This week I sat down with physiotherapist Anna Walsh, who has spent the last 26 years helping people recover from injuries, move better, and stay active as they age. Anna has seen the fitness and rehabilitation world evolve dramatically over the past two decades, from the early days of Pilates being viewed as an alternative therapy to its widespread use in rehabilitation and performance today. One of the big themes of our conversation was simple: movement matters. As we get older, many of the aches, pains, and injuries we experience aren’t necessarily caused by age itself. More often, they’re the result of reduced movement, poor loading strategies, long periods of sitting, or simply not maintaining strength and mobility over time. Why Tendons Need Load, Not Rest We spent a fair bit of time discussing tendon injuries, something many runners, gym-goers, and myself struggle with. Anna explained that tendons generally don’t respond well to complete rest. Instead, they need carefully managed loading that gradually builds their capacity over time. Too often people either push through pain and make things worse, or stop moving altogether and lose strength and function. The key is finding the right amount of load at the right time. The Hidden Cost of Sitting Another topic that resonated was the impact of prolonged sitting. Many people blame tight hip flexors, weak glutes, or poor posture on getting older, but Anna explained that much of this comes back to spending large portions of the day in the same position. The solution isn’t necessarily complicated stretching routines. It’s simply moving more frequently, changing positions often, walking regularly, and maintaining strength through the hips and legs. The Importance of Pre-Hab Before Surgery One of my favourite parts of the conversation was Anna’s discussion on surgery preparation. Her message was clear: The stronger and fitter you are before surgery, the better your recovery is likely to be afterwards. Whether it’s a knee replacement, hip replacement, or another procedure, investing time in strength training and conditioning beforehand can dramatically improve outcomes. “Pre-hab before surgery improves recovery.” The Brain’s Role in Pain We also explored the fascinating connection between the brain and pain. Anna discussed how pain isn’t always a direct reflection of tissue damage. The nervous system, previous experiences, stress levels, and beliefs can all influence how we experience pain. Understanding this doesn’t mean pain isn’t real. It means that recovery often requires addressing both the physical and neurological components of injury. Active Recovery Beats Passive Treatment A recurring theme throughout the episode was the importance of taking an active role in your own health. While hands-on treatments can be helpful, lasting improvements usually come from understanding your body, making good decisions, building strength, and maintaining healthy movement habits. The goal isn’t simply to become pain-free. The goal is to become more resilient. Key Takeaways * Movement is one of the most powerful tools we have as we age. * Tendons respond best to progressive loading, not complete rest. * Sitting for long periods can contribute to many common aches and pains. * Building strength before surgery often improves recovery outcomes. * Pain is influenced by both physical and neurological factors. * Education and self-management are essential for long-term health. * Active treatment strategies generally outperform passive approaches. If you’re dealing with an injury, preparing for surgery, or simply trying to stay active and healthy after 50, there’s plenty of practical wisdom in this conversation. Enjoy the episode. RodStrong After 50 Get full access to Strong After 50 at strongafter50.substack.com/subscribe
