Menopause Physiotherapy

What changes around menopause

As oestrogen falls, bone loss speeds up, and it's fastest in the first few years after the final period. Muscle mass and strength decline too, a process that starts earlier but accelerates without regular strength work. Many women notice new aches in their hands, knees, shoulders and back, which is common enough that it has a name: menopausal joint pain. And the tissues of the vagina, bladder outlet and pelvic floor become thinner and less elastic, which can bring urgency, leaking or a feeling of heaviness for the first time.

None of this happens overnight, and none of it is inevitable to the same degree. How active and strong you are going into menopause makes a large difference to how you come out of it.

Strength training is the main treatment

Bone responds to load. Walking is good for the heart and mood, but on its own it's not enough of a stimulus to protect bone. Progressive strength training, at least two sessions a week, is what makes the difference. A 2018 Australian trial known as LIFTMOR found that supervised, progressive high-intensity resistance and impact training improved bone density in postmenopausal women with low bone mass, without increasing injuries. The word that matters there is supervised.

That's what we provide: a program that starts where you are, teaches technique properly and increases the load steadily. If you already have osteoporosis or a previous fracture, we adapt the exercises, especially avoiding loaded forward bending of the spine.

Joint and back pain

Aching knees, stiff hands and a sore lower back are some of the most common complaints we hear from women in their late forties and fifties. Frozen shoulder also peaks in this age group and is more common in women. Most of this responds well to strengthening and graded activity, and joint aches are not a reason to stop exercising. Where arthritis is involved, our arthritis physiotherapy program applies the same principles.

Balance and fall prevention

A fracture needs two things: a bone that's weaker than it used to be, and a fall. Strength training helps with the first; balance training helps with the second, and it's just as important. We test balance at the first visit, often using simple timed tests, and build specific balance work into your program. Our fall prevention exercises are a good starting point at home.

Pelvic floor after menopause

Leaking, urgency or a sense of heaviness can appear for the first time around menopause, even in women who never had a problem after childbirth. Pelvic floor training helps, and it often works best combined with treatment your gynaecologist may offer for vaginal tissue changes, such as local oestrogen. See pelvic floor physiotherapy, urinary incontinence and pelvic organ prolapse for more.

How the program runs

• Assessment

  Strength, grip, sit-to-stand and balance tests, joint and back review, pelvic floor screening, and your medical history including bone density results if you have them.

• Weeks 1 to 12

  Supervised, progressive strength and balance training, usually weekly, with a home or gym routine in between.

• After 12 weeks

  An independent routine you can keep up, with periodic reviews to progress it.

Frequently asked questions