Trish Trumper, RMT

03/04/2026

Tendon failure as … a drug side effect?

In early 2024, I partially ruptured my triceps tendon while doing something EXTREMELY athletic: standing up from my office chair. 🙄 Sheesh.

Reckless, I know. Ironically, I was standing up to do one of my many daily “movement snacks” — an injury prevention strategy!

Guess I should have stayed put.

I’m hardly alone. I’ve heard many stories of tendons that ruptured with little provocation: Stepped off a curb. Reached into the back seat. Caught a falling coffee mug. Sneezed hard.

Partial ruptures like mine are probably even more common, but often undiagnosed. It was less dramatic than a full rupture, of course, but I could feel it tearing, an awful sensation: a wet, shuddering GIVING WAY. It felt just like the last time I definitively tore some connective tissue (coracoclavicular ligament rupture, a sports accident in the mid 2000s). A memorable sensation.

I didn’t curse. I just groaned and rolled my eyes and sighed the sigh of the defeated. I have already endured so many insults like this, what’s one more? But perhaps I should have cursed, because it turned out that this injury was probably the tip of a much more disturbing iceberg.

THIS tendon tear was — drum roll please — quite possibly a DRUG SIDE EFFECT.

Say what now? Yes, you heard that right: tendon rupture as the side effect of a medication. A side effect which I had never heard of before, despite my expertise — despite even knowing about OTHER drugs that do this.

This is a complicated and fascinating topic, and I really went way down the science rabbit hole. NEW POST, a hefty one, about a 20-minute read, heavily referenced (some big footnotes), with a long audio version for members:

PainScience.com/blog/tendon-failure-as-a-drug-side-effect.html

~ Paul Ingraham, PainScience.com publisher

02/17/2026

🧠 What Was the LIFTMOR Study?

The *LIFTMOR* (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) trial was a scientific study done in Australia with postmenopausal women who had *low bone mass* (osteopenia or osteoporosis). The researchers wanted to see whether heavier strength training could help bones and overall physical strength, and whether it could be done safely.

👉 What makes this study special is that it challenged the usual idea that older women with weaker bones should *avoid* heavy lifting because of fear of injury.

💪 What They Did in the Study

Women in the main exercise group did:

* Twice-weekly supervised sessions
* ~30 minutes per session, for 8 months
* High-intensity resistance and impact training — which means heavier lifting with controlled movements and some impact activities (like jumps) done safely and with professional supervision.

Examples of exercises used in the study included (as part of a structured program):
• Deadlifts
• Overhead shoulder presses
• Squats
• Jump-type impact actions (e.g., controlled landings)
(all done with attention to safety and progression)

📊 What They Found

Compared with a control group doing *light home exercise*:

✔️ Bone density improved — especially at the spine and hip.
✔️ Strength and physical function improved — this means things like standing up from a chair, balance and power got better.
✔️ Posture improved, reducing forward-leaning spine posture.
✔️ Safety was excellent — no fractures or serious injuries happened when the sessions were supervised and technique was taught properly.

In simple terms: *stronger bones, stronger muscles, and better movement without added risk when done right.*

🌟 Why This Matters for Midlife Women

As women go through midlife and menopause, hormonal changes accelerate bone loss and reduce muscle strength. This raises the risk of falls and fractures later in life.

The *LIFTMOR* study shows that targeted strength training can be a powerful tool to:

✨ Keep bones stronger
✨ Maintain or improve muscle strength
✨ Better posture
✨ Help keep independence as you age

Importantly — it’s not about lifting *as heavy as possible* — it’s about the right progressions, technique, and supervision.

📣 Simple Exercises for Midlife Women

(*Always start at your level and ask a health professional if you’re not sure.*)

1. Squat Progression
• Sit–stand from a chair
• Then bodyweight squats
• Eventually weighted squats (with light dumbbells)

2. Hip Hinge / Deadlift Pattern
• Practice hip-hinge (bending forward at the hips, spine straight, then coming back to vertical) with no weight
• Progress to kettlebell or dumbbell deadlifts

3. Overhead Press Variations
• Start with light weights or resistance bands
• Gradually increase as strength improves

4. Step-ups or Small Controlled Jumps
• Use a low step for stability
• Focus on controlled landing and knee alignment

5. Core and Balance Moves
• Single-leg stand, single leg squat
• Planks or modified planks

👉 Start with 2 sessions a week, 20–30 minutes each, and increase slowly.

🏁 Bottom Line

Heavy-load strength training — when well taught and supervised — can be safe and effective for women in midlife and beyond.
It doesn’t just help muscles — it can *help your bones stay stronger too*.

[1]: https://academic.oup.com/jbmr/article-abstract/33/2/211/7605709?utm_source=chatgpt.com "High‐Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial | Journal of Bone and Mineral Research | Oxford Academic"
[2]: https://afterhoursphysio.com.au/can-lifting-weights-help-osteoporosis-the-surprising-science-behind-the-liftmor-study/?utm_source=chatgpt.com "Best Treatment For Osteoporosis | Home Physio Melbourne"

02/14/2026

𝗣𝗼𝘀𝘁-𝗲𝘅𝗲𝗿𝘁𝗶𝗼𝗻𝗮𝗹 𝗺𝗮𝗹𝗮𝗶𝘀𝗲 (𝗣𝗘𝗠) 𝗮𝗻𝗱 𝘁𝗵𝗲 𝗺𝘆𝘁𝗵 𝗼𝗳 𝗰𝗮𝗿𝗱𝗶𝗮𝗰 𝗱𝗲𝗰𝗼𝗻𝗱𝗶𝘁𝗶𝗼𝗻𝗶𝗻𝗴: 𝗿𝗲𝘁𝗵𝗶𝗻𝗸𝗶𝗻𝗴 𝘁𝗵𝗲 𝗽𝗮𝘁𝗵𝗼𝗽𝗵𝘆𝘀𝗶𝗼𝗹𝗼𝗴𝘆 𝗼𝗳 𝗹𝗼𝗻𝗴 𝗰𝗼𝘃𝗶𝗱

PEM is a hallmark feature of long COVID, affecting approximately 80% of patients (https://pubmed.ncbi.nlm.nih.gov/39694730/ ). It is characterized by a delayed exacerbation of symptoms following physical or cognitive activity that exceeds a patient's specific, often narrow, threshold. Crucially, these "crashes" are not merely temporary fatigue; they can persist for weeks or even result in a permanent decline in the patient's baseline health. Because of this risk, major health authorities like the WHO have cautioned against traditional graded exercise therapies for these individuals (https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2023.2).

📘In a brand-new publication, Charlton and colleagues (https://bjsm.bmj.com/content/early/2026/02/09/bjsports-2025-111387) debunk the deconditioning myth of long covid. While physical inactivity (deconditioning) can occur in chronically ill patients, the authors present evidence that it cannot explain the specific cardiac alterations seen in long COVID:

✅ Preload Failure: Many patients suffer from "preload failure," where the heart does not fill with enough blood—a phenomenon not typical of simple deconditioning.

✅ Structural and Inflammatory Changes: Research has identified myocardial scarring, inflammation, and "leaky" blood vessels in long COVID cohorts.

✅ Mitochondrial Dysfunction: There is significant evidence of deranged mitochondria and impaired oxygen extraction at the cellular level, suggesting an energy production failure rather than just a lack of fitness.

👫 A Human-Centered Approach to Rehabilitation

The authors emphasize that because long COVID is highly heterogeneous, treatment must be personalized and data-driven. They advocate for several specific strategies:

▶️ Systematic Screening: Healthcare providers should use tools like the DePaul Symptom Questionnaire to identify PEM early and distinguish it from other pathologies.

▶️ Heart Rate Pacing: Utilizing wearable monitors to stay within the "first ventilatory threshold" allows patients to remain within their "energy envelope," preventing the repetitive exposure to PEM events that can worsen their health.

▶️ Postural Management: For those with POTS or severe PEM, gentle upright postures, supported sitting, and compression garments are recommended to prevent skeletal muscle decline without triggering a crash.

▶️ Targeted Pharmacotherapy: The use of low-dose naltrexone, beta-blockers, or pyridostigmine may be necessary to reduce the symptom burden of PEM and autonomic dysfunction.

💡Ultimately, the paper concludes that cardiac alterations in long COVID are largely independent of deconditioning, and safe recovery requires moving away from historical exercise guidelines toward an individually tailored management strategy.

02/09/2026

On March 1, eligible menopausal hormone therapy and diabetes meds will be covered by the new National Pharmacare plan in BC 😊

“On March 6, 2025, the Province of B.C. and the Government of Canada signed an agreement for the implementation of national pharmacare in B.C., with the federal government providing up to $670 million in funding over three years. Under the agreement, 100% coverage for eligible diabetes medications, including for Type 1 and Type 2 diabetes, and hormone replacement therapy (HRT), now called menopausal hormone therapy (MHT), will begin in B.C. on March 1, 2026.

Expanded coverage for certain diabetes-related devices and supplies will begin on April 1, 2026.

Since B.C. already offers universal coverage of contraceptives, the Province is putting federal funding for contraceptives towards free treatment of menopausal symptoms.”

02/04/2026

Strength Training After 50: Simple Moves for Balance, Mobility & Fall Prevention

As a family doctor, I often remind patients that strength training is one of the most powerful tools we have to prevent falls and preserve independence as we age. You don’t need a gym or equipment to get started—just your body and a few minutes a few times a week.

Here are safe, beginner-friendly body-weight exercises for adults over 50:

1️⃣ Sit-to-Stand (Chair Squats)
• Sit in a sturdy chair, arms crossed or lightly on the armrests
• Stand up slowly, then sit back down with control
• Strengthens thighs and hips—key for getting up safely
➡️ Try 8–12 reps

2️⃣ Wall Push-Ups
• Stand arm’s length from a wall, hands on the wall at chest height
• Bend elbows and lower chest toward the wall, then push back
• Builds upper-body and core strength for daily tasks
➡️ Try 8–12 reps

3️⃣ Heel Raises
• Hold the back of a chair for balance
• Rise up onto your toes, then slowly lower
• Strengthens calves and ankles—important for balance
➡️ Try 10–15 reps

4️⃣ Standing Marches
• Hold a chair or counter if needed
• Lift one knee at a time, slowly and with control
• Improves hip strength and balance
➡️ Try 10 reps per side

5️⃣ Single-Leg Stance
• Stand near a counter or wall
• Lift one foot slightly off the ground
• Builds balance and fall resistance
➡️ Hold 10–30 seconds per side

How often?
Aim for 2–3 times per week. Start slow. Good form matters more than doing more.

Important reminders:
✔️ You should feel challenged, not in pain
✔️ Breathe normally—don’t hold your breath
✔️ If you have new pain, dizziness, or a history of frequent falls, check in with your doctor or a physiotherapist first

Bottom line: Strength training isn’t about “getting bulky”—it’s about staying steady, mobile, and independent for years to come.

Your future self will thank you 💪

01/28/2026

What is Making Sense of Pain: Online? Do you live with chronic pain? Making Sense of Pain: Online is a free nine-week program from Pain BC designed to empower you to improve your quality of life and well-being through pain education and social connection. The weekly 90-minute online group will be fa...

01/14/2026

How menopause affects arthritis

12/28/2025