Bursitis) – Outer hip pain, often misdiagnosed as hip bursitis, worsened by side-lying sleep or prolonged standing.
• Plantar Fascia (Plantar Fasciitis) – Heel pain from tight calves, weak foot muscles, or high-impact activities.
Upper Body
Repetitive Use & Postural Strain Areas
• Rotator Cuff Tendons (Shoulder Tendinopathy) – Common in women with weak shoulders, poor posture, or overhead activity.
• Tennis Elbow (Lateral Epicondylitis) – Outer elbow pain due to gripping, typing, or repetitive arm movements.
• Golfer’s Elbow (Medial Epicondylitis) – Inner elbow pain, often from lifting weights incorrectly or repetitive wrist flexion.
Final Thoughts In conclusion, the increased risk of tendinopathy during perimenopause is largely driven by hormonal changes, muscle loss, joint stiffness, and heightened inflammation. However, proactive management strategies such as strength training, eccentric exercises, mobility work, and proper recovery can significantly reduce the risk and improve tendon health. By addressing these factors, women can maintain their musculoskeletal resilience and continue leading active, pain-free lifestyles. Scheduling regular physical therapy sessions can be an effective way to manage perimenopausal symptoms. A physical therapist can develop a personalized program focusing on strength training, mobility exercises, and pain management techniques tailored to your individual needs. Consistent appointments allow for progressive loading to build tendon resilience, guided movement corrections to prevent injury, and hands-on therapies to reduce discomfort. Additionally, structured therapy sessions provide accountability and expert support, helping women navigate this stage with confidence and improved physical function.
To learn more about the services we offer, visit Chardon Performance Therapy online, on Instagram, and Facebook. To book a discovery call today, contact us!
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