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!