Curently there is a lot of discussion on the usefulness of stretching both from a therapeutic and preventive standpoint. Read more about the controversy.

While you may think strength training is not for you, you are too old to start, or you don’t have time or equipment, there are many ways to get this done with lots of options to take advantage of. Strength training is as important as cardiovascular exercise from a health perspective. Muscle weakness, termed sarcopenia and dynapenia, is a normal age-related phenomenon, occurring at a rate of 1% to 5% annually from the age of 30. Losing strength as we get older is potentially debilitating. Sarcopenia or muscle mass loss can lead to falls, a decline in function and a host of metabolic changes resulting in a higher prevalence of insulin resistance, type 2 diabetes, poor blood cholesterol and fat levels, and high blood pressure.

For a lot of non- traumatic musculoskeletal pain, the anatomy does not explain it all. Structural changes we see on images are present in painfree individuals. The trend is driving surgical decisions while at the same time repairing, resurfacing and replacing structures too early, or perhaps unneccessarily, which is coming under critisism. This is not to say surgery is never necessary, but an alternative approach is worth exploring.

Tendinopathy describes injury to a tendon that results in pain, weakness, sometimes inflammation, stiffness and a reduction in function and exercise tolerance. The most common overuse tendinopathies involve the rotator cuff, the inside or outside of the elbow, the hip ( gluteal tendon), the knee ( patellar tendon) and the ankle ( plantar fascia and tibialis posterior and achilles tendon). While overuse is a common mechanism of injury, interestingly tendons can undergo similiar changes/injury in association with the use of antibiotics known as fluoroquinolones, excessive corticosteroid use, metabolic diseases associated with lifestyle factors, and genetics.

Rotator cuff related shoulder pain ( RCRSP) is very common and 40 % of people with this condition report symptoms of pain, poor sleep and loss of function after 12 months. Most people over the age of 45 have non traumatic RCRSP. RCRSP is also known as sub -acromial impingement syndrome, subacromial bursitis, rotator cuff tendinopathy and painful arc syndrome. Also part of the continuum of RCRSP are non traumatic rotator cuff tears. Rotator cuff tears are classified as full thickness, partial thickness, degenerative or traumatic. Massive rotator cuff tears are those where more than 1 of the 4 tendons of the rotator cuff has a full thickness tear.