When elbow pain has been around for months, it can start to shape your day. You think twice before lifting a pan, swap hands on your bag and notice the ache after a long stretch at your laptop. If this has coincided with menopause, the way your tendons respond to load may be part of why it has lingered, and gradual strengthening is one of the most helpful things you can do.

Why tendons can be slower to settle in midlife

Tendons are made mostly of collagen, and oestrogen helps support how that collagen is built and repaired. As oestrogen falls around menopause, tendons may adapt more slowly to load and take longer to recover from irritation. Research on tendons and menopause suggests they may need a slower, steadier build-up than they did in your 20s or 30s.

That is useful to know, because it changes what to expect. Progress may be gradual, but it is still very possible.

What the outlook looks like

Elbow pain on the outer side tends to settle with time. A typical episode can last anywhere from six months to two years, and studies following people for a year found that around nine in ten had improved by the end of it.

So long-term elbow pain is not a sign that things are stuck. It usually means your tendons need a steady, well-paced reason to get stronger.

Why strengthening helps tendons

Tendons respond to load. When you ask them to work a little harder, gradually and consistently, they slowly become better at handling everyday demands. Resting a tendon completely tends to have the opposite effect, leaving it less able to cope when you return to normal tasks.

The key is the right amount. Enough to give your tendon a reason to adapt, but not so much that it flares up.

A gradual strengthening routine

Something to try three or four times a week:

• Grip squeezes. Squeeze a soft ball or rolled-up towel gently, hold for five seconds, then relax. Repeat ten times.
• Slow wrist lifts. Rest your forearm on a table with your hand over the edge, palm down. Holding a light object, like a tin of beans, slowly lift your hand up, then lower it over three seconds. Repeat eight to ten times.
• Palm-up lifts. Do the same with your palm facing up.
• Worktop press-ups. Lean your hands on a kitchen worktop, lower your chest towards it, then push away, if your elbow feels comfortable.

If you would like to follow along, VIDA has a short video of grip-squeezes you can use at your own pace.

A mild ache during exercise, around three or four out of ten, that settles by the next day is usually fine. If your elbow is sorer the following morning, ease back a little next time.

Building up over time

Once the routine feels easy, you could add a little more. Options include a slightly heavier tin or bottle, an extra few repetitions, or slowing down the lowering part of each movement. Adding one change at a time, every week or two, gives your tendon time to catch up.

Around menopause, it can help to build up a little more slowly than you might expect. Steady weeks add up to real progress.

Easing the daily load

While you build strength, small changes can stop your elbow being overloaded. You could try lifting with your palm facing up, using both hands for heavier things, and keeping your mouse close so your forearm rests on the desk. Avoid scrolling on your phone in bed with your elbow bent, which keeps the tendons working when they could be resting.

Looking after sleep and stress

Tendon pain can feel louder after a poor night or a stressful week. Night sweats and broken sleep are common around menopause, so a cool bedroom, a calm wind-down and a regular wake-up time can all help your elbow feel less sensitive.

What to take away

• Strengthen your forearm and grip three or four times a week.
• Keep exercise discomfort mild, and ease back if your elbow is sorer the next morning.
• Build up one small change at a time, more slowly than you might expect.
• Lift with your palm facing up and use both hands for heavier things.
• Look after your sleep to help your elbow feel less sensitive.

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