VO2max Testing in Calgary: What Your Number Actually Means (And Why It’s Not Just for Elite Athletes)

Carla Robbins

Pain Flare-Ups Don't Mean You're Getting Worse

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Introduction: The Number That Could Change How You Train

Most people have heard the term VO2max — usually in the context of elite runners, pro cyclists, or Olympic athletes. It sounds clinical. Complicated. Like something only serious competitors need to worry about.

But here's the truth: VO2max testing is one of the most actionable things any active person can do, regardless of your sport, age, or fitness level.

At Vital Performance Care in Calgary, our exercise physiologists use VO2max testing as a cornerstone of performance assessment — not to rank athletes, but to help real people train smarter, recover better, and understand their bodies in a way that generic fitness programs never could.

If you've been training hard but not seeing results — or if you want to stop guessing and start knowing — VO2max testing might be exactly what's been missing.

Want to know your number? BOOK A VO2MAX ASSESSMENT AT VITAL

What Is VO2max — Really?

VO2max stands for maximal oxygen uptake — the maximum rate at which your body can consume oxygen during intense exercise. It's measured in millilitres of oxygen per kilogram of body weight per minute (mL/kg/min).

In simple terms: it's a measure of how efficiently your cardiovascular and muscular systems work together under maximum effort.

Why Does It Matter?

VO2max is widely considered the gold standard measure of cardiorespiratory fitness. Here's why it matters beyond elite sport:

It predicts long-term health outcomes — higher VO2max is associated with lower risk of cardiovascular disease, type 2 diabetes, and all-cause mortality
It tells you how you're actually adapting to training — you can train for months without knowing if your cardiorespiratory system is improving. VO2max gives you an objective answer
It helps personalize your training zones — generic heart rate zones are estimates. VO2max-derived zones are tailored to your physiology
It reveals performance limiters — if your VO2max is high but your performance is lagging, the bottleneck is elsewhere. This is incredibly useful information

What the Test Actually Involves

At Vital Performance Care, a VO2max test typically involves:

The Protocol

Equipment fitting: You'll wear a specialized breathing mask connected to a metabolic analyzer. We can do the test on a treadmill or a cycle ergometer (bike).
Graded exercise protocol: You'll exercise on a treadmill or cycle ergometer, starting at a comfortable intensity and increasing gradually every few minutes
Data collection: The analyzer tracks your oxygen consumption, carbon dioxide production, ventilation, and heart rate in real time
Results and interpretation: Your exercise physiologist will walk you through your data — VO2max score, ventilatory thresholds, heart rate response, and training zones

How Long Does It Take?

The exercise protocol itself is typically 10–20 minutes. With warm-up, briefing, and results discussion, plan for 60–75 minutes total. The test is safe for the vast majority of healthy adults.

Who Should Get VO2max Tested?

Runners and Endurance Athletes

If you're training for a 5K, half marathon, marathon, or ultramarathon in Calgary, VO2max testing tells you where your ventilatory thresholds fall — critical for pacing strategy — and whether your aerobic base is the limiting factor.

Anyone Who Has Hit a Wall in Training

You've been consistent. You're logging the hours. But your pace, your lifts, your times — they've plateaued. A VO2max test can reveal whether your aerobic system is the bottleneck, or confirm that it's something else entirely.

People Returning from Injury

After a significant injury or time off, it can be hard to know where you actually are fitness-wise. VO2max testing gives you an honest baseline so your return-to-sport progression is data-driven, not guesswork.

Health-Conscious Adults Over 40

Cardiorespiratory fitness declines with age, but it's highly trainable. Many of our clients in their 40s, 50s, and 60s use VO2max testing as part of a broader longevity strategy — understanding where they stand and tracking their progress over time.

What Your Number Tells You (and What It Doesn't)

Age	Aerobic Fitness	Male VO₂max (ml/kg/min)	Female VO₂max (ml/kg/min)
15–19	Excellent	>57.4	>49
	Very Good	52.4–57.3	43.7–48.9
	Good	48.8–52.3	39.5–43.6
	Fair	43.6–48.7	36.8–39.4
	Poor	<43.6	<36.8
20–29	Excellent	>55.6	>47.2
	Very Good	50.6–55.5	42.0–47.1
	Good	47.2–50.5	37.8–41.9
	Fair	41.6–47.1	35.0–37.7
	Poor	<41.6	<35.0
30–39	Excellent	>48.8	>45.4
	Very Good	45.4–48.7	40.1–45.3
	Good	40.1–45.3	36.0–40.0
	Fair	33.7–40.0	33.0–35.9
	Poor	<33.7	<33.0
40–49	Excellent	>47	>40
	Very Good	42.7–46.9	35.1–39.9
	Good	35.5–42.6	31.9–35.0
	Fair	31.9–35.4	27.1–31.8
	Poor	<31.9	<27.1
50–59	Excellent	>41.8	>36.6
	Very Good	36.5–41.7	34.0–36.5
	Good	30.1–36.4	31.0–33.9
	Fair	26.0–30.0	24.6–30.9
	Poor	<26.0	<24.6
60–69	Excellent	>38.4	>35.8
	Very Good	32.8–38.3	32.8–35.7
	Good	28.7–32.7	29.6–32.7
	Fair	23.5–28.6	23.5–29.5
	Poor	<23.5	<23.5

Adapted from from Canadian Society for Exercise Physiology (2019). CSEP Physical Activity Training for Health (CSEP-PATH) Resource Manual (2nd ed.). If these differ from your health benefit ratings on other pages of this report, just know that there are slightly different scoring systems.

Note: Norms vary by age. An exercise physiologist will interpret your score relative to your age and goals.

Importantly, VO2max alone doesn't explain everything. Two athletes with identical VO2max scores can have very different performances based on lactate threshold, running economy, strength, and pacing strategy. This is why at Vital, we use VO2max as one piece of a larger performance picture — not the whole story.

How We Use VO2max Data at Vital Performance Care

What sets our approach apart isn't the test itself — it's what we do with the data.

Personalized Training Zones

Your results will map out precise training zones — Zone 1 through Zone 5 — based on your actual physiology, not population averages. This makes every training session purposeful.

Integration with Injury History and Clinical Care

Your exercise physiologist works alongside our physiotherapy and chiropractic team. If you've had a knee injury, Achilles issue, or history of overtraining, your VO2max results inform not just your training plan but how your clinical team supports your tissues through the process.

Longitudinal Tracking

A single test is valuable. Serial testing — every 3–6 months — is transformative. Tracking your VO2max over time tells you whether your training is actually working, and helps us adjust if you're not adapting as expected.

Ready to train with actual data behind you? BOOK WITH OUR TEAM HERE

The Bottom Line

VO2max testing in Calgary isn't reserved for Olympic hopefuls. It's for anyone who wants to understand their body, train with purpose, and make the most of the effort they're putting in.

At Vital Performance Care, our exercise physiologists use VO2max testing as part of a comprehensive approach to performance — one that connects your aerobic capacity data to your clinical care, your training, and your long-term goals.

Whether you're a seasoned runner, a weekend warrior, or simply someone who wants to train smarter as you age, we'd love to help you find your number — and know exactly what to do with it.

READY TO FIND OUT WHERE YOU STAND?

Book a VO2max assessment with the Vital Performance Care team in Calgary.
We'll assess your aerobic capacity, set your training zones, and build a plan around your goals.

→ BOOK NOW HERE

Or call us: (587) 834-2001 | info@vitalperformancecare.com

References

American College of Sports Medicine. (2022). ACSM's guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer.

Blair, S. N., et al. (1996). Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality. JAMA, 276(3), 205–210.

Kodama, S., et al. (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events. JAMA, 301(19), 2024–2035.

Myers, J., et al. (2002). Exercise capacity and mortality among men referred for exercise testing. New England Journal of Medicine, 346(11), 793–801.

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Introduction

"Oh, it's just part of getting older."

Cool, cool, cool. Except your shoulder used to work fine. You used to jump out of bed. You weren't rehabbing a new injury every other week. So no, this isn't just a normal part of aging, and it doesn't have to be something you just accept.

There's actually a clinical name for it: the musculoskeletal syndrome of menopause. It's our understanding of how the hormonal changes of perimenopause and menopause affect the musculoskeletal system, and how hormone therapy can be used to help treat these symptoms as part of a holistic approach to rehabilitation.

The same hormonal changes that cause our hot flashes, disrupted sleep, and make us not feel like ourselves are also directly impacting the tissue that lets you move: how your muscles repair themselves, how your joints handle load, how your tendons hold up over time, and how your bones maintain their density and strength.

This article breaks down what's actually happening in your body during perimenopause and menopause, why declining estrogen hits your musculoskeletal system so hard, and how a collaborative approach between hormone therapy and rehabilitation can improve your quality of life.

Not sure if hormones are behind your aches and pains?

A hormonal health consult with Pause Health can tell you whether hormonal changes may be part of the picture, and whether hormone therapy is appropriate for you. A movement assessment with Vital Performance Care tells you what's actually happening with your strength, mobility, and joints. The real answer often needs both.

Book a Hormone Consult with Pause Health

Book a Clinical Musculoskeletal Assessment with a Chiropractor or Physiotherapist at Vital Performance Care

What Is the Musculoskeletal Syndrome of Menopause?

The term was formally introduced in 2024 by orthopedic surgeon Dr. Vonda Wright and colleagues, in a review published in the journal Climacteric (Wright et al., 2024). It covers the cluster of musculoskeletal symptoms that show up as estrogen declines during perimenopause and menopause:

"Common doesn't mean normal, and it doesn't mean untreatable."

Why This Gets Missed

Imaging isn't always helpful here, and a normal scan doesn't mean nothing's wrong. It usually means a single joint in isolation isn't the whole story.

If you're in midlife dealing with shoulder pain, recurring tendon issues, stiffness, or a real drop in strength, the useful question isn't just "what's wrong with this joint." It's what else has changed:

All of it can be part of the same picture, and all of it is worth bringing up with your provider.

It's Not Only a Post-Menopause Problem

These changes often don't wait for your final period to show up. For a lot of women, this starts in perimenopause, while hormones are still fluctuating rather than non-existent. New stiffness, more frequent tendon flare-ups, muscle that's harder to maintain, an injury that seems to have come out of nowhere — these can all start years before menopause or the one-year anniversary of your last menstrual period.

That doesn't automatically mean hormones are the cause, but when it's happening alongside other perimenopause symptoms, it is worth considering the connection. Waiting until you're fully postmenopausal to start paying attention also means missing a window where building strength and addressing risk factors is a lot easier than trying to recover ground later.

How Estrogen, Progesterone, and Testosterone Affect Your Joints, Muscles, and Bones

Your musculoskeletal system is more hormone-sensitive than most people realize. Estrogen, progesterone, and testosterone receptors exist throughout your muscles, tendons, ligaments, cartilage, and bone. When those hormone levels shift, so does the health of every one of those tissues.

Estrogen: The Primary Driver

Estrogen plays several distinct roles that matter for your joints and muscles:

1) Muscle repair and growth.

Estrogen supports the satellite cells responsible for repairing and building skeletal muscle. As estrogen declines, muscle protein synthesis becomes less efficient, contributing to the accelerated loss of muscle mass and strength seen after menopause (Critchlow et al., 2023; Hansen, 2018).

2) Inflammation control.

Estrogen has anti-inflammatory effects on muscle and connective tissue. Lower estrogen is associated with higher baseline inflammation, which can show up as generalized aches, tendon irritation, and slower recovery from exercise.

3) Bone density.

Estrogen slows the rate of bone breakdown. Its decline is the single biggest driver of the rapid bone loss that happens around the final menstrual period, which is why osteoporosis risk climbs so sharply in this window (Karlamangla et al., 2021).

4) Collagen and connective tissue.

Estrogen supports collagen production in tendons, ligaments, and cartilage. Research measuring tendon tissue directly has found that postmenopausal women on estrogen therapy have higher tendon collagen synthesis rates than those who aren't (Hansen, 2018), meaning their tendons are literally better equipped for ongoing repair. This is part of why frozen shoulder and tendon injuries become more common in this stage.

Progesterone: An Underexplored but Meaningful Role

Progesterone gets far less research attention than estrogen when it comes to musculoskeletal health, but it isn't inactive. It has a calming effect on the nervous system that influences sleep quality and pain perception, and both poor sleep and heightened pain sensitivity make other MSK symptoms feel worse. That alone makes progesterone relevant to how you feel day to day.

There's also emerging research on progesterone's more direct role in connective tissue. Progesterone receptors have been identified in tendon tissue, and some research suggests progesterone may support collagen synthesis rates in muscle in postmenopausal women (Hansen, 2018). At the same time, animal studies have shown progesterone can increase the expression of relaxin receptors in ligaments and tendons, which theoretically could make tissue more responsive to joint-loosening effects, though this evidence is largely limited to rodent models rather than human studies. Put simply, the current research suggests progesterone has a mixed, tissue-dependent effect, and the science is still catching up to what's seen clinically.

What is well established is that progesterone works alongside estrogen rather than independently, and has anti-inflammatory properties of its own. So as progesterone declines during perimenopause, you're losing more than estrogen's protective effects — you're also losing progesterone's contribution to sleep, pain modulation, and inflammation control.

Testosterone: Relevant Beyond Libido

Testosterone is routinely mislabeled as a "male hormone," but women produce it throughout their lives and actually have more testosterone than estrogen, with levels declining gradually with age, often starting well before menopause itself.

Its best-established, evidence-based clinical use in women remains the treatment of low sexual desire (Davis et al., 2019). But that's not the whole picture. A 2023 systematic review of observational studies examining endogenous testosterone levels found associations between testosterone concentrations and muscle mass, strength, and physical performance in women (Taylor et al., 2023) — an area of research that has historically been underexplored. Testosterone contributes to muscle protein synthesis and strength, plus it's a motivation hormone, motivation to get up and go, to move, all of which are directly relevant to musculoskeletal health.

"If training effort has stayed consistent but the results haven't, testosterone is worth discussing with your provider — not just in the context of libido, but in the context of strength and function."

What You Can Actually Do About It: Hormone Testing, Physiotherapy, and Strength Training in Calgary

The musculoskeletal syndrome of menopause is treatable, and a lot of it is preventable with early intervention. Managing it well usually comes down to two things working together: an accurate picture of your hormones, and a training approach suited to this new hormonal environment.

Start With a Hormone Consultation

A hormone consult can help put your symptoms and hormonal changes into context, including whether testing for estrogen, progesterone, and testosterone is appropriate for you. From there, your care team can use your symptoms, clinical history, and, when appropriate, lab results to guide treatment as you move through perimenopause and into postmenopause.

For women who are good candidates, current clinical guidance supports hormone therapy as a favourable option: for those under 60 or within 10 years of their final period, the benefit-risk balance generally favours symptom relief and bone protection (NAMS 2022 Hormone Therapy Position Statement Advisory Panel, 2022). However, if you are outside of that window, that doesn't necessarily mean you cannot safely take hormone therapy. This is where an individualized consultation is important, to help you understand your unique risk and benefit profile and determine whether hormone therapy is right for you.

Then Build a Body That Can Handle the Transition

Resistance training is one of the most effective tools available here. A 2024 systematic review and meta-analysis found consistent benefits of resistance training on strength, body composition, and physical function in healthy postmenopausal women (González-Gálvez et al., 2024). Strength training does what hormones alone can't:

Working with a physiotherapist, chiropractor, or strength coach who understands hormone-related musculoskeletal changes makes a real difference here. A generic program built for a 25-year-old's physiology isn't the right fit for a 48-year-old whose estrogen has dropped 40% in two years. Structured, joint-specific rehab — like shoulder, hip, or foot foundation programs — can be especially useful if you're already managing pain or an old injury and need to rebuild strength without aggravating it.

A Team Approach Works Best

Hormone health and musculoskeletal health aren't separate problems; they're the same problem viewed from two angles. That's the premise behind the partnership between Pause Health and Vital Performance Care: Pause Health handles the hormone side — testing, interpretation, and treatment where appropriate — while Vital Performance Care's physiotherapists, chiropractors, and strength coaches handle the movement side, building a program suited to what your body actually needs.

Conclusion

Joint pain, stiffness, muscle loss, and tendon injuries in your 40s and 50s are common. Common doesn't mean normal, and it doesn't mean untreatable. The musculoskeletal syndrome of menopause has a strong hormonal component, and understanding your estrogen, progesterone, and testosterone levels is often a key piece in explaining these changes. Paired with the right strength and rehab program, this is one of the more addressable parts of the menopause transition.

If you're in Calgary and dealing with new aches, stiffness, or strength loss that started around perimenopause, it's worth investigating rather than waiting. Get your hormones tested, get assessed, and build a plan suited to where your body actually is.

Book a Hormone Consult with Pause Health

Book a Clinical Musculoskeletal Assessment with a Chiropractor or Physiotherapist at Vital Performance Care

About the Author

Shelby Sheppard, BN, MN, FNP-C

Shelby Sheppard, BN, MN, FNP-C, is a Nurse Practitioner and the founder of Pause Health (pausehealth.ca), a virtual hormone and sexual health clinic based in Calgary, Alberta. Her practice focuses on hormone health, sexual medicine, and evidence-based menopause care.

Shelby is a community partner of Vital Performance Care, and the practitioners at Vital refer to and rely on Shelby to co-manage complex client cases with.

References

Critchlow, A. J., Hiam, D., Williams, R., Scott, D., & Lamon, S. (2023). The role of estrogen in female skeletal muscle aging: A systematic review. Maturitas, 178, 107844. https://doi.org/10.1016/j.maturitas.2023.107844

Davis, S. R., Baber, R., Panay, N., Bitzer, J., Cerdas Perez, S., Islam, R. M., Kaunitz, A. M., Kingsberg, S. A., Lambrinoudaki, I., Liu, J., Parish, S. J., Pinkerton, J., Rymer, J., Simon, J. A., Vignozzi, L., & Wierman, M. E. (2019). Global consensus position statement on the use of testosterone therapy for women. Climacteric: The Journal of the International Menopause Society, 22(5), 429–434. https://doi.org/10.1080/13697137.2019.1637079

González-Gálvez, N., Moreno-Torres, J. M., & Vaquero-Cristóbal, R. (2024). Resistance training effects on healthy postmenopausal women: A systematic review with meta-analysis. Climacteric: The Journal of the International Menopause Society, 27(3), 296–304. https://doi.org/10.1080/13697137.2024.2310521

Hansen, M. (2018). Female hormones: Do they influence muscle and tendon protein metabolism? The Proceedings of the Nutrition Society, 77(1), 32–41. https://doi.org/10.1017/S0029665117001951

Karlamangla, A. S., Shieh, A., & Greendale, G. A. (2021). Hormones and bone loss across the menopause transition. Vitamins and Hormones, 115, 401–417. https://doi.org/10.1016/bs.vh.2020.12.016

NAMS 2022 Hormone Therapy Position Statement Advisory Panel. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028

Taylor, S., Islam, R. M., Bell, R. J., Hemachandra, C., & Davis, S. R. (2023). Endogenous testosterone concentrations and muscle mass, strength and performance in women, a systematic review of observational studies. Clinical Endocrinology, 98(4), 587–602. https://doi.org/10.1111/cen.14874

Tehalia, M. K., Agarwal, S., Lalwani, A., & Sharma, S. (2026). Estrogen deficiency in menopause: A major contributor to cartilage degeneration and osteoarthritis: A systematic review and meta-analysis. Journal of Menopausal Medicine, 32(1), 18–29. https://doi.org/10.6118/jmm.25141

Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472. https://doi.org/10.1080/13697137.2024.2380363

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