08/21/2026
A new 2026 review proposes something called the hormone–tissue–load mismatch. During the menopause transition, hormonal changes can affect: • bone remodeling and microarchitecture • collagen turnover and tendon repair • muscle mass and strength • ligament compliance • neuromuscular control That mismatch between hormones + tissue capacity + mechanical load may help explain why some women suddenly develop problems like Achilles or rotator cuff tendinopathy, plantar heel pain, or stress injuries during midlife. And this does NOT mean women in perimenopause should exercise less. We do need to be strategic about how much we load it and the recovery. Progressive resistance training. Adequate recovery. Enough protein and overall nutrition. Bone-loading exercise. And avoiding huge, sudden spikes in training volume. We can’t drive it like we stole it. PMID: 42332940