Menopause, Running & Bone Health

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The big drop in oestrogen production is the primary cause of many of the symptoms that accompany menopause – all the usual suspects, hot flushes, insomnia, weight gain, urinary incontinence to headaches and anxiety.

The good news is that exercise can help to alleviate some of the symptoms of menopause, so staying active is beneficial.  Runners can reap a lot of those rewards associated with greater activity, including avoiding some weight gain (although as you’ll see in a previous post, sometimes long distance steady state exercise isn’t always the best way to dodge the chub).

BUT running isn’t enough.  Yes, it satisfies the cardiovascular side of things, but resistance or strength training, flexibility and neuromuscular training are all just as important, particularly in relation to bone health.

Most people know that impact is good for increasing bone mineral density, however, bones are quite crafty things.  They get wise to the loads that you’re putting on them.  In other words, you can pound the pavement for hours and hours, but if you’re always pounding the pavement for hours and hours your bones essentially get bored and they don’t adapt.  Bones like novelty.  They’re like the weird little brother you never had who liked to poke an ant’s nest to see what would happen.  Bones adapt to novelty.  If you start jumping up and down when you’re running, climbing over stuff, hopping over a puddle etc. then your bones are more likely to perk up and take notice and, as a result make the decision to grow stronger – increase in density.  If you’re doing the same old same old with them, they just really can’t be arsed.  It’s not so much that they’re lazy, but it’s hard work for the body to create new bone – it needs a really good reason – like you putting extra demands on it and insisting that it creates more.

One of the major issues with oestrogen loss at menopause is the corresponding dip in bone health.  A peri, menopausal and post menopausal runner (and any other female) then, needs to put some serious effort into strengthening them there bones.  I think we’ve all heard the term stress fracture as a female runner – or even experienced it!  Not pleasant.

What to do?

If you’ve read any other posts on this site, you’ll know I’m a big fan of strength training.  Why? Because the muscles that you’re strengthening pull on the bones and this in turn helps to create greater bone density.  Adding it into your training regime a couple of times a week isn’t difficult, it just takes a bit of time to learn the correct form and manage it safely so you’re not overloading your tissues to start with.  It will also help offset the loss of lean muscle mass that occurs during menopause.  Get in touch for strength training and other programmes designed for the menopausal runner to help offset the very real but also very dealable with symptoms of this unique time in a woman’s life.

Just as a p.s. here because I haven’t really touched on it in other posts, Vitamin D is also vital to bone health and it might be a good idea to get your levels checked.  Spend some time outside; without sunscreen, a hat and dark glasses – no, you don’t need to burn yourself to a crisp, but you do need the sunshine for vitamin D and therefore calcium absorption which in turn helps with bone density.

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Managing Menopause Middle Spread

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It’s like you wake up one morning and think, “Shit, what the fuck just happened, why does my body look like a melting candle… everything is heading south.”  What’s going on?  Well, for one thing, as menopause approaches our metabolism slows down.  Okay, so can we blame our pesky hormones?  Well, yes, to an extent, but really, let’s face it, we reached 40, we’re heading to 50 and even though we take care of ourselves, we exercise etc. we might have been a little bit naughty on the weekend more than we should have and we could quite possibly be a tad more sedentary that we know is good for us… BUT “I’m tired,” I hear you say, “I’m busy, life is full of stuff to do…” and so on…

So what’s actually going on?  Our body composition changes – and what does that mean?  As we become more sedentary and as our hormones change our body composition of lean muscle to fat changes.  As we become more sedentary we lose lean muscle and we replace it with fat.  There are plenty of resources for how much fat we pile on in place of our lean muscle tissue, but essentially what this means is that although we might be eating the same, the loss of lean muscles and the consequent lower metabolic rate leaves us feeling like we can’t even look at a cupcake without putting a stone on.  

Panic not, help is at hand, we can prevent the problem in the first place, but if you’re in that place where the problem hasn’t just reared it’s nasty little fat laden head, but appears to have swallowed you whole and spat you out the other end feeling like your middle has a mind of it’s little own and refuses point blank to fit into anything you show it, then consider this…

As we age our bodies get a little bit over-sensitive to the stress hormone, cortisol.  This is the belly fat hormone.  Up your cortisol levels and your belly fat gets excited about increasing too.  It’s why destressing yourself and getting enough rest are top priorities at any age, but particularly as you’re going through the changes of menopause.  What’s most distressing (not destressing), is that our bodies don’t understand that our attempts to exercise our wayward bellies into submission are what we think are good for us.  In fact, our bodies actually experience long workouts, particularly long steady state workouts as quite stressful and, as a result, increase the cortisol floating about which, yep, you guessed it, doesn’t help with the spread of our middle regions.  

If you want me to be specific, long, steady state workouts, such as jogging on the treadmill, hours on that weird machine in the gym where your legs don’t do a circle, but kinda go in a long oblong with your arms doing something with handles, cycling long distances and so on and so forth… yep, all increasing the cortisol floating around your system.  They also tend to be lower body based too, which means that your upper body, the bit that every female that I have ever met bemoans as not being strong enough or shaped right (think bingo wings)… but which every female I have ever met has never focused their attention on, preferring instead to pound away on a treadmill or weird doofer machine or bouncing up and down on a spinning bike… often because they’re convinced that the ‘fat burning zone’ is a thing – news flash, it ISN’T A THING – completing this never ending cycle of physical torture is overuse injuries, sore feet, bad knees, tight hips and a low back pain that won’t shift.

Begrudgingly I hear you ask – “So, smart arse, what do I do?”  And here is where I tell you what you need to do and you panic because you think you’ll get bigger, not smaller, that you’re going to turn into Arnold Schwarzedoofer’s twin sister… so let me start by pre-empting that.  Unless you’re some kind of Amazonian genetic mutation of an individual, you will not get big…

 

Yes, through resistance training, strength training, building lean muscle mass with shorter cardiac bursts.  Does that mean you need to stop running?  You know I love running and that I think it has lots of health benefits, particularly those of being outside with others, BUT it’s also important to intersperse running with other stuff that alleviates some of the repetitive stresses of pounding the pavements.

What can you do?

To start with and for a lot of people, body weight training is plenty – can you do 10 push ups or 5 pull ups?  Well, if not, then you probably don’t want to be running around flinging massive weights about the place.  If you’re already doing some resistance or strength training then it might (MIGHT) be appropriate to increase the intensity.  Working with someone who can guide you appropriately with good form is really important or you’re potentially setting yourself up for injury (particularly if you’re new to this form of training), but once you know what you’re doing, then strength/resistance/body weight training can help you manage the belly fat and also injury-proof your running as well.

Proper Pilates on the large equipment is a good form of resistance training.  There is a strong focus on building strength and integrating the back line of the body – the glutes in particular (but not exclusively – Pilates should work the body as a whole), which are just one (or three) of the muscles around the hips that should power your running. 

 

Combining Pilates as a way of cross-training in a low impact way which focuses on the mind-body connection, helping you to develop better movement patterns and greater strength, balance, flexibility and stamina can be a fantastic step towards improving your running AND preventing the spread.  But coupling running with Pilates that includes higher intensity intervals will work like magic. 

Magic, however, can only be achieved by sorting out what’s in your fridge.  You can’t exercise your way out of poor nutrition (and lack of sleep/rest for that matter), but that’s the subject of another post,

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Menopause and Running – Am I more prone to injury?

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As a movement specialist, Pilates teacher, sports therapist, barefoot/minimal shoe ultra runner and general foot enthusiast, I see a lot of female runners who are starting to experience foot, ankle, knee, hip and low back pain which they attribute to running.  Typically they’re seeking some way of understanding how their bodies are changing and why, seemingly all of a sudden, their body isn’t working quite the way it was.    Most of these women are in the peri-menopause stage, the period (sometimes years and years) prior to actual menopause or menopause stage, when the change finally occurs and periods stop.  Although there is very little research exploring injury risk and menopause there are some changes that occur due to hormone changes worth noting.  Oestrogen levels and the effect of oestrogen all over the body, including its effects on collagen, can impact the elasticity of tendons and ligaments.  Also, the ageing process affects the ability of muscles, tendons and ligaments to heal and repair as efficiently as they once did, making sleep, rest and rejuvenation even more important at this stage of life.

Reducing oestrogen levels and the effect on ligaments can also mean an increased risk of pelvic prolapse, particularly with the increases in intra-abdominal pressure when running.  Pelvic floor strength and associated core stability and control therefore become vital to prevent pelvic floor issues developing or worsening.

Research suggests there is a higher degree of tendon related issues with in peri-menopausal women, particularly in the gluteus medius (the muscle which attaches to the bony bit on the outside of your thigh), and also in the posterior tibial tendon.

What can I do?

Reduce your stress!

Stress affects the way your body heals.  Running is a stress on the body and even though you love it, your body doesn’t really understand the difference between the stress that you’re under at work from the demanding boss, and the demands of running 3, 5 or 10 miles.  If you can reduce the other stressors in your life, then the running stress won’t have such a detrimental impact on your body.

REST!!!!!  SLEEP!!!!!!

This sentence, right here, this one… I hereby give you permission to rest!  Rest, sleep, rejuvenate.  Your body needs a good eight hours of deep, restful, consistent, sleep in order to full heal.  If you’re feeling guilty because you’re not doing all the things that you’ve got on your to do list at 3:30am, then you’re not dedicating that time to healing from the stress of the long run you did the day before.  Do yourself a favour – if you’re a runner and you want to keep running, you need to rest and recover.

Cross Train

Yes, yes, I know you love running and I know you don’t really want to do anything else but run, but your body really wasn’t built to do the same repetitive thing over and over and over… Yes, I know running is a natural movement, you’re right, but it’s not natural to run the same distances, on the same surfaces, in the same ridiculous shoes (yep, ridiculous), and expect your body to handle the stress of that.

This is where Pilates – and not the floaty watered down fitness crap you get at the local gym – PROPER PILATES, can help.  Body weight strengthening through Pilates is a good way to balance the body, develop some better movement patterns and potentially injury-proof your body.  Most people associate Pilates as being good for the ‘core’.  The ‘core’ is a loaded word these days and, in my opinion, not really a thing.  The body works as a whole and that’s why Pilates is so awesome – it works every part of your body in connection with the next part of your body.

I find the female runners (and women in general) that walk into my Pilates studio are desperate to find a solution to their running-related pain because they want to continue running for as long as possible.

Through a programme of Pilates, strength training, lifestyle, alignment and movement habit changes, you can injury proof your body (as much as we can with the lives we live these days), rebalance your muscles, fire up those lazy glutes everyone keeps talking about and extend your running career to the point where you can’t even remember going through the menopause!

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