Exercise Past 50?


Recently there was an article going around social media about what exercise you shouldn’t do past 50. I am not going to link it, since it was ridiculous. Telling people we shouldn’t run, dead lift, squat, or do push ups past 50, among other things.

There are many beliefs and myths about aging. And being 50 myself I can’t imagine not being active and enjoying the outdoors. Many of these types of exercise can help keep us strong and able to enjoy many of the things we do. Unfortunately, many people take these negative messages to heart and stop doing stuff “because I am too old”.

Most anybody can do any type of exercise they want at any age. Just be sensible. If you haven’t been doing something build it up. If you have lost some capacity in strength, flexibility, or balance, work on those fundamental things to help you with those activities that require them. Most importantly, keep doing what you love and have fun.

The magazine came out with a new article after there was so much push back against the first one. Here it is.

Exercise after 50

Have fun out there. And, if you are unsure how to proceed with exercise or an injury is limiting you, give us a call at 970-949-9966 or email me t Keith@ascent-pt.co

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How Long Does It Take


Many people with nagging running or other athletic injuries underestimate how long things take to get better sometimes. If we aren’t realistic with healing times, it can lead to a difficult recovery. We chase a “quick fix” that may not be there rather than staying the course and doing the work to improve. Sometimes we worry and stress about our condition which makes it seem worse as “something must be really wrong” if its not better yet. Sometimes we dive into aggressive procedure with mixed outcomes too soon. Here is a great infographic from Tom Goom with some average healing times for certain injuries. And here is a link to the complete study. Keep this in mind when you are searching for answers to your pain.

Grading and building load tolerance are important concepts to return from these types of injuries. Taking the time to calm tissues down and then rebuild their tolerance is important. Understanding realistic time frames can help.

If you have any questions about a running or sport injury contact me at 970-949-9966 or keith@ascent-pt.com

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5 Tips to Reduce Neck Pain at Work


I am lucky. I get this view in one form or another every day on my way to work. But for some people going to work means neck pain. Sometimes we get neck pain from being on our bike, but it continues to trouble us at work. Sometimes it seems to start at work for no particular reason, but may limit sports participation, or even make sleeping difficult.


Here are 5 tips to help out your neck pain. As always, if your pain persists or gets worse, seek medical advice. But doing some of these things may help your neck pain, or even just make you generally more efficient and more comfortable at work.

  1. Move more- Your body is made to move.  In today’s modern world we tend to sit…A lot. 8 hours at the computer, on the phone or in meetings, the half hour commute in the car each way, sitting for dinner, reading or watching a movie. It adds up. Our tissues like movement. Our nerves like movement. Plan your day to add movement. Walk on your lunch break. Look at tasks that require you to move and mix them in. Take planned stand up and walk breaks during the day. If you have been sedentary outside of work add some fun movement off work. Go skiing in winter, go for a hike, work in your garden, go dancing. Whatever gets you moving and you enjoy.
  2. Do some simple exercises- This builds off the first point to help you move. Periodically doing neck and upper back specific movements can help decrease sensitivity in tissues that may not be moving well. A few simple ones pictured below are chin tucks, trap stretches, and shoulder blade pinches.  There are others. Do what feels best. If something increases your pain more than temporarily, then have it looked at
  3. Eye Breaks- Our eyes get tired staring the same distance at a screen all day. When they get tired we can get extra tension in our head and neck and increase headaches and neck pain.  Every 15 or 20 minutes, give them a break and focus at a point in the distance. Look out a window or focus on a point in the distance. If this continues to be an issue get your eyes checked.
  4. Check out your work space- Is the temperature ok? Is there a glare on your screen certain times a day? Can you adjust your chair so you can change postures when you need to? Are your keyboard, mouse, and monitor set in comfortable positions? Making sure your office is adapted to your comfort can help reduce unneeded stress on your body, make you more comfortable and more efficient.
  5. How is everything in the rest of your life?- Neck pain at work can be affected by other things too. Pain is influenced by sensitivity in our nervous system. A nervous system can be sensitized by things like poor sleep, stress, poor nutrition, worry, feeling down, and lack of activity. On the other hand, we can improve sensitivity with good sleep, fun meaningful activity, exercise, being outside, and doing things we like with people we enjoy. Look at the whole picture and see what things you can control.

These are some basic things that may help with neck pain at work and life in general. If you have looked at all these things and still have pain, or try these things and it continues, seek medical advice. Call your local PT today. Post in the comments is you have questions, You can get a hold of us at keith@ascent-pt.com or 970-949-9966 if you need some help.

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Ski Injury Prevention


This weekend winter really hit in the high country. Wolf Creek opened the lifts and, I am sure Arapahoe Basin and Loveland will sure be soon too follow. Hopefully, you are working on your conditioning as skiing will be happening soon. You can see our post on conditioning here.

People often else what else they can do to prevent ski injury. Being physically fit is one thing for sure. Being strong enough and having endurance to last as long as you want can definitely keep you healthy.

The second area to look at is your equipment. Making sure your skis or board is tuned and running well is important. It will help you ride better and safer and conserve energy.  Also, make sure your boots fit well and your binding are adjusted. You want them to release when they are supposed to, but not when they are not. Getting these looked at before you start should be on your list. Have a professional do it to be safest.

Staying in control, and limiting falls is another area we can look at. Ski on terrain and in conditions you are comfortable with. Ski in control. Be aware of terrain, light, snow surfaces, and crowds. Take a lesson if you need or want to try more challenging things. And, lastly, if you are going to jump, know where you want to land. Flat landings are prime for injuries. Unexpected situation on landing can also be trouble. Scout it out and get a spotter if there is any chance of collision with other riders.

Some times we do fall though, and we can look at is how we fall. Especially for ACL tears, one of the more common ski injuries, there has been research on what types of falls may lead to more risk. There are 6 common things that lead to more risk:

  1. The uphill arm gets back.
  2. The skier gets off balance to the rear.
  3. The skier’s hips get below their knees (sitting in the back seat)
  4. The  uphill ski becomes unweighted.
  5. The skiers weight goes to the tail of the downhill ski.
  6. The upper body becomes twisted to face the downhill ski

Here are a couple examples:


Now you may be thinking, How do I stop that? Falls are unexpected and happen fast. But learning a few things can make a difference. If you feel like you are losing control the first things to think of are hands forward, feet together, and hands over skis. These 3 things are meant to keep your body from twisting, your weight forward, and as equal as you can. This can hopefully prevent the chain of events that lead to a more dangerous fall.

If you do fall, there are a couple other things you can do to limit your damage. The first is if you need to stop yourself from sliding, do not fully straighten your knees, keep the flexed and “soft” so they can give. Locked knees are more likely to rear a ligament.  The second thing to do is stay down until you stop moving. Many injuries occur when someone falls and attempts to stand while they are sliding. This leaves us prone to falling back and twisting if we lose our balance.

For more information here is a link with more details.

Keep safe out there and have fun. If you need any more information on getting ready for skiing go to www.ascent-pt.com or email me at Keith@ascent-pt.com.

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Arthroscopic Surgery for Meniscus


Meniscus tears are on of the more common knee injuries we see in therapy. Especially, here in the valley. Lots of people injure their meniscus skiing, but also it is common in sports like basketball and soccer. We also see a lot of degenerative tears, where someone injured their knee while they were younger and over time the meniscus breaks down.

For years this has been frequently treated with surgery, although many people do well conservatively. Recently a number of studies have come out that show this surgery isn’t really better than a conservative course of treatment. This one came out last week.

It shows no difference in people with surgery vs. conservative care in a 2 year follow up. So, if you are having meniscus issues, talk to a PT before committing to the knife.

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World Mental Health Day.


This post is a day late for World Mental Health Day. But, better late than never. You may ask why post about mental health on a physical therapy website. Well there are a couple reasons.

One is if you notice how many things in the infographic is how many things that affect our mental health are physical/biological in nature. Taking walks, exercise, eating well, getting outdoors, and doing things we enjoy are physical things that can affect our mental health and emotional state.

The second is that pain and injury can be looked at through a biopsychosocial lens.



Whether you have a minor sports injury, are recovering from a surgery, or dealing with a long term pain issue, we cannot separate biology, psychology, and sociology. They all affect and play off each other. Both in negative and positive ways. We tend to think of our bodies as machines, and that when we are injured or in pain, we need to discover the broken part and repair it, or activate it, or put it back in place.  In reality, we are much more complex than that.

When we have physical things happen it affects our psychology. We worry about it. We may lose some of our stress relieving activities. It may place other stress on us, because our job or family life is affected. We may fear what will happen, or get angry about letting it happen. We may lose sleep.

When we have physical things happen, it may affect our social structure. If we can’t do our sports or go to work, we may lose connection with people we enjoy. It may change roles in our family from care giver to patient, or provider to dependent. Our family may struggle with you not being yourself, and you may struggle with not being yourself.

Changes in psychological and social situations then can have a feedback loop with our physical state. We can have more stress chemicals in our body. We can lose sleep. We can become fatigued. Our nervous system can become more sensitized. This can lead to more pain.

You might be able to see how these different factors can affect each other and complicate an injury recovery. The good news is we have some power over these. We can be aware of the changes, and try to change the things we can. Figure out ways to be the parent, spouse or friend you want to be despite being injured. Get what exercise you can. Be outside. Do creative, enjoyable things. Whether you have an injury or not, paying attention to your whole self can make things better.

If you have any questions, or examples of how the biopsychosocial model of health has affected you, post a comment or drop me a line at Keith@ascent-pt.com

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Ski and Ride Conditioning



The weather has stayed chilly and snow has kept coming up on the mountain the last few days. That means skiing isn’t far off and its time to get our bodies ready. The last 2 posts I wrote about two tenets of conditioning, load capacity and grading. Those posts are here if you missed them.  https://ascentpt.blog/2018/10/08/what-does-load-tolerance-mean/  and https://ascentpt.blog/2018/10/09/what-does-grading-mean/.

Ski conditioning, or any sports conditioning is the combination of these 2 things. Figuring out what your load tolerance is. Then steadily building your capacity at a rate that won’t injure you by doing too much too fast. Some of this we can do in the fall on dry land. Some will need to happen once the mountain opens, when you can actually ski or ride. Building up your vertical as your body allows.

Unfortunately, there is no exact recipe for grading and building tolerance. Everybody starts at a different point. From someone who has been very active all off season with different sports to someone who hasn’t done much since last season to someone who is coming back from an injury.  The first thing to do is be realistic with where you are and start building from there.

There are a few types of activity or loading that you can look at aerobic capacity, anaerobic capacity, strength, and plyometric capacity are some major ones to be aware of.  All of them are valuable for skiing. And you can be strong in one and not in another.

Aerobic capacity is the ability to maintain exertion over a sustained time. This needs to be at a certain level to progress to other activities that are more aggressive. If you don’t have a good aerobic base, you may find your self  out of breath all the time when trying to load your body more vigorously. You can build this with running, swimming, cycling, hiking up hill, or elliptical machine. Think of getting your breath and heart rate up and maintaining it for a while.

Anaerobic is shorter bursts of activity that force you to work closer to maximum capacity. This is very much like skiing or riding as we may exert ourselves for a few minutes then rest on the way back up the lift. You can stress your system anaerobically with things like intervals running or on the bike, wind sprints, or sustained hopping or jumping activities.

Strength is the capacity for your muscles to tolerate load and continue to control your movements. This involves control, power, and endurance. You need a base amount of strength to perform plyometrics. You can build plyometric strength with various types of resistance training. Weight machines, free weights, and band training are some examples.

Plyometrics are activities that require you to load your muscles quickly and then use that energy to recoil and produce force in the opposite direction. Again, an important ability for higher level skiing and riding, especially for bump skier and steep skiers. Activities that you can do include jumping and hopping activities.

Many of these things will overlap its easy to do anaerobics and plyometrics together. What is important is building up steadily, so your body increases capacity to keep you safe and ski more efficiently come winter. Over the next couple weeks, I will try to post some examples of different types of exercises. As always if you have any questions, post a comment or email me at keith@ascent-pt,com.

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What Does Grading Mean?


Things are really starting to change here in the mountains.  Getting colder and this is what Beaver Creek looked like last evening with more in the forecast. Hopefully we start out fast and furious when the mountain opens in just over a month!!!. That means we need our bodies to be ready to ramp up for skiing fast. Last post I talked about load tolerance. If you push to much too soon you can have issues. Here is that post.  https://ascentpt.blog/2018/10/08/what-does-load-tolerance-mean/

So how do we improve load tolerance? That concept is called grading. It is the foundation for any training. We can do this for getting in better shape for a sport, but also in returning to activity after an injury or with pain. For getting in shape for a sport it will let us go harder faster, and allow us to have more fun out there. With pain or injury, its about coming back without setbacks, so we can get up to speed as quickly as possible. Ramping up too quickly can give us pain, and ultimately slow our return. The difference between training and injury return in where we begin.

The basics of grading is beginning at a place your body is comfortable with and steadily progressing, rather than just starting out full force. Kind of like going down a set of stairs rather than jumping off the top step.

Where we start depends on where we have been. If we have been injured or very sedentary we will start at a lower level of activity. If we have been very active but doing different things than the new activity we are getting ready for we can begin at a higher level. So, assess realistically where you have been, and how your body has responded before.

Any starting point will be a bit of an educated guess. Do your best and then begin with some activity or exercise. This may look like your sport, such as plyometrics for skiing, if you have been active and are just trying to fine tune for the sport. It may be general fitness if you have been less active or returning from injury. Then, I like to use the stoplight analogy to progress. If what you do feels like no issue at all, its a green light. You can progress. If what you do feels challenging and there is some discomfort, its a yellow light. Keep doing that level, with appropriate rest in between. Once this becomes easier you will get a green light. If what you do causes major discomfort or pain that lasts 24 hours, that’s a red light. You need to stop and reassess. You probably need to back down your intensity.

Ideally we get lots of green and yellow lights, but not too many reds. As we progress week to week, think of adding consistently to challenge yourself and steadily increase your capacity.

Hope this helps understand grading and training. Drop a comment or email is at keith@ascent-pt.com if you have any question.

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What Does Load Tolerance Mean?



As it turns to fall here in the mountains, it means skiing is just a few short weeks from beginning. Many people wonder what they can do to prevent injury during the season. Ski conditioning classes are popping up all over the valley. Which is fantastic.

The concept of load tolerance is a great thing to understand when trying to prevent injury, and one that many people don’t understand very well. A quote I heard recently about this is “Many injuries occur after doing too much too fast after doing too little for too long.” This brings into play 2 concepts for training and recovering from injury load tolerance and grading.

Load tolerance, which I will address in this post, is the ability for your tissues to handle a certain amount of stress and deal with it. Grading is the concept of building up your tissues to handle more stress.

We innately understand load tolerance. Everyone has a limit. Its just sometimes we minimize it or forget about it in our daily life. If I told you without any training, how would your body handle running an ultramarathon or doing an ironman, you would understand that you wouldn’t be able to do it, or you would have some serious issues. We also understand that people who train for these events can do them.

When we don’t understand load tolerance this can lead to issues in understanding and prolonging injuries. Many activities we do here in the mountains are seasonal because of our climate. We ski in winter. We bike and hike in summer. There are other examples of course. Even if we are relatively active and staying in decent shape these various activities can places different demands on our body. Sometimes we finish a season of one activity and don’t do it for months then expect to pick it right back up again like we never left. If we do this too hard or too fast we can run into load tolerance issues. Our body is telling us it may be stressed too much in that way and may give us tightness, fatigue, or pain.

The problem in not understanding load tolerance, is that we can misdiagnose problems easily. Many times we assume if something is painful, it must be damaged, broken, out of place, or somehow off. We can focus on trying to “fix” things. We reason I have done this before without pain. Now it hurts. It must need fixing. Sometimes the way we increased activity changes. Sometimes we have changed our other activities. Sometimes our bodies change. Its worth looking if something has been damaged of course. But, many times what needs to occur is we need to look at our activity level. This could mean anything from backing off a bit, to resting, to altering a training plan.

I see many people who are convinced something must be very damaged because it hurts when they do their sport. Once we tweak their training plan, and work on a way to build it back up, they are able to get going again. This involves grading and we I will address this in another post.

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20 More Reasons to See a PT


Yesterday to help commemorate National PT month I listed 20 reasons to see a physical therapist. There are so many, I couldn’t fit them all in. So, here are 20 more.

  1. Your doctor told you should stop running because you will wreck your knees.
  2. Your MRI or Xrays show you have degeneration or arthritis in your joints and you are not sure what to do, but know you don’t want surgery.
  3. You are having problems with dizziness.
  4. You own a small business, and your workers are getting hurt and you want to make it safer and keep your costs down.
  5. You are a physician, and your patients with persisting pain need guidance and you aren’t sure what to tell them.
  6. When every morning you wake up and get that ice pick feeling in your heel and it keeps happening.
  7. You are getting pain in your elbows when you play golf or tennis.
  8. You keep having back or neck pain, even though you are getting massages every week.
  9. When you come out of the hospital, and you need someone to come to your house for a bit to help you be able to get out of your house.
  10. When you want to be treated as a whole person, and not as a body part that is broken.
  11. You want to be more comfortable and productive when you are working long days in your office.
  12. Your child is not meeting their developmental milestones.
  13. You want to get back to the gym, but you aren’t sure what’s safe after having an injury or pain.
  14. You want your daughter to go through an ACL injury prevention program before soccer/basketball/volleyball start.
  15. You want to learn about your condition and be able to manage it as much as you can yourself.
  16. You want to get the most out of that surgery you did and get back at it as soon as possible.
  17. You keep waking up in the middle of the night with back pain.
  18. You are fearful of going places or doing things, because it might be too much.
  19. You want an affordable, non-invasive, low risk way to deal with your pain or injury.
  20. You want to live your best life.

There are so many things a PT can help you with. If you have questions about an issue or can think of other ways a PT has helped you drop a note in the comments or ascent-pt.com.



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