{"id":622997,"date":"2026-06-05T17:04:13","date_gmt":"2026-06-05T17:04:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/622997\/"},"modified":"2026-06-05T17:04:13","modified_gmt":"2026-06-05T17:04:13","slug":"im-an-over-50s-physio-the-five-midlife-aches-you-should-never-ignore","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/622997\/","title":{"rendered":"I’m an over-50s physio – the five midlife aches you should never ignore"},"content":{"rendered":"

\u2018There\u2019s a deeply embedded cultural narrative that says pain, stiffness and declining function are inevitable parts of getting older<\/a>,\u201d says Will Harlow, a physiotherapist specialising in treating the over-50s. \u201cThey\u2019re not. They\u2019re common, yes \u2013 but common and inevitable are very different things.\u201d<\/p>\n

Mid-lifers misunderstanding this is something he sees \u201cevery single week\u201d in clinic. \u201cThe problem is when people write off pain or restriction as \u2018just ageing\u2019, they then stop moving, stop loading the affected area, and often start compensating around it \u2013 favouring one leg, avoiding bending, stopping activities they love.\u201d<\/p>\n

The effects of which spiral quickly. \u201cWhat might have been resolved with six weeks of targeted exercise instead becomes a year of worsening stiffness, reduced confidence and a growing list of things they \u2018can\u2019t do\u2019 any more.\u201d<\/p>\n

In his new book, Independence for Life<\/a>, Harlow focuses on five \u201cproblem areas\u201d which come up time and time again in his practice: the back, neck and shoulders, hips, knees and feet.<\/p>\n

\u201cThey\u2019re all load-bearing or high-use regions, absorbing enormous forces across a lifetime,\u201d he explains. \u201cAnd they\u2019re the areas most affected by the age-related, changes such as reduced muscle mass and changes in connective tissues.\u201d But, he adds, he chose to focus on these \u201cbecause they\u2019re all areas where the research overwhelmingly shows they respond to exercise<\/a> \u2013 meaning these are issues you can do something meaningful about\u201d.<\/p>\n

Here, Harlow shares everything you need to know about each of the problem areas, and what you can do to fix them for good.<\/p>\n

\"WillWill Harlow is a physiotherapist specialising in treating the over-50s (Photo: David Cummings)<\/p>\n

Back pain<\/p>\n

\u201cBack pain is almost universal \u2013 around 80 per cent of adults will experience a significant episode at some point in their lives \u2013 but it is also one of the most mismanaged conditions in medicine.<\/p>\n

\u201cThe key thing to understand is this: pain<\/a> does not equal damage. In fact, there is very poor correlation between what scans show and what people actually feel. We know from large studies that a significant proportion of people with bulging discs, \u2018wear and tear\u2019, and degenerative changes on MRI have no pain at all.<\/p>\n

\u201cWhat actually matters is restoring movement, building stability and gradually exposing the body to progressive strengthening. Bed rest \u2013 which was the medical approach for decades \u2013 is actively harmful because the spine needs movement to heal.<\/p>\n

\u201cFor anyone managing back pain, my core advice is to keep moving, don\u2019t fear the pain and start building strength in the muscles that support the spine. Specifically, the stabilisers around the spine \u2013 the glutes and core especially.<\/p>\n

\u201cMy go-to exercise recommendation for the back is called toe taps. It looks deceptively simple but is extraordinarily effective at building the deep spinal stabilisers without loading the spine<\/a>. Lie on your back, knees bent to 90 degrees. Slowly lift one leg, then the other, keeping your lower back pressed into the ground throughout. Then slowly drop one leg down until your toe touches the ground, then bring it back up. Return and repeat on the other side. Done correctly, this trains the pattern of bracing that transfers directly to everyday activities \u2013 getting up from a chair, lifting shopping, walking up stairs.<\/p>\n

\u201cFor anyone with chronic back pain, I\u2019d strongly recommend a physiotherapy assessment before any exercise programme. Not all back pain is the same, and there is no perfect exercise for everyone, so a precise diagnosis shapes the most effective treatment.\u201d<\/p>\n

\"TiredSore necks and shoulders are a common complaint (Photo: Kate Wieser\/Getty)<\/p>\n

Neck and shoulders<\/p>\n

\u201cAs a population, we have more neck and shoulder pain than ever. Sustained \u2018forward head\u2019 posture \u2013 from screens, phones, driving \u2013 puts a cumulative load on the neck and the muscles of the upper back and shoulders. For every inch the head moves forward from its natural position, the effective load on the neck approximately doubles. Most people\u2019s heads are two to three inches forward of where they should be.<\/p>\n

\u201cWhat I see clinically is the downstream effect: tight neck muscles<\/a> causing headaches, compressed facet joints [small joints in the spine] causing neck stiffness and referred pain into the arms, and chronically overloaded upper trapezius muscles that feel permanently knotted. None of this is just because of age, and all of it is addressable.<\/p>\n

\u201cThe key thing to understand is that the solution is not to endlessly stretch and massage these areas \u2013 though that can provide temporary relief. The solution is to strengthen the muscles that are chronically weak: the deep neck flexors, the lower trapezius, and the serratus anterior [one of the muscles controlling your shoulder blade]. These muscles are effectively \u2018switched off\u2019 in most people and need to be deliberately retrained.<\/p>\n

\u201cMy top exercise for neck pain is the chin tuck, which is probably the simplest and most evidence-backed intervention for pain in this region. Standing or sitting, gently draw your chin straight back, creating a \u2018double chin\u2019 position. Hold for five seconds, release, repeat 10 times. This directly activates the deep neck flexors<\/a> and counteracts the forward head pattern. Pair this with wall angels \u2013 standing against a wall, arms in a goalpost position, slowly sliding them up and down while keeping your back and arms in contact with the wall \u2013 and you have a powerful postural reset.\u201d<\/p>\n

\"\"Will has released a new book packed with advice <\/p>\n

Hips<\/p>\n

\u201cHip pain in over-50s falls into two broad categories: true hip joint pathology \u2013 usually osteoarthritis \u2013 and equally common but frequently misdiagnosed soft tissue problems, particularly gluteal tendinopathy, which is sometimes known as bursitis. The two require quite different management, which is why a proper assessment matters enormously.<\/p>\n

\u201cBut what almost everyone with hip pain shares, regardless of diagnosis, is weakness and underuse of the gluteal muscles. The glutes are the largest and most powerful muscle group<\/a> in the body, and they are almost universally underpowered in adults who sit a lot. Weak glutes shift load onto the hip joint itself, onto the iliotibial band [a thick band of tissue along the outside of the thigh], and onto the lower back. So strengthening the glutes is foundational for almost any hip presentation.<\/p>\n

\u201cPeople are often told to rest hip pain, particularly when a diagnosis of osteoarthritis or tendinopathy is made. This is frequently the worst advice they can receive. The hip joint \u2013 and the tendons around it \u2013 respond positively to appropriate loading. Tendon problems need progressive loading to stimulate tissue healing. Rest allows symptoms to settle temporarily, but the underlying capacity never improves, and symptoms return the moment activity resumes.<\/p>\n

\u201cOne of my top exercises for hip health is the single-leg glute bridge. Lying on your back with knees bent, lift one foot off the floor and drive your hips upward through the heel, squeezing the glute at the top. This isolates the gluteus maximus<\/a>, and the single-leg component adds an element of stability training. Start with three sets of 10 on each side and progress by increasing the range of motion and eventually adding load. The two-footed bridge \u2013 keeping both feet on the floor as you drive your hips upwards \u2013 is a good substitute for anyone who can\u2019t do the single-leg version.<\/p>\n

\u201cAnyone with significant hip pain should also be evaluated for hip mobility \u2013 specifically rotation, which is often severely restricted with early hip arthritis \u2013 because restoring mobility and strength together produces far better outcomes than either in isolation.\u201d<\/p>\n

\"ManYou don\u2019t have to live with knee pain (Photo: Anastasiia Krivenok\/Getty)<\/p>\n

Knees<\/p>\n

\u201cKnee pain is what I probably see more than any other in our practice, and it is also the one where patients have been most poorly served by the traditional medical advice to rest it, take anti-inflammatories and avoid what hurts. That approach manages symptoms. It does not address the underlying cause, and it doesn\u2019t build the strength the knee needs to function well long-term.<\/p>\n

\u201cThe fundamental thing to understand about knee pain is that the knee joint is like a middle-manager \u2013 it gets problems from both above and below. It sits between the hip above and the foot below, and its health is heavily determined by what happens at those two joints.<\/a> Weak hips create a collapsing inward at the knee, and poor ankle mobility forces the knee to compensate in ways it wasn\u2019t designed for. This is why treating only the knee so often produces mediocre results.<\/p>\n

\u201cThe good news is that the evidence base for knee arthritis \u2013 which affects around one in five adults over 45 \u2013 is now clear: exercise is the most effective intervention available, outperforming both pain medication and knee replacement in quality-of-life outcomes for most patients.<\/p>\n

\u201cMy go-to exercise for knees is the sit-to-stand. Find a sturdy chair, then get up without using your hands. Then, take four seconds to return to the chair and repeat 10 times. This strengthens the quads that sit above the knee <\/a>and the glutes at the back of the hip.<\/p>\n

\u201cI also recommend step-ups onto a sturdy surface for those who can manage them: slow, controlled, single-leg loading that builds quad and glute strength without excessive compressive force on the knee joint.\u201d<\/p>\n

\"LegsTry calf raises to strengthen your ankles and feet (Photo: Tatiana\/Getty)<\/p>\n

Feet and ankles<\/p>\n

\u201cFeet and ankles are the most underappreciated region in the whole system, and the consequences of ignoring them affects the entire chain. The foot is a complex structure of 26 bones, 33 joints and over 20 muscles \u2013 and it is the only part of the body in constant contact with the ground. What happens there shapes everything above it.<\/p>\n

\u201cThe two things I see most commonly are plantar fasciitis \u2013 a painful condition at the base of the heel that can make the first steps of the morning genuinely agonising \u2013 and ankle joint problems, often the legacy of old sprains that were never properly rehabilitated.<\/a> Both respond very well to physiotherapy but are highly neglected because people either assume they\u2019ll resolve on their own or wear orthotics [supports or braces] as a permanent fix rather than addressing the weakness.<\/p>\n

\u201cThe intrinsic muscles of the foot \u2013 the small muscles inside the foot itself \u2013 are almost universally weak in anyone who has spent decades in supportive footwear. The arch of the foot is a dynamic structure designed to load and spring back. When these muscles are weak, the arch collapses, the plantar fascia is overloaded, and every step transmits abnormal forces up into the ankle, knee and hip.<\/p>\n

\u201cThe most important exercise I prescribe for foot health is the short foot exercise. Sitting or standing, try to shorten the foot from toe to heel \u2013 creating an arch without curling the toes. This activates the intrinsic foot muscles directly and is the foundation of any serious foot rehabilitation programme.<\/a><\/p>\n

\u201cFor plantar fasciitis specifically, the evidence strongly supports calf raises done on the edge of a step \u2013 both double-leg and single-leg \u2013 performed slowly with a three-second lowering phase. This progressively loads the plantar fascia, calf and Achilles tendon, stimulating tissue healing that helps to resolve the condition effectively.<\/p>\n

\u201cGoing barefoot on varied surfaces when safe to do so, also provides the stimulation the foot needs to restore its natural function, though make sure to build up gradually. The foot was designed to move and most of us have spent a lifetime preventing it from doing exactly that.\u201d<\/p>\n

\u2018Independence for Life<\/a>\u2019 by Will Harlow is out now (Hay House, \u00a318.99)<\/p>\n","protected":false},"excerpt":{"rendered":"\u2018There\u2019s a deeply embedded cultural narrative that says pain, stiffness and declining function are inevitable parts of getting…\n","protected":false},"author":2,"featured_media":622998,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[46],"tags":[5079,1167,6647,102,23050,12719,159976,56,54,55],"class_list":["post-622997","post","type-post","status-publish","format-standard","has-post-thumbnail","category-fitness","tag-ageing","tag-exercise","tag-fitness","tag-health","tag-iweekend","tag-physical-exercise","tag-physiotherapy","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/622997","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=622997"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/622997\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/622998"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=622997"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=622997"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=622997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}