Strong Bones, Pain-Free Play:
Beyond Pickleball for Menopause
Dr. Apple D. Cepedoza
As I warm up for another match at the Bohol Medical Society pickleball tournament, I’m reminded why I keep recommending this sport to my patients in perimenopause and menopause. It’s not just the camaraderie or the fun—it’s the science. Two of the most pressing concerns women face during this transition are bone loss and musculoskeletal pain. Pickleball addresses both, provided we play smart. But pickleball alone isn’t the whole prescription. Here’s what else works—and how to protect yourself.
The Bone Health Case
Menopause triggers accelerated bone loss due to declining estrogen. Research shows that weight-bearing and resistance exercises are effective in increasing bone mineral density of the spine in postmenopausal women. Pickleball, with its pivots and lunges, delivers that dynamic impact. But if you’re not on the court, progressive resistance training—using weights or resistance bands—builds bone at the hip and spine. Even simple walking is effective for hip bone density. For a gentler option, traditional Chinese exercise like Tai Chi has shown significant improvements in bone mineral density, balance, and quality of life in postmenopausal women with osteoporosis.
The Pain Relief Connection
Perimenopausal joint pain is real, not imagined. Estrogen decline reduces joint lubrication and collagen production, leading to stiffness and inflammation. Movement is medicine here. Low-impact exercise like swimming, walking, Pilates, or yoga can decrease stiffness and joint pain. Physical therapy is another powerful tool—therapists can develop targeted strength and stability plans that reduce stress on painful joints.
Common Injuries and How to Prevent Them
The most common pickleball injuries include ligament sprains and muscle strains, often involving shoulders, knees, hips, wrists, and ankles, with tendonitis in the elbow being very common. Overuse injuries—shoulder pain or knee pain that develops over time—are most frequent, along with acute injuries like sprained ankles and pulled hamstrings. Women in menopause are at higher risk because estrogen decline reduces tendon and ligament resilience, increasing injury susceptibility.
Prevention starts before you step on the court. Warm up properly—light stretching and active movements from feet to neck. Take lessons to learn proper mechanics; pickleball’s low bounce makes the motion more violent than tennis. Play at your skill level and avoid ramping up too quickly if you’ve been inactive. Strength training off the court—2 to 3 days weekly—preserves muscle mass and builds joint stability.
When to Seek Help and Who to Consult
See a doctor if symptoms don’t improve after 3 to 4 days of rest and self-treatment, if you can’t bear weight, or if there’s deformity, numbness, or more than mild bruising. For overuse injuries that affect your training or daily activity, don’t wait—early diagnosis prevents more serious damage.
For musculoskeletal pain or injury related to menopause, a physiatrist (Physical Medicine and Rehabilitation specialist) is an excellent first stop. They take a holistic approach to diagnosing and treating sports injuries and musculoskeletal conditions. We, your OB-GYN, remains your partner for menopausal hormone therapy decisions, which may reduce aches and pains and support bone density.
My Prescription
Play pickleball two to three times weekly. Pair it with resistance training on off days. Add walking, yoga, or Tai Chi for variety. Get your calcium and vitamin D. Know the warning signs. And remember: every dink, every lunge, every laugh on the court is an investment in a stronger, more mobile second half of life.
See you on the court. Let’s stay strong together.