Your knees have started to ache on the stairs, feel stiff after sitting through a meeting or complain at the end of a long walk. If this is new and you are around menopause, it is natural to wonder what has changed. Knees often become more noticeable in midlife, and keeping them moving and strong can help them settle.

Why knees can ache more in midlife

Knee aches become noticeably more common in women from their late 40s onwards. Research suggests falling oestrogen may play a part, as it helps support cartilage, the smooth cushioning at the ends of your bones, and helps keep inflammation in the joint in check.

Muscle changes matter too. The muscles at the front of your thighs act like shock absorbers for your knees, and muscle tends to decline more quickly through midlife. When those muscles are less strong, the knee itself takes more of the load.

None of this means your knee is wearing out. Knees respond well to movement and strength at any age.

Why knees like to move

Cartilage has no direct blood supply. It relies on movement to circulate the fluid that keeps it nourished. That is why knees often feel stiff after sitting and loosen once you get going.

Keeping your knees moving often through the day, rather than resting them completely, usually helps recent knee pain settle.

It is also common for a knee to click or creak as it moves. On its own, without pain or swelling, this is usually nothing to worry about.

Gentle movement to try

Something to try a few times a day:

• Sitting on a chair, slowly straighten one knee, hold for a few seconds, then lower.
• Lying on your back, slowly slide one heel towards your bottom, then back out.
• Stand up and walk around for a minute or two every half hour or so if you sit for long periods.

Keep each movement within a comfortable range. A mild ache that settles quickly is fine.

Building strength around your knees

As your knee starts to feel easier, strengthening the muscles around it helps share the load. Something to try two or three times a week:

• Sit to stand. Rise from a chair without using your hands, then lower yourself slowly.
• Heel raises. Rise onto your toes, pause, then lower slowly.
• Bridges. Lie on your back with your knees bent, lift your hips, then lower them slowly.

If you would like to follow along, VIDA has short videos of sit to stands, heel raises and bridges you can work through at your own pace. A few repetitions of each is a good start. A mild ache during exercise that settles by the next day is usually fine. If your knee is sorer the following morning, ease back a little next time rather than stopping.

Easing the load while it settles

A few small changes can help your knee while it settles:

• Take stairs one at a time, leading with your stronger leg going up and your sorer leg going down.
• Break longer walks into shorter ones spread across the day.
• Choose supportive, cushioned shoes for walking.
• Kneel on a cushion or folded towel if you need to get down to the floor.
• Use a wrapped cold pack if your knee feels warm or puffy, or warmth if it feels stiff.

Looking after the bigger picture

Broken sleep around menopause can make pain feel louder, so a cool bedroom and a regular wake-up time can help your knees as well as your nights. If you sleep on your side, a pillow between your knees can make you more comfortable.

Staying generally active, with walking, swimming or cycling, helps your knees and supports your bones through midlife. Your VIDA pain check-in is a good way to keep track of how your knee is shifting over time.

What to take away

• Keep your knees moving often through the day.
• Straighten your knee while sitting and slide your heel while lying down.
• Add sit to stands, heel raises and bridges as your knee eases.
• Break longer walks into shorter ones while it settles.
• Use a pillow between your knees in bed.

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