Peri-menopause and Joint Pain: Why Are Your Shoulder, Hip and Foot Problems Suddenly Appearing?
If you’re a woman in your 40s or 50s and you’ve suddenly started noticing aches and pains that seem to appear out of nowhere - sore shoulders, nagging hip pain, painful feet, or tendons that just don’t seem to tolerate what they used to - you are not imagining it.
We see many women coming in with very similar concerns. They often say things like:
“I’ve never had this problem before.”
“I haven’t changed anything, but now my shoulder hurts.”
“Why am I suddenly getting pain in my feet or hips?”
There is often a good explanation behind these changes. For many women, this stage of life coincides with peri-menopause, a time when fluctuating hormones can influence the way our bodies respond to stress, exercise, injury, and recovery.
How do hormones affect tendons?
Estrogen plays an important role throughout the body, including maintaining healthy tendons and ligaments. During peri-menopause, estrogen levels can fluctuate and gradually decline, which may affect tendon health.
Tendons are the strong tissues that connect muscles to bones, helping us move efficiently. Changes in hormone levels may influence:
Tendon structure and elasticity
The way tendons adapt to load and exercise
Recovery after activity or injury
The body’s ability to manage repetitive stress
This doesn’t mean that every woman going through peri-menopause will develop tendon pain, but it may help explain why some women suddenly experience problems such as:
Shoulder pain (including rotator cuff-related pain)
Tennis elbow or other tendon irritation
Achilles tendon pain
Plantar heel pain
Hip or gluteal tendon pain
Sometimes the activity that once felt completely normal, like gardening, running, Pilates, gym workouts, or even sleeping in a certain position, can suddenly trigger discomfort.
What about bone health?
Estrogen also plays an important role in maintaining bone density. As estrogen levels decline around menopause, bone turnover can change, which may increase the risk of reduced bone density over time.
This is why this stage of life is an important time to focus on:
Strength training and progressive resistance exercise
Adequate calcium and vitamin D intake
Balance and mobility exercises
Maintaining an active lifestyle
Your bones respond to the demands placed on them, and the right type of exercise can be one of the most powerful tools for supporting bone health.
“But I haven’t done anything differently…”
One of the things we hear frequently from patients in clinic is “I haven’t changed my routine - why is my body suddenly struggling?” The answer might be that your body has changed, even if your lifestyle hasn’t.
Hormonal changes can affect how tissues tolerate load. Things that your body previously handled without issue may now require a different approach - sometimes it’s a slower progression, more recovery time, targeted strengthening, or addressing movement patterns that were never a problem before.
This is where physiotherapy can help.
Your pain is real, and there is a reason for it.
Pain during peri-menopause is sometimes dismissed as “just getting older” or something women have to put up with. But your symptoms are real, and they deserve attention.
Understanding the connection between hormones, tendons, muscles, and bones allows us to create a more personalised approach to treatment.
Rather than simply treating the painful area, we look at the bigger picture:
What activities are aggravating your symptoms?
How strong and resilient are your muscles and tendons?
Are you loading your body in a way that supports adaptation?
What strategies can help you return to the activities you love?
The takeaway
If you’re suddenly experiencing shoulder pain, hip pain, foot pain, or recurring tendon issues during your 40s or 50s, you’re not alone. We see many women going through this exact transition, and there are practical, evidence-informed ways to help.
Your body isn’t failing you, it’s just changing. With the right support, you can build strength, confidence, and resilience through this stage of life.
If you’ve noticed new aches and pains that seem to have appeared “out of nowhere”, a physiotherapy assessment can help you understand what’s happening and what you can do about it.
Written by Katelyn Baumgartel
References and/or further reading:
Tidd MM, Shrestha M. Postmenopausal estrogen deficiency and tendon degeneration: a systematic review. Muscles, Ligaments and Tendons Journal. 2025.
Ansari M, Hussain F, Shopon M, Ajmal H, Asif M, David S. Hormonal shifts and structural strain: A literature review of menopause and perimenopause in relation to overuse injuries and stress fractures. Annals of Rehabilitation Medicine.2026;50(3):139–149. doi:10.5535/arm.250134
Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric.2024;27(5):466–472. doi:10.1080/13697137.2024.2380363