Best Exercise for Aging Muscles: How to Maintain Strength and Mobility After 50 - Dr. Michael Ruscio, DC

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Best Exercise for Aging Muscles: How to Maintain Strength and Mobility After 50

Key Takeaways:

  • While resistance training specifically focuses on muscle growth, mobility training and cardio are good for aging muscles in some capacity.
  • Exercises for aging muscles have been shown to have health benefits including better sleep, mood, heart health, and cognitive function
  • Noticeable muscle decline begins for most people around age 50, so consistent exercise becomes essential to maintain skeletal muscle and mobility with further aging.
  • Precautions should be taken for older adults who are prone to dehydration, taking certain medications, or are otherwise more at risk of falling, but the overall benefits of exercise outweigh the risks in most people. 
  • Exercise can also have a social aspect that benefits older adults both physically and mentally.

Although it may look different than the fitness routine of a 20-year-old, exercise is even more important for older adults to practice and maintain. Just as much if not more than eating a healthy diet, working out can be an effective way to counteract and prevent common issues of aging, increase life expectancy, and lower mortality risk due to chronic disease [1, 2]. 

Additionally, exercises for aging muscles have been shown to have health benefits that extend to other areas of health besides just musculoskeletal, including better sleep, mood, heart health, and cognitive function [3, 4, 5, 6, 7, 8]. 

In this article, we’ll identify the best exercise for aging muscles, review resistance training, mobility exercises, and aerobic exercise, note precautions to take when training aging muscles, and what a weekly training schedule might look like for an older adult. 

A Timeline of Your Muscle Function as You Age

When I say “aging muscles,” what does that really mean? We’re all aging, of course, but after a certain point, it becomes necessary to take extra care with the types of exercise and recovery you’re doing to maintain good muscle function and mobility with aging. Here is a timeline of what your muscle function looks like as you age:

  • 20s: Muscle function and recovery are at their peak. This is when it’s important to build good exercise habits and make sure you’re getting enough protein.
  • 30s-40s: Muscle mass begins to decrease around age 30, at a 3–8% decline with each decade, and muscle mass is not as easy to maintain. However, most people are still quite mobile and are able to complete activities easily, provided they are getting enough rest and nutrition
  • 50s: Muscle cells continue to naturally decline during the aging process, even in athletes. The natural decline in hormone production (sex hormones like testosterone and estrogen, growth hormone, and thyroid hormones) can also affect muscle loss in both men and women, though estrogen loss makes women particularly vulnerable to fall risk and fractures.
  • 60s-70s: Muscle decline picks up roughly around age 60 [9]. In clinical research, “older participants” refers to those aged 65 and up, so this age group is more reflective of what constitutes “aging muscles.”
  • 80+: This population is at the highest risk for sarcopenia (muscle wasting) and loss of mobility. Often this is due to a lack of movement and a lower intake of nutrients as appetite declines with age. 

One of the biggest risks with aging is a condition called sarcopenia, a decline in muscular function due to the loss of skeletal muscle mass [10]. Sarcopenia is associated with the loss of aerobic capacity (your body’s ability to use oxygen efficiently), and can lead to increased risk of death, falls, osteoporosis, fracture risk, and disability. It significantly affects the activities of daily living like sitting, standing, hygiene, and eating. 

Sarcopenia affects 5–15% of people between the ages of 60–70, and jumps to 50% in those over the age of 80. Someone is considered frail when they have both sarcopenia and osteoporosis, significantly impairing their daily activities and increasing the risk of falls and other injuries. Lack of physical activity is the number one risk factor for developing sarcopenia and can hasten the above process [10, 11].

Best Types of Exercise for Aging Muscles

Now that we’ve looked at what happens to your muscles naturally as you age, let’s dig into the specific types of exercise that can support healthy muscle mass and prevent sarcopenia and other aging-related conditions. 

Some specific types of exercise for aging muscles include:

  • Weight training using dumbbells, kettlebells, or barbells
  • Bodyweight exercises such as squats, lunges, pushups, etc.
  • Walking
  • Yoga/stretching
  • Balance training, like Tai Chi

These are just a few examples, and we’ll get into the different categories of exercise these represent below. But in practice, all types of exercise are good for aging muscles — the best exercise is making sure you get some exercise at all. From there, you can optimize to prevent injury and build muscle, but you don’t have to overthink it. 

Resistance Training

Resistance training is the number one type of exercise that supports aging muscles. Resistance exercise is one of the best ways to combat fall risk and muscle wasting by building muscle strength and mass that helps to stabilize the body. It has the added effect of increasing bone density to counteract osteoporosis and fracture risk, making it particularly helpful for postmenopausal women [11, 12, 13, 14].

Resistance training can include weightlifting and bodyweight exercises, or any exercise that is specifically targeting muscle building. 

A 2021 meta-analysis found evidence that “integrated training” (resistance + balance + core) significantly reduced fall risk [15]. Resistance training was superior to other mobility training — Tai Chi, pilates, Ba Duan Jin — though all showed benefit.

A 2022 randomized controlled trial with 28 healthy, older adults found that three months of resistance training led to increased muscle strength and overall metabolism compared to the sedentary controls [12].

Ideally, you have experience with resistance training and are practicing it consistently well before the point where you really need it to combat muscle deterioration. But it’s never too late to start building the habit. If you are a complete beginner to resistance training in your 60s or beyond, you may want to work with a trainer or follow a regular exercise program catered to your fitness level. And don’t forget about getting enough protein!

Mobility Training

Mobility training is another type of exercise that supports healthy muscle function and retaining healthy movement patterns. Mobility training — which involves core strengthening, balance, and flexibility components — builds strength, lowers fall risk, and assists with activities of daily living like reaching, bending over, squatting, and lifting [16, 17, 18, 19]. 

As these activities become increasingly difficult with age, mobility training not only benefits aging muscles but overall quality of life. Older people are subject to lowered self-esteem when they have to lean on others to help them with daily activities of living, such as personal hygiene and daily movement. Increasing mobility through exercise is a great way to boost confidence and strength.  

Mobility exercises can also contain a strength training component, making it easy to simultaneously implement these two exercise modalities. Mobility exercises can include yoga, stretching, range of movement exercises, and balance training.

Preventing falls is important for reducing the risk of physical trauma, but has health effects that are even more far-reaching. Quality of life in older adults tends to drastically decline after a serious fall, while the risk of mortality goes up.

A meta-analysis of 88 randomized controlled trials with 19,478 participants found that exercise, as a whole, decreased fall risk by 21% in older populations. Balance training had the greatest risk reduction, as did regimens that were 3 hours per week, offering a 36% reduction in fall risk when combined [16]. 

This benefit also extended to those who had Parkinson’s (53% reduced fall risk) and cognitive impairment (45% reduction).

Aerobic Exercise

Lastly, it’s also beneficial to incorporate some aerobic exercise such as: 

  • Swimming
  • Walking
  • Golfing
  • Basketball
  • Cycling/ stationary bike
  • Tennis
  • Stair climbing
  • Rowing
  • Aquatics

These forms of exercise don’t build muscle as much as resistance training does, but they can help maintain muscle mass and promote better cardiac, respiratory, and metabolic health, which are also crucial to healthy aging [20, 21, 22, 23]. 

Many of these activities can also serve as a way to connect with others and be part of a community, which is a highly underrated yet essential part of healthy aging. 

Exercise Regimen for Older Adults

The American College of Sports Medicine (ACSM) recommends an exercise regimen for older adults should contain the following [24]:

  • Exercise 3–5 days per week
  • 20–60 minutes per session of aerobic activity
  • Resistance training 2–3 days per week
  • Exercise that engages major muscle groups
  • Flexibility training 2–3 days per week

So to simplify, this could look like a session with 20 minutes of aerobic exercise, 20 minutes of resistance training, and 20 minutes of flexibility or mobility exercises. Repeat three times per week. It doesn’t have to be difficult or complicated. You could also do shorter sessions and increase to 4–5 times per week if that’s more sustainable and habit-forming. Whatever you do, make it simple, fun, and consistent.

Take Caution When Training Aging Muscles

A few key points to remember when beginning an exercise program with older participants. The biggest concerns for exercise in older adults are falls during exercise and having a major cardiac event, though these are quite rare, and exercise can actually help prevent these from occurring [25]. 

The most common risks of exercise are soreness, joint pain, and ankle injuries, but for most people, the benefits of exercise outweigh the risks, including in elderly populations. Fear of worsening pain is a common misconception that keeps older adults from starting an exercise regimen [25].

Depending on age, the presence of chronic disease, and the initial level of physical function, those starting a new exercise program should be monitored by their doctor and/or exercise therapist. Programs that contain strenuous activity like HIIT training or advanced balance training are not recommended for beginners — start low and slow, then build up to more advanced exercise to prevent injury. 

Those who are frail can benefit by starting with mobility and strength training exercises before moving on to aerobic workouts [25]. Some mobility exercises, like yoga, can be adapted to be more suitable for older populations, such as doing seated yoga or having a chair nearby to hold on to. Those who cannot tolerate land-based exercise, such as in the case of chronic pain from neuropathy or osteoarthritis, can try aquatic exercises that are easier on the joints and have no fall risk [25, 26, 27]. 

Other risks to consider include:

  • Dehydration
  • Prescription medications such as beta blockers
  • Any other predisposition to dizziness or loss of balance

Dehydration is common in older populations due to decreased water intake and use of diuretic medications, and can increase the risk of dizziness, fatigue, and falls during exercise [28]. Taking certain prescription medications may also interfere with exercise tolerance (such as beta blockers used for hypertension). This is why checking in with a doctor before starting a strenuous and/or aerobic program in older adults is generally a good idea.

Staying Active Is Essential for Health and Longevity

Preventing muscle decline and optimizing strength and mobility via exercise is one of the best strategies we have for healthy aging. With the goal of keeping older adults as independent and healthy as possible, the sooner you can implement consistent exercise, the better. But that doesn’t mean it can’t be fun or involve a social aspect too — exercise can become even more sustainable when you become part of a community around it. 

For more information on healthy aging, exercise, gut health, and more, check out my book Healthy Gut, Healthy You.

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➕ References
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