Hi guys! This video is about how the menopause can affect your tendons; both causing tendinopathies and
maybe delaying your response to treatment, that it takes longer for you to recover. In this talk,
we're going to look at what makes the Achilles tendon so strong, so that you can understand why
the menopause affects it. We're gonna look at what happens during the perimenopause, the menopause,
and postmenopausal years, and then, why that can affect tendon injury; so, predisposing you to
them or delaying your response to treatment. And then lastly, I'll give you three tips that may
help your recovery if you think you are being affected by the menopause or perimenopause.
Excellent! So, my name is Maryke. I'm one of the physiotherapists from treat-my-achilles.com,
where you can get online assessment as well as treatment for your Achilles tendon injuries. You
can check out … the link to our website is in the Description of this video. Now, the first bit is,
what makes the Achilles tendon so strong? So, if we look at the Achilles tendon; it's made up
out of loads of collagen fibres that's packed in parallel to each other, and they are organised in
bundles, and the bundles again are packed parallel to each other. Now, I don't know if you ever did
that thing at school where they … the teacher I, remember, showed us that if you take one piece of
string, you can easily break it, but if you take about ten pieces of string together, it's really
hard to break it. So, these collagen fibres that's parallel aligned is what makes it so strong. Now,
what happens during the perimenopause and the menopause and the postmenopause to cause the
trouble? Your oestrogen level starts to drop. So, perimenopause is the years leading on to
the menopause; so, where you start seeing some symptoms that you associate with menopause. So,
we're talking hot flushes, joint pains, struggles sleeping, things like that. And it can last for
anything up to ten years, and it's the gradual drop of oestrogen that you then see. Now,
menopause; you're classified as being in the menopause if you've not had a menstrual cycle
for a full 12 months, then you are menopausal. And then you have postmenopause, where the body slowly gets
used to the now lower levels of oestrogen. And for some people, they can totally get rid
of the symptoms that they experienced during the menopause, whilst others may still experience some
of them. But where you used to have oestrogen levels up there, you now have slightly lower
oestrogen levels – that's the important thing. And why is this important for tendons? Well basically,
oestrogen is in charge of collagen turnover. So, if your oestrogen levels drop, then you start
taking longer to produce new fibres. The fibres may not be of such good quality. So,
what happens is, if you do a training session that you always used to do, like a hill training
session – something hard that really works the Achilles tendon – it may now take that tendon
longer to produce the new fibres and things in response to the exercise. Because remember,
whenever we exercise, you create micro-trauma in your bones, your muscles, your tendons,
everything; and that's normal, that's part of our normal daily routine. The body then takes the next
few hours to repair it, and then you're stronger for your next session. But during the menopause,
because it takes longer for those collagen fibres to repair, you're more prone to overuse injuries
like Achilles tendinopathy, because the micro-trauma basically accumulates and then
causes an injury. Also, if your oestrogen levels are low, it may take you longer to respond to
the same types of exercise that I would use for somebody who's not in the menopause to get your
tendon healthier. And also, we may have to be quite slow with how we introduce load and give
you a lot more rest periods in between. So, that's why the menopause can affect your tendons. Now,
top tips for anybody who thinks they may be perimenopausal or in the menopause or have gone
through it already. Let me just get my slide up … there we go! First of all, it's, take notice of
your body. Forget what you used to be able to do. So, forget how many times a week you could train,
how hard you could train for, all of that; it all has to be reset. Your body is not the same that
it used to be; you have different hormone levels now, and hormones are in charge of everything. So,
start to really take note of how everything feels after a training session; how long do you now need
for recovery before things are not sore anymore. You have to really tune in to your body. So,
you've got to look at recovery time. So, if you've had hard sessions, do you need a few
more extra days than what you would normally have to do? Do you need more things like cross-training
sessions in there? Fewer running sessions maybe, or jumping sessions, depending on what you tend
to do for your sport? So, that's the first tip. Then, the second one is: Start introducing slow,
heavy resistance training. Now, please don't just jump into it, especially if you've got a painful
tendon. You have to ease into it, because you have to condition your tendons to be able to cope with
it. But we know from the research that tendons react really well to slow, heavy resistance
training, and it stimulates them to produce more collagen and be stronger. The other thing that
I haven't mentioned yet is that oestrogen levels that's low also effect the quality
of your muscle tissue, it affects your joint cartilage, everything that has collagen in it,
it is affected; that's why we get wrinkles as well in our skin. So, slow resistance training will
help all of those systems to make them stronger and give you better support. And then thirdly,
you could consider HRT or hormone replacement therapy. Now, there's some research studies
that suggest that taking hormone replacement can help with collagen turnover and allow your body
to recover more quickly, but there's also other research that shows that, uhh, it's not quite so simple;
it depends on what you do while you’re taking the hormone therapy, and it doesn't seem to be
similar for … for between different people. But I will say this: There's not a lot of high-quality
research that's been done on this topic yet, and I will watch this area with quite a bit of interest
in the next few years, because I think the more people become aware of this, hopefully the more
researchers will look into this. So, HRT - it's not a given that it will help, but it may help you. Have
a look into it, discuss it with your doctor, and see what it does. Excellent! If you've got any
good advice that you feel may help people who are in the menopause and recovering from tendon
injuries, please do share it in the Comments. And also, if you've got any questions for me,
feel free to ask them or message me or email me. And if you want to know more about our online
service, have a look at our website and let me know if you've got any questions. Take care!