The human body is either in a state of growth or decay.
I think it’s safe to say the majority of functional fitness coaches and trainers have seen the recent, and misinformed, news “story” where some orthopedic surgeons told people over 50 that they shouldn’t do some common exercises after 50. Pull-ups, push-ups, weighted squats, and deadlifts were victims of the list. This claim represents the tradition of orthopedic and medical practices for decades. But we’re over here wondering what sports medicine journals these doctors have read over the past 20 years. Because they aren’t keeping up with the times. Senior fitness programs are proven to be essential for maintaining an independent life as we age.
Our bodies are designed to either improve as the result of new challenges or to atrophy, preserving energy, when these challenges are no longer present. It is not adequate to simply exercise when you’re young or have an active job. Your body quickly forgets how to perform these tasks when they’re no longer required.
When everyday tasks become difficult, loss of independence is inevitable.
The negative effects associated with aging largely involve the decline of muscle mass and functional capacity. This means losing the ability to perform every day tasks of living with ease. Activities like going up stairs, getting in and out of a chair, and carrying laundry baskets or groceries in from the car can become difficult or nearly impossible. When nearly all of these activities require assistance, people greatly increase their risk of losing independence and transitioning to a long-term care facility.
How do we get to that point? I’ve never met a single person who is excited about the prospect of ending up in a nursing home. Or being disabled. In the fitness industry, we tell able-bodied adults to “train for life” all the time. We encourage people who’ve lived sedentary lifestyles to get off the couch and exercise so they can keep up with their kids. And we know that moderate exercise is a huge benefit for people’s quality of life.
It’s mind-boggling to me that we see these benefits of exercise through childhood, young adulthood, and middle-age. Then we turn around and create an arbitrary age where we suddenly stop training for life and act in fear of disability or death. When the very things we’re avoiding out of fear can help prevent or reverse the symptoms of old age.
We create an arbitrary age when we stop training for life and act in fear of death; but the activities we start to avoid can actually prevent or reverse the symptoms of old age.
Though we’re making great strides in the right direction, many doctors and allied health professionals continue to recommend low-intensity exercise programs for individuals over the age of 50. For the better part of the 20th century, medical professionals assumed, at a certain age, our muscles stopped responding to stimuli from exercise. The idea was: if you haven’t started exercising by the time you’re in your 30’s, there’s no point in starting now.
Thankfully, this left some doctors scratching their heads at the logic, and they set out to prove common practice wrong. We see evidence of the benefits of exercise in the lives of our friends, family, and patients every single day. Their research did not disappoint.
Older folks experience the same improvements in strength from exercise as young people do.
Spoiler alert: every single study shows older adults are able to increase muscle mass and functional capacity when introduced to a progressive strength program. And there is no upward age limit. In 1990, Fiatarone et. al. studied nursing home residents between the ages of 90 and 99. They found an average size increase in thigh muscles by 174% and nearly 50% increase in gait speed after only 8 weeks of resistance training. That’s not the most exciting thing about this study. These results mirrored the improvements in muscle size of young adults starting a new exercise program.
This wasn’t a fluke either. Another study by Liu and Latham, 2009, followed 6,700 participants. Each patient saw improvements in muscle size, strength, gait speed, and the ability to stand from a chair without assistance after they followed a high-intensity resistance exercise program.
High-intensity exercise programs increase functional capacity.
Many physicians and allied-health professionals continue to recommend low-intensity exercise programs. Their intentions are in the right place. It’s a general prescription that, in theory, reduces injury risk and is appropriate for all fitness levels. Typical programs include chair yoga, water aerobics, and ankle/wrist weights. They may be effective for those starting from a completely sedentary or disabled capacity. However, these programs are not sufficient to drive physiologic changes after a very short period of time. Just because they need to start with 2 lb dumbbells, older adults shouldn’t stop there.
The American College of Sports Medicine recommends high-intensity resistance exercise training for older adults. Programming should focus on improving muscle strength and endurance, balance, flexibility, and cardiovascular endurance. As a coach, these should sound familiar as they are the same key components of training for all athletes.
Core components of fitness are applicable at all ages.
We need to consider normal training concepts such as frequency, intensity, and exercise selection when programming for older adults. It is also important to account for health concerns such as arthritis or heart disease. Proper movement patterns are crucial to avoid injuries at all ages but even more so as we get older. Therefore, supervision is encouraged during exercise.
This being said, the rate of catastrophic injury or cardiac event during exercise is no higher than their occurrence during normal daily activities. There is no need to be intimidated by high-intensity training. Intensity is always relative and can be managed with proper programming.
Programming guidelines for older adults.
Programming for senior fitness classes is pretty straightforward. People respond best to a program when they participate consistently. ACSM recommends a 30 minute to hour-long session two to four times per week. Ideally, these should occur every other day and involve all major muscle groups. Delayed onset muscle soreness can affect all age levels, but older adults have a reduced capacity to recover between training sessions. This buffer day can help manage soreness and keep your clients motivated.
Compound exercises are highly encouraged, as functional exercises are proven to help reduce the need for daily task modifications, per Manini et. al, 2007. It’s easy to see how exercises like deadlifts, farmer carries, and step-ups mimic our everyday life. Taking a laundry basket upstairs, getting on the floor with our kids, and sitting down to a toilet without assistance are things we take for granted now. But they are of utmost importance to our quality of life as we age.
Use your best judgement when it comes to exercise selection. Functional exercises may be ideal and can be scaled to nearly every level of ability. But some clients may come to you with some level of disability that may require use of machines or those light ankle weights to overcome.
Managing intensity without maximum effort.
There are two different times when an individual is at higher risk for injury, regardless of age. The first is when first starting a new exercise routine. We combat this in all our athletes with diligent and knowledgeable coaching. The second situation is when we are familiar with these movements and pushing ourselves to true maximum effort. When we’re younger, we might decide the pride of deciding just how much we can actually deadlift might outweigh the risk of injury. As we age, our focus shifts to being as mobile as possible. A major injury could require surgery. Surgery comes with increased risks and more downtime – exactly what we’re trying to avoid.
Intensity, in regards to resistance training, differs depending on the maximum amount of weight one can lift. It is a crucial component in creating neuromuscular adaptation to exercise. Most studies show older adults increase their strength when working with 65-75% of their one rep max. They also show older individuals can tolerate loads of 80+% in moderation. So, how do you determine how to come up with those numbers without testing a maximum effort lift?
Estimating a One-Rep Max
If an athlete is able to perform 18-32 repetitions at a given weight before fatiguing, this weight is estimated to be 60% of their 1RM. At 8-15 repetitions, we estimate 80%, and, at 4-12 repetitions, we’re looking at 90% effort. Using these numbers, we can gradually challenge our athletes with appropriate sets and reps at <60%, 60-69%, 70-79%, and then 80+% over the course of 4 weeks. Now, what constitutes as maximum effort can have quite a range. You may have a client come in who can use a lightly weighted barbell after some technique coaching. Another client may fatigue after 10 reps of TRX-assisted squats to a chair. Wherever their baseline, gradually increase their intensity appropriately.
Resistance training is an important tool to prevent and correct age-related muscle loss and weakness.
Progressive-overload resistance training has no match when combatting the atrophy and disability that can occur with age. A well-designed program improves both the nervous and musculoskeletal systems which dramatically improve muscle mass and strength. Our bodies are only designed to thrive when they are regularly forced to adapt to new challenges. The most common senior citizen exercise programs do not do enough.
Medical professionals have come around to the scientific consensus over the past few decades. More and more recommend resistance training as the primary treatment for early stages of muscle loss and decreased functional capacity. Compliant programs are needed to accommodate this growing demand, and that’s where your gym comes in. There are a few special considerations for older clients, but they’re not much different from your average members now. We all work out to be better at this thing called life. This shouldn’t stop being our goal just because one qualifies for Medicare.
You might also like:
- Use it Or Lose It: Exercise After 60
- Coaching Seniors in Functional Fitness
- Is Your Workout Causing Shoulder Pain?
Fiatarone, Maria A., and William J. Evans. “The Etiology and Reversibility of Muscle Dysfunction in the Aged.” Journal of Gerontology, vol. 48, no. Special_Issue, Jan. 1993, pp. 77–83., doi:10.1093/geronj/48.special_issue.77.
Law, Timothy D, et al. “Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia.” Chronic Obstructive Pulmonary Disease: Open Access, vol. 02, no. 02, 2017, doi:10.21767/2572-5548-c1-003.
Manini, T., et al. “Efficacy of Resistance and Task-Specific Exercise in Older Adults Who Modify Tasks of Everyday Life.” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, vol. 62, no. 6, Jan. 2007, pp. 616–623., doi:10.1093/gerona/62.6.616.
“Progressive Resistance Strength Training for Improving Physical Function in Older Adults (2009).” Australasian Journal on Ageing, vol. 29, no. 2, 2010, pp. 98–98., doi:10.1111/j.1741-6612.2010.00435_1.x.