Contact Physiotherapy Methven, NZ

20/05/2026

18/05/2026

After 50, your hippocampus shrinks by 1 to 2% per year. A 12-month aerobic exercise trial in older adults reversed that. The exercise group gained 2% in hippocampal volume. The stretching controls lost 1.4%. That 3.4-percentage-point gap reverses roughly one to two years of typical age-related decline. Spatial memory improved, and the gains correlated with hippocampal volume changes.

That trial, run by Kirk Erickson's team at Pittsburgh and published in PNAS in 2011, remains one of the strongest single pieces of cognitive-aging intervention evidence we have in healthy older adults. It hasn't been overturned. It's been extended and validated in larger meta-analyses since.

A paper published this month in the Journals of Gerontology adds the mechanism we can't directly measure in humans. The team took 18-month-old mice (roughly equivalent to a person in their 50s or 60s, depending on the conversion table), induced neuroinflammation, and gave them eight weeks of moderate aerobic exercise. Hippocampal mitochondrial homeostasis recovered. Inflammation, oxidative stress, and apoptosis all fell. Memory impairment reversed.

Mouse to human translation isn't automatic. We can't measure mitochondrial dynamics in living human hippocampus, because no one is biopsying living human brain. The mechanism is inferred in humans, not proven. But the human imaging outcomes are real, replicated, and unambiguous.

This is what gets lost in cognitive aging marketing.

Brain health products line shelves. Nootropics, mushroom blends, lion's mane, NAD precursors, methylene blue. Every one is sold with mechanism claims (often plausible) and weak or absent cognitive outcome data. The single intervention with replicated structural brain outcomes in healthy older adults is exercise. It's free, requires no bottle, and takes 150 minutes a week.

Sleep is the other real competitor. The cognitive evidence for sleep quality is solid, and the structural brain effects of chronic poor sleep are well documented. Treat sleep and exercise as the two foundations, not as alternatives.

What the data actually supports:

150 minutes of moderate aerobic exercise per week, split into 3 to 4 sessions of 30 to 45 minutes. Moderate means you can hold a conversation but not sing. Heart rate around 60 to 70 percent of your maximum. Brisk walking on an incline, light jogging, cycling at a sustainable pace, swimming, rowing. The Erickson protocol used progressive walking, ramping up duration over the first weeks until participants were sustaining roughly 40-minute sessions at moderate intensity.

Vigorous exercise produces similar benefits in roughly half the time, though the evidence base is smaller in older adults specifically.

Resistance training has growing evidence for cognitive aging. The SMART trial in Sydney showed it slowed brain atrophy in adults with mild cognitive impairment. It's worth doing for several reasons, including independent mobility, bone density, and fall prevention. But the cognitive-specific evidence stack is thinner than for aerobic exercise.

What the data does not support:

That compounds or cognitive training apps substitute for exercise. Nothing in those categories has reached the structural brain outcomes Erickson demonstrated.

That casual walking counts as the trial dose. The intervention used elevated heart rate, sustained for 30 or more minutes, multiple sessions per week. Walking your dog around the block is good for you. It's not what was tested.

The bottom line:

If you're over 50 and not currently doing 150 minutes a week of moderate aerobic exercise, this is the single highest-confidence intervention with replicated structural brain outcomes for the second half of life. Sleep is the other foundation. Everything else, every compound and app and stack, sits below those two on the evidence ladder.

Start with 10 minutes of brisk walking three times this week. Build to 30 minutes. Get to 150 minutes a week by month two. That's the kind of progression that produced 2% hippocampal growth in 12 months.

Li et al., J Gerontol A, 2026
Erickson et al., PNAS, 2011
Colcombe et al., J Gerontol A, 2003
Northey et al., Br J Sports Med, 2018
Suo et al., Mol Psychiatry, 2016

15/05/2026

💡 ACL injury management is more nuanced than “physiotherapy vs surgery.”

Great point this decision is not simply about comparing outcomes, but about aligning treatment with individual patient factors: activity demands, expectations, and personal goals.

📊 Findings from a recent systematic review highlight that:

* Long-term pain outcomes are similar between exercise-based rehabilitation and ACL reconstruction
* Differences in function are small and often not clinically meaningful
* No guidelines exist for the conservative management of ACL injuries.
* Tai Chi, Pilates, Perturbation training can be beneficial versus no treatment.
* No specific exercise was likely more beneficial than another.
* Surgery is likely beneficial over exercises with no clinically relevant effect.
* Exercise can be considered as a useful and cost-effective intervention.

👉 This shifts the conversation.

It’s not about “which is better” in isolation
but about who benefits from what, and when.

✅ The current evidence supports:
* A rehabilitation-first approach for many patients
* Shared decision-making, not protocol-driven care
* And critically, improving how we design and deliver exercise interventions

Disclaimer:
👉 Sharing a study is NOT an endorsement.
👉 You should read the original research yourself and be critical.

12/05/2026

💡 Specific exercise treatment for patients with subacromial pain was effective and reduced the need for surgery with maintained results after 10 years.

👉🏻 This is from the new paper "No need for subacromial decompression in responders to specific exercise treatment: a 10-year follow-up of a randomized controlled trial" by Petersson et al 2025

Disclaimer: Sharing a study is NOT an endorsement. You should read the original research yourself and be critical.

—---------

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09/05/2026

🧠 “Older adults don’t adapt to strength training like younger people”→ The new evidence says otherwise.

A new study by Antonio Casolo et al. (2026) showed that ageing does NOT eliminate the nervous system’s ability to adapt to strength training.

Using high-density surface EMG, researchers tracked the SAME motor units before and after 4 weeks of intensive isometric strength training.

What did they find?
✅ Older adults significantly increased strength
✅ Higher motor unit discharge rates after training
✅ Increased persistent inward currents (PICs)
✅ Neural drive enhancement was strongly linked to force improvements

Yes, adaptations were somewhat attenuated compared with younger adults.But importantly:

🚨 The ageing nervous system remained highly trainable.

For physiotherapists and rehabilitation clinicians, this matters.

Too often, older adults are approached with low expectations, overly cautious loading, or assumptions that weakness is simply “inevitable ageing.”

This paper reminds us:
💡 Older nervous systems still respond to challenge, overload, and meaningful strength training.

👀 Perhaps the question is not:
👉“Can older adults adapt?”

👀 But rather:
👉 “Are we giving them an adequate opportunity to adapt?”

Casolo A. et al. (2026)“Ageing does not impair motor neuron adaptations: comparable motor unit responses to strength training in young and older adults.”

Disclaimer:
👉 Sharing a study is NOT an endorsement.
👉 You should read the original research yourself and be critical.

04/05/2026

⚠️ Skip the car? 🚘 🤷‍♂️

Active commuting and coronary atherosclerosis 🚴‍♂️ ❤️

NEW ⬇️

https://bit.ly/49cche1

18/04/2026

Public notice.

Phones with Satellite texting are NO replacement for a Personal Locator beacon.

If you activate this SOS phone feature with Satellite reception it will put you in contact with a completely different Country! The Netherlands / Apple phone centre. Not the New Zealand Rescue Coordination Centre.
If your life is threatened in the mountains don’t expect to be rescued in any timely fashion pressing this.

Please carry and use a PLB.

15/04/2026

This is how misinformation creeps back in.

In February, a paper dropped in Menopause Journal with a very reasonable title:
“Health Outcomes of Hormone Therapy Initiated or Continued After Age 65.”

I read it and immediately thought:
Watch—this will be used against women.

And here we are.

Because when you actually read the study, here’s the problem:
👉 They didn’t study the hormones.

No data on:
– what formulation
– what dose
– what route (oral? transdermal?)

Let that sink in.

We’re talking about completely different medications being lumped together and conclusions being drawn as if they’re the same thing.

That’s not science.
That’s noise.

So I co-authored a letter with a breast oncologist and menopause specialist Dr. Linda Bosserman to say what needed to be said clearly:
You cannot make meaningful claims about hormone therapy without knowing the actual therapy.

And yet… studies like this get picked up, simplified, and used to reinforce fear.

This is how women lose access.
This is how clinicians get confused.
This is how progress gets rolled back.

We’ve spent decades trying to bring nuance to hormone therapy:
Individualized care.
Risk stratification.
Route matters.
Dose matters.

Details matter.

And when those details are missing?
The conclusions shouldn’t stand.

I’ll keep saying it:
Bad data doesn’t just sit quietly—it causes harm.

If you want the full breakdown (and what the study actually means for you), it’s in today’s Substack.