You know that feeling when you start a new workout routine in January? You’re all excited and motivated… and then your knees start screaming at you, or your shoulders ache, or your lower back tightens up after every single workout.
If that sounds familiar – if joint pain has become your body’s way of saying “nope!” to exercise after 40 – I want you to know something important: it’s not your fault, and it’s not just “getting older.”
What’s really happening is that your hormones are changing (hello, perimenopause!), and those changes are directly affecting your joints. But here’s the good news – you don’t have to give up on getting stronger. You just need a different approach.
I’ve spent years helping women just like you build muscle, protect their bone density, and get stronger without the joint pain that comes with traditional exercise programmes. Let me share what actually works.
What’s Really Going On With Your Joints (That Most Trainers Don’t Understand)
That new twinge in your knee isn’t just bad luck or because you’re getting older. It’s actually connected to your changing hormones.
Here’s what’s happening in simple terms:
- As oestrogen drops, your body makes less collagen (that’s the stuff that keeps your connective tissues strong and flexible)
- Your joints aren’t getting lubricated as well as they used to be
- Your body tends to get more inflamed more easily
- Changes in how your body holds onto water affects pressure on your joints
Put all this together, and suddenly exercises that felt totally fine in your 30s are causing pain now. And when trainers tell you to “push through it” or “just modify a little bit,” they’re missing the bigger picture – your body needs a completely different approach.
Why Regular Exercise Programmes Make Your Joints Hurt More After 40
Most workout programmes (even ones that claim to be “for women”) are designed as if your hormones stay the same your whole life. They usually include:
- Lots of jumping and high-impact moves that irritate your joints
- Adding more weight every week whether your body’s ready or not
- Not enough rest between similar types of exercise
- One-size-fits-all approaches that ignore what’s happening with your hormones
When you try to follow these programmes during perimenopause, you’re basically asking your changing body to act like it did 10 years ago. No wonder your joints hurt! No wonder you get stuck in that frustrating cycle of starting an exercise programme, getting sore or injured, stopping, then trying again a few months later.
But there’s good news! You can make some simple changes to how you exercise that will work WITH your changing body instead of against it. Here are five approaches that really work for women in perimenopause:
Modification #1: Make Basic Movements Joint-Friendly
You don’t have to give up on the fundamental movements that help you get strong – you just need to tweak them a bit. Here’s how:
Squats:
Instead of: Deep squats with a barbell on your back (ouch!)
Try this instead: Sit back to a box or chair with dumbbells held at your shoulders
Why this works: You control exactly how far down you go, which takes pressure off your knees but still works all the right muscles.
My client Janet (47) had knee pain every time she tried to squat. We switched to box squats, and within 6 weeks, her pain was gone. She gradually phased out the box as her joints felt better.
Deadlifts (picking things up):
Instead of: Bending all the way to the floor to pick up a barbell
Try this instead: Start with weights raised up on blocks or a rack
Why this works: You don’t have to bend as far forward, which reduces strain on your back while still working your hamstrings and glutes.
Michelle (52) couldn’t do deadlifts without her back hurting for days. We raised her starting position by just 6 inches, and she can now lift without any pain.
Pressing (pushing weights up):
Instead of: Lying flat on a bench and pressing weights straight up
Try this instead: Use an inclined bench with neutral grip dumbbells (palms facing each other)
Why this works: This position is much friendlier to your shoulders while still strengthening your chest and arms.
Sarah (49) had a frozen shoulder and thought she’d never be able to do upper body exercises again. By switching to this modified position, she’s back to regular training without pain.
The key isn’t avoiding these basic movements – it’s adapting them to work with your body as it is right now.
Modification #2: Change How You Lift, Not Just What You Lift
How you lift weights matters just as much as which exercises you choose. Your joints will thank you for these simple changes:
Slow Down the Lowering:
Instead of focusing on lifting heavier weights each week, try slowing down the “down” part of each movement. Taking 4 seconds to lower the weight stimulates similar strength gains with much less stress on your joints.
Add Pauses:
Holding briefly during the middle of a movement builds strength without stressing the end ranges of your joints. For example, pause for 3 seconds at the bottom of a goblet squat to build leg strength with minimal knee strain.
Use Resistance Bands:
Adding bands to your dumbbells creates resistance that matches your strength curve – more resistance where your muscles are strongest and less where they’re weakest. This is much gentler on your joints.
Here’s a simple 8-week plan that works for most of my clients:
- First 2 weeks: Focus on lowering weights slowly (3-second count down)
- Weeks 3-4: Add mid-range pauses of 2-3 seconds
- Weeks 5-6: Keep the slow tempo while gradually adding a little more weight
- Weeks 7-8: Try adding resistance bands to your usual weights
This approach builds strength while giving your connective tissues time to adapt – super important when your hormones are changing.
Modification #3: Give Your Joints More Recovery Time
How you schedule your workouts makes a huge difference in joint comfort. Most programmes have you work all lower body one day and all upper body another day, but that’s not ideal during perimenopause.
Instead, try organising your workouts like this:
- Day 1: Deadlift variations + pressing movements
- Day 2: Rest or gentle movement (walking, yoga)
- Day 3: Squat variations + pulling movements
- Day 4-5: Rest or gentle movement
- Repeat
This approach gives each joint at least 3 days to recover before you stress it again – which is what your body needs now.
Also important: Plan for easier weeks every 4-6 weeks where you cut back on how much you do by about half. Think of it as taking your foot off the gas pedal occasionally to prevent burnout.
Modification #4: Feed Your Joints What They Need
What you eat directly impacts how your joints feel, especially during perimenopause when inflammation changes. Here are the simplest things that make the biggest difference:
Drink More Water:
- Increase your water intake by about 25% on training days
- Consider adding electrolytes (especially if you get hot flashes)
- Sip consistently throughout the day rather than chugging a lot at once
Focus on Anti-Inflammatory Foods:
- Include oily fish, walnuts, or flaxseeds regularly for omega-3s
- Add colourful fruits and vegetables to each meal (berries and dark leafy greens are especially helpful)
These simple nutrition tweaks can dramatically improve how your joints feel during and after exercise (without the need for any expensive supplements either!).
Modification #5: Listen to Your Body (No, Really)
This might be the most important change of all: learning to adjust your training based on how you feel each day. Even during perimenopause when your cycles get wonky, your hormone levels still fluctuate a lot.
Here are signs you should modify your workout:
- Joint discomfort that sticks around more than 24 hours after training
- Suddenly not being able to move as freely as usual
- Waking up extra stiff in the morning
- Sleeping poorly after workout days
Instead of forcing yourself through the same routine regardless of how you feel, try this approach:
- High energy days: Go for it! Focus on getting stronger
- Low energy days: Focus on form and technique rather than pushing hard
- Very low energy days: Just do gentle movement and recovery
Rebecca’s story says it all. At 48, she was about to quit strength training completely because of joint pain. By adjusting her training based on how she felt each day (instead of forcing herself to stick to a rigid schedule), her joint pain disappeared, and she actually got stronger than she was in her 30s.
“I thought my body was just breaking down,” she told me. “But it turns out I just needed to work with my hormones instead of ignoring them. Now I’m lifting heavier than I did years ago, but without the constant pain.”
You Can Be Strong Without Pain
Joint pain isn’t something you just have to accept after 40. By making these five simple modifications, you can build strength, protect your bones, and improve your functional fitness without the joint pain that derails so many women’s fitness journeys during perimenopause.
The key is working with your changing hormones rather than against them. With these adjustments, strength training becomes not just possible but comfortable and enjoyable throughout your perimenopausal years and beyond.
If you could use more straightforward guidance that cuts through the noise around perimenopause, I can help:
- Download my free “2 Session Strength Kickstart” guide – the perfect starting point if you’re not sure where to begin. Download Now →
- Join my Midlife Strength Newsletter for weekly guidance on simple, effective strength training for perimenopausal women. Subscribe Here →
- Explore personalised support options:
- 1:1 Coaching: Get the same personalised approach that transformed Hannah’s fitness journey, tailored specifically to your needs, schedule, and goals.
- Strength Essentials Programme: Learn the foundations of perimenopausal strength training with a progressive programme – so you don’t have to think about what to do, you just need to show up.