Why Your Tendons Suddenly Hurt in Menopause? 5 Ways to Rebuild Them by Dr. Vonda Wright

Dr. Vonda Wright (0:00)

So listen to this, the minute your foot hits the floor, every single morning, it hurts. Your shoulder is waking you up in the middle of the night. Your elbow is on fire, and you don't even swing a racket. So how many of you show up with these itises? You know, the plantar fasciitis on the bottom of your foot, the Achilles tendonitis in the back of your leg, the tennis elbow right here, the frozen shoulder that suddenly out of nowhere will not move or even trigger fingers. Often they come as a set. You come into my office and you say, I don't know what's happening, doc. I think I'm falling apart. Well, here's the news. You are not falling apart, and you are not going crazy. And today I'm going to explain what is really happening. But first, I'm Dr. Vonda Wright. I'm your orthopedic sports surgeon and longevity and women's health expert. Last year, my team wrote the paper on the musculoskeletal syndrome of menopause. And what's more, we paid $5,000 to make it open access so that everybody could read it. And you know what? More than 550,000 people have downloaded and read it, which was the whole point. And today, I'm going to teach you the tendon piece of the syndrome. I call it the itises, because this is the part women come to my office for the most. It's not a fracture.

It's not sarcopenia, because they don't even know they're losing muscle, but they do come in for the itises. And this is the part that almost nobody has explained to them. But remember, despite the itises, you are not falling apart. You are not going crazy, and you did nothing to earn this pain.

If you were in my office, I would explain this to you, and I would draw it out for you exactly what is happening in your body. Your tendons, which are the connections between your muscle and your bone, are not just structural.

They are living tissues, and every one of them has estrogen receptors. And when estrogen is no longer sitting in the receptors and walks out the door in perimenopause and menopause, your tendons, like so many other tissues, lose collagen, they lose water, and they lose the ability to repair the microscopic damage that happens every day in normal activity. Here's an analogy. A healthy tendon is like a wet rope. It's strong, it's flexible, it bends and springs back. A menopausal tendon that has lost its estrogen is more like a dry rope. It frays, it splits, it breaks where it was never even used before. But here's another analogy. Tendons are also cousins to your bone and your muscle. Remember, all of these skeletal tissues come from the same stem cell. So when your tendon starts hurting, your bone and muscle are hearing about it too. It's like your kids or your cousins complaining. You're not strangers, you know what they're going through. They're your family. So everybody in the musculoskeletal system is listening to each other. But let's talk more about what these cousins actually are. Tendons are around 70% collagen.

When estrogen leaves, we can lose up to 30% of our collagen.

And that's not a small change. That's a mechanical change. So how do I treat this in my office? Well, here's the biggest one. I want you to write this down. We load the tendon. We do not rest it. The old advice was rest. Just wait it out. Let it go.

That is wrong advice. Because you can wait 3 months, you can wait 6 months, get totally out of shape, lose muscle mass, and the minute you start back, your tendons aren't likely to hurt again because you've done nothing to repair them. The new advice is load. A tendon that is not being asked to load while recovering gets weaker, not better. What I actually prescribe is slow, heavy, controlled reps for the tendon that is hurting.

Usually 3 sets of 8, 3 seconds down slowly, 3 seconds up. And we do this several times a week.

For plantar fasciitis on the bottom of your foot or Achilles tendonitis, single heel raises off a step are very helpful.

For tennis elbow, wrist extensions with a light dumbbell or a band. For frozen shoulder, range of motion every day. Our therapists teach women to do slow, steady, long stretches. Accompanying bipendulums, wall walks, door stretches. Think of a tendon like a rope that you are rebraiding. Every controlled rep is another strand being put back in place. Number two, what does collagen need to heal? It also needs to be fed. Collagen is mostly protein, or collagen is protein. We need to feed our cartilage with protein. So listen people, tendon is mostly protein. So is bone, so is muscle. So if you are eating like a teenager who never wants to gain a pound, and you are starving your musculoskeletal system of the raw material your tendons need to rebuild, I commonly prescribe one gram of protein per ideal pound of body weight. I like to front load at breakfast 30 to 40 grams in the first meal to switch the protein synthesis on. Real foods like eggs or egg whites, Greek yogurt, cottage cheese, even chicken, fish, tofu, nobody says that you can't eat lunch and dinner for breakfast. Think of these building blocks as a construction site. Your tendon is a construction site, protein is the lumber. If the lumber truck never arrives, the crew stops working to repair. Number three, we need to cut inflammation at the source. I'm about to say something you're going to hate. We need to cut sugar and ultra-processed food.