Why Bone and Muscle Health Matters
As women move through perimenopause and menopause, many notice subtle but frustrating changes — slower recovery from workouts, new aches, or feeling less strong than before. These shifts are not “just ageing.” They reflect the natural drop in estrogen, a hormone that plays a key role in maintaining muscle, bone, joint, and tendon health.
Without targeted exercise, this can lead to:
Osteopenia or osteoporosis
Arthritis progression
Muscle weakness and fatigue
Tendon and ligament injuries
Increased risk of falls or loss of independence later in life
The encouraging news? Exercise, done the right way, is one of the most powerful tools to protect your body through midlife and beyond.
What the Research Shows
Estrogen helps regulate bone turnover, muscle repair, and connective tissue recovery. When levels decline, bone loss accelerates, and muscle strength can fade more quickly.
But here’s the empowering part: bones and muscles are living tissues that respond directly to load. When you challenge them with the right kind of exercise, they adapt and become stronger.
Two factors make the biggest difference:
Nutrition — especially adequate protein, calcium, and vitamin D.
Exercise prescription — the right type, intensity, and frequency for your stage of life.
That’s where physiotherapy comes in. A physio can design a safe, individualised program to build strength and resilience while protecting your joints and tendons.
What Counts as “Real” Strength Training?
Not all exercise builds muscle or bone strength. Walking, yoga, and Pilates are fantastic for general wellbeing, flexibility, and balance — but they don’t apply the heavy loads needed to stimulate bone growth and significant strength gains.
True strength training involves:
Lifting loads heavy enough that you can only complete 8–12 reps before fatigue
Training 2–3 times per week
Gradually increasing resistance over time (progressive overload)
For example, lifting a 12–16 kg kettlebell for 10 reps challenges your muscles and bones. Using 1–2 kg weights for the same movement won’t produce the same results.
Building Stronger Bones
Bone is living tissue that strengthens when you load it — just like muscle. After age 50, bone loss naturally outpaces new bone formation, especially with declining estrogen.
The best way to counter this is through high-load, low-repetition strength training and impact-style exercises that safely challenge your bones. Even women already diagnosed with osteoporosis can perform this type of training successfully with proper supervision.
The LIFTMOR Trial
The Australian LIFTMOR Trial showed that postmenopausal women with osteoporosis safely improved bone density, posture, and daily function after only eight months of supervised heavy resistance training.
The program started with lighter loads to focus on technique, then gradually increased intensity — proving that strength training can be both safe and transformative for bone health in midlife.
Supporting Tendon and Muscle Health
Tendons are another area that can become more vulnerable around menopause. Conditions like tennis elbow, frozen shoulder, hip bursitis, or plantar fasciitis are common — and heavy strength training has been shown to improve tendon load tolerance and reduce pain over time.
Muscles also respond quickly to resistance training, improving strength, endurance, and coordination — key factors in preventing falls and maintaining independence.
Creating a Safe, Sustainable Program
A balanced exercise routine for women in midlife should include:
Strength training: 2–3 sessions per week targeting major muscle groups
High-load or impact work: where safe and appropriate, e.g. squats, step-ups, or medicine ball throws
Balance and mobility exercises: to reduce falls risk and improve movement quality
Aerobic activity: like walking, swimming, or cycling for cardiovascular fitness
Your physiotherapist will guide you through safe loading progressions, adapt for existing conditions (like arthritis or osteoporosis), and ensure correct technique to prevent flare-ups.
Moving Forward with Strength and Confidence
The decline in estrogen is a natural part of life — but losing muscle, bone strength, or confidence doesn’t have to be. With the right exercise plan, women can stay strong, mobile, and independent well into later life.
At Spearwood Physio, our physiotherapists design evidence-based programs specifically for women in midlife, helping you build strength safely and maintain long-term bone and muscle health.
Ready to get started?
Book an appointment with one of our physiotherapists today. We’ll help you build a tailored, safe strength program to protect your bones, support your joints, and move with confidence at every stage of life.