Why Your Tendons Flare in Perimenopause (and How to Keep Them Strong)

Why Your Tendons Flare in Perimenopause (and What You Can Do About It)

Let’s talk about something that doesn’t get enough attention: tendon pain during perimenopause.

If your wrists, shoulders, hips, or heels are suddenly more sore and stiff than they used to be, you’re not broken—and you’re definitely not just “getting older.”
These are real, biological changes happening in your connective tissue, and once you understand why, you can take simple, powerful steps to prevent them.

The Quick Why (In Plain English)

As estrogen levels begin to fluctuate and trend down in perimenopause, the collagen that gives your tendons bounce and flexibility starts to change.
Estrogen actually binds to receptors in your tendon tissue (yes, your tendons listen to hormones!). When that signal gets quieter, your tendons become less springy, more irritable, and slower to heal.

Then, add the modern mom-life load—constant phone scrolling, computer work, lifting kids, high-intensity workouts on too little sleep—and friction builds.

Common hotspots for midlife women:

• Shoulders (rotator cuff)

• Outer hips (gluteal tendons)

• Achilles and feet

• Wrists and thumbs (De Quervain’s or “mom wrist”)

The good news? Tendons are incredibly adaptable. With smart movement, consistent recovery, and collagen-friendly nutrition, you can rebuild their strength and resilience.

Early Signs to Catch (Before They Snowball)

• Morning “first-step” pain or stiffness (Achilles or plantar area)

• Tenderness when gripping, reaching, or stepping sideways

• Pain that improves when you warm up but returns later

• Clicking or snapping in thumb or wrist

If you’ve noticed these for more than two weeks, it’s time to act—before irritation turns into chronic inflammation.

Your Prevention Plan: Eat • Move • Think • Live

 MOVE – Load Smart, Then Strong

Your tendons love gradual, consistent strength work—think “smart loading,” not “all-out bootcamp.”

• Go slow and steady: increase workout intensity by no more than 10–15 % a week.

• Strength is your #1 protector: focus on hip hinges, squats, pushes, pulls, and carries 2–3 times/week.

• Slow resistance (HSR): lower weights slowly (3–4 seconds) and rest 48–72 hours between sessions for the same area.

• Isometrics when sore: hold mid-range positions for 30–45 seconds to calm pain.

• Add bounce later: once you’re pain-free, include gentle hops or skips to retrain elasticity.

• Movement snacks: every 60–90 minutes at a desk, do 1 minute of mobility—shoulder rolls, wrist opens, or calf raises.

EAT – Collagen-Smart Nutrition & Blood-Sugar Calm

Your meals directly influence how your tendons rebuild.

• Protein target: ~1.6 g per kg bodyweight daily, spaced across meals.

• Collagen boost: 10–15 g hydrolyzed collagen or gelatin + 50 mg vitamin C 30–60 minutes before exercise. Creatine is also helpful for muscle building and more.

• Stabilize blood sugar: combine protein, fiber, and healthy fats each meal to prevent stiffness-inducing insulin swings.

• Anti-inflammatory basics: colorful veggies, omega-3s (fish, chia, flax), and magnesium-rich greens keep tissues supple.

THINK – Calm Your Nervous System

Pain amplifies when your stress hormones are high. A calmer nervous system equals a calmer tendon.

• 4–6 slow breaths between tasks

• A short walk in morning light

• A 5-minute wind-down before bed

These mini downshifts lower cortisol and help tissues repair overnight.

LIVE – Recovery Is the Remodeler

• Sleep is tendon fertilizer: 7–9 hours nightly in a cool, dark room.

• Audit the friction: rotate grips for phones, strollers, or weights—give your thumbs rest days.

• Cycle your stressors: don’t stack heavy training and long, stressful workdays together.

A Gentle 12-Week Prevention Plan

Weeks 1–2 | Reset & Repattern

• 10–15 min daily mobility (ankles, hips, wrists, shoulders)

• Strength 2×/week (bodyweight + light load)

• Collagen + vitamin C before two sessions/week

• Protein-rich breakfast + tech-off 1 hour before bed

Weeks 3–6 | Build Capacity

• Strength 3×/week with heavier, slower reps

• Isometrics on “twinge” days

• Farmer’s carries 2×/week

• Keep collagen timing consistent

Weeks 7–12 | Resilience & Return-to-Play

• Maintain strength; add gentle hops/skips 1–2×/week

• Reintroduce sport-specific drills (pickleball, hiking)

• Collagen before heavy sessions + 7–9 hours sleep

Smart Supplement Support (Food First!)

• Collagen + Vitamin C before loading

• Vitamin D + Magnesium if low (test, don’t guess)

• Creatine (approx. 5 g/day) for muscle strength and tendon protection

If pain persists beyond lifestyle changes, talk with your provider about deeper hormone or rehab options.

When to Ease Up or Get Help

• Pain > 3/10 lasting > 24 hours

• Night pain, swelling, or catching

• Loss of motion or strength

Early, tendon-literate care prevents long-term injury.

Bringing It Home

Perimenopause doesn’t have to mean constant flare-ups or mystery aches.

With hormone-smart training, collagen-supportive nutrition, restorative sleep, and small daily resets, your tendons can be stronger than ever.

This is your comeback season — strong, steady, and pain-smart.

 Dr. Patti Hort is a perinatal chiropractor and functional perimenopause health coach. She helps busy moms in midlife rebalance their hormones, reclaim their energy, and move into their strongest, healthiest years yet through her New Aging programs and community.

Disclaimer: The information provided in this post is not intended as medical or health advice. Always consult with your healthcare provider before making any decisions regarding your health or well-being.