This week I want to talk about another pattern I keep seeing: women in their 40s and 50s feeling like they are training hard (the sweat is dripping, the steps are clocking) but still feeling like something big is "off". Or, women in their 60's getting big wake up calls with sudden bone breaks, achy joints, and injuries that keep creeping up.

Low energy. Tendons that flare up out of nowhere. Weight creeping on despite feeling like patterns have not changed. Sound familiar?

These aren't signs you're doing something wrong. They might be signs your body is going through one of the biggest physiological shifts it'll ever experience - and your training hasn't caught up yet.

This one covers a lot of ground. Skim for the golden nuggets if you're short on time.

YOUR BONES ARE CHANGING. MOST WOMEN FIND OUT TOO LATE.

I recently sat down with Leah Kaluta - a researcher at the University of Calgary who studies peri- and early postmenopausal women - and our kinesiologist Renee Braddick, to plan an upcoming seminar on this topic. The conversation blew me away, and I want to share some of what we discussed.

Leah is involved in a study called STOP-EM (Strength Training for Osteoporosis Prevention during Early Menopause) - a randomized controlled trial looking at high-intensity resistance and impact training in perimenopausal and early postmenopausal women aged 45–60. The pilot data showed 1–2% increases in bone mineral density with this type of training. That might not sound like much, until you realize that without intervention, women can lose 1–2% of bone density per year during the menopausal transition.

This is crazy: Doctors in Canada WON'T order you a DEXA scan until age 65/70 unless you experience a fragility fracture (they won’t give a requisition even if you ask)! In which case it may be too late - as significant bone loss will have already occurred. Leah's research suggests that early intervention - especially heavy resistance training - may be the single most impactful thing you can do to protect your bones during this transition. The key word is early.

How you should approach this: Strength training first, everything else second. One of the things Leah cautioned against is trying to do it all at once - stacking HIIT, sprint work, and heavy lifting on top of each other too quickly during perimenopause. The hormonal environment is already volatile. Her recommendation: establish a consistent strength training pattern first, then layer in conditioning gradually. Otherwise you risk burnout, elevated cortisol, and paradoxically - weight gain.

Tendon issues might not be a coincidence. If you're in your 40s and suddenly dealing with tendinopathies (like me!) you've never had before (Achilles, rotator cuff, lateral elbow), you're not alone. Leah flagged this as one of the most common issues in the peri-menopausal demographic. Hormonal changes affect tendon health directly - which makes proper mechanics, progressive loading, and recovery even more important during this stage. (If you read last week's newsletter on tendons, this will connect some dots.)

Supplements that could help: Leah highlighted emerging evidence on supplementation that could help peri and post menopausal women - but we will be covering that in our seminar..... read on!

There's a lot more we covered - including what the research says about protein timing, collagen supplements (spoiler: Leah's skeptical), and how to categorize where you actually are in the menopausal transition if you're on an IUD. I'm intentionally not giving it all away here, because...

We're running a live seminar on this. And there are only 3 spots left as I write this email.

Training for Peri/Post Menopause - led by Renee Braddick, with research contributions from Leah Kaluta June 16, 2026 | 9:30 – 11:00 AM | In-person at Vital Performance Care inside Eau Claire Athletic Club

This is a small-group, interactive session where you'll get specific guidance on how to adjust your training, what to prioritize, and what the research actually supports. Not generic advice — the kind of conversation you'd have with a researcher and a kinesiologist who specialize in this.

​Reserve Your Spot​

Can't make a morning session? Renee is considering running an evening session later this summer or fall - reply to this email and let us know if you'd attend an evening one instead, and we'll make it happen.

BFR TRAINING: WHY WE JUST ADDED INDIVIDUALIZED CUFFS TO THE CLINIC

If you've been in a physio or rehab setting in the last few years, you may have heard of Blood Flow Restriction (BFR) training. The idea: wrap a pneumatic cuff around the top of your limb, partially restrict blood flow, and train at low loads (20–30% of your max) while getting strength and hypertrophy responses closer to what you'd see with heavy lifting.

It sounds gimmicky. It's not. The research base is now substantial, and we recently invested in AirBands BFR cuffs - individualized, autoregulated systems designed by sport scientist Dr. Mike MacPherson - to add this tool to our rehab and training arsenal.

Why individualized cuffs matter

Here's the problem with most BFR: fixed pressures. Slap 150 mmHg on everyone regardless of limb size, body composition, or blood pressure, and you get wildly inconsistent results - too much restriction for some, not enough for others.

The 2026 standard is percentage-based arterial occlusion pressure (AOP). A recent study in Frontiers in Physiology used 80% of individually measured AOP for BFR training, and a 2026 study in Medicine & Science in Sports & Exercise compared absolute (100 mmHg) vs. relative (80% AOP, ~128 mmHg) pressures, finding meaningful differences in the cardiovascular response. Fixed pressure is out. Individualized is in.

A comprehensive 2025 review on evolving BFR training confirmed that individualized cuff pressure based on AOP is now strongly recommended for both clinical and research applications, and that body position and cuff size meaningfully influence your occlusion pressure — another reason cookie-cutter setups fall short.

Who is this for?

BFR is particularly valuable for people who can't load heavy right now - early-stage post-surgical rehab, tendinopathies where heavy loading isn't tolerated yet, or older adults who need to build strength without the joint stress of heavy resistance training. It's not a replacement for getting strong. It's a bridge.

Try it out: We rent AirBands cuffs for $20/week if you're in an early-stage rehab situation and want to use them during your own workouts. Please reply here if you're interested in learning more.

GOLDEN GRIPS x VITAL: A NEW PARTNERSHIP FOR HAND + WRIST FOUNDATIONS

Speaking of grip... we've been building Hand + Wrist Foundations behind the scenes, and part of that process has been scanning for the best tools - both basic and advanced - to complement the program.

Enter Golden Grips.

We've partnered with Golden Grips to bring their equipment to our Hand + Wrist Foundations audience, and they've generously offered 10% off with code VITAL at checkout.

I want to specifically shout out their Forearm Finisher - a wrist extensor trainer that solves a problem most people don't realize they have. Think about a standard dumbbell wrist extension: you're trying to train your extensors, but the limiting factor is your flexors getting tired from gripping the dumbbell. You fail the grip before you fatigue the muscle you're actually trying to train. The Forearm Finisher places the load on the back of the hand, so you can progressively overload your extensors without grip being the bottleneck. There's really nothing else on the market that does this well. Ours arrives this week 😍

We've been testing it with Grant and Nick as we build the program, and it's become a staple in our exercise lineup.

10% off everything at goldengrip.com with code VITAL

Want a discount on our 12-week program once it comes out? Join the Hand + Wrist Foundations waitlist here →​

Questions? Reply to this email, we reply 100% of the time.

Yours in performance and care,

Carla & the Vital Performance Care team