Exercise For Older Adults - How To Get It Done (With A Focus On Strength Training)
Ok, we've set the scene and laid out some general principles.
Now, let's dive in to the nitty gritty about how to engage in strength training and improve your cardiorespiratory (heart and lungs) fitness.
How long? How often?
I suggest you try to adhere to the Australian government physical activity guidelines.
Here are the recommendations for adults (18-64):
Adults should be active most days, preferably every day. Each week, adults should do either:
2.5 to 5 hours of moderate intensity physical activity – such as a brisk walk, golf, mowing the lawn or swimming
1.25 to 2.5 hours of vigorous intensity physical activity – such as jogging, aerobics, fast cycling, soccer or netball
an equivalent combination of moderate and vigorous activities.
And here’s the recommendations for adults 65 and over:
For people aged 65 years and over, we recommend at least 30 minutes of moderate intensity physical activity on most, preferably all, days.
If you find 30 minutes difficult right now, start with just 10 minutes once or twice a day. After 2 weeks, increase to 15 minutes twice a day.
If you can do more than 30 minutes, you will get extra benefits.
Over the course of the week, try to incorporate different types of activities.
Try to reduce the time you spend sitting down – break that time up as often as you can.
Go here to find out more.
(Note: “moderate” means an intensity which requires some effort, but allow a conversation to be held. Examples include brisk walking, gentle swimming, social tennis, etc. And “vigorous” exercise is that which makes you breathe harder or puff and pant (depending on fitness). Examples include aerobics, jogging and some competitive sports.)
Are these guidelines any good?
It is worth saying that an amount which is LESS than the guidelines will still help a lot. The most benefit is gained when someone doing no exercise does one unit of exercise.
From there, the line of benefit is less and less steep. The least benefit is gained by the person who's already very active doing even more.
Some readers are quite dubious of trusting these sort of bodies. If that’s you … look - I get it. I do share that general posture. You’re right to squint your eyes at this. It all sounds a bit … food pyramid-ey.
There are inherent methodological issues which make these sort of guidelines a fairly blunt instrument.
But in this instance I suggest you suspend disbelief, because:
It is abundantly clear that exercise (both "cardio" and "strength") are really, really good for you. You don’t need a PhD to see that.
In general, the more you do, the more you benefit.
The guidelines represent an amount of exercise that most people can reasonably achieve.
This amount of exercise (in the guidelines) will have a very positive impact on your health and longevity.
How To Strength Train
Now, we’ll turn our focus to strength training.
I’ll be addressing cardiorespiratory fitness training in my next article.
WHICH EXERCISES?
There are all sorts of different exercises that can be used, but in general we want to provide beneficial stress to all the major muscles of the body twice per week (maybe more).
Ideally, you'd choose exercises which map well onto ordinary life, so that the strength improvements can be maximally beneficial.
For example, when you do calf raises, you also work on your balance - a physical skill which can deteriorate as you age. Step ups with a weight prepare you for … real staircases. Squatting with a bar across your back prepares you for piggybacking your grandchildren.
Other exercises, like a leg extension or a prone hamstring curl are less directly transferrable to daily life (but they are still mostly really beneficial).
BUT, the main thing is that you get the training done, so if there's some non-functional exercises which you really like; that you feel you're more likely to actually DO, then you should do those ones.
The best program or training is the type that actually gets done - as opposed to the theoretically perfect program that's too boring or intimidating to regularly check off.
I have two ways that I like to think about selecting strength training exercises.
MOVEMENT PATTERNS
There are limited ways that the body moves. We’re constrained by our joints.
There are a million ways to move and countless exercises but they’re all variations on a theme.
Climbing steps is really similar to running.
Getting up from a low couch is just like lowering yourself onto the ground (only in reverse).
The way you hit a golf ball looks a lot like shovelling sand.
When you take the major movements of the body, add resistance, and do them repeatedly, you strengthen all the main muscles and you train your movement skills in one go.
This is the "movement pattern" framework. It's way of conceptualising strength training is great for people who are excited by the idea of "functional training" or preparing yourself for anything (which was the ethos behind CrossFit).
OK then, what are the major movement patterns? Here’s my take:
SQUATTING
HIP HINGE-ING
PUSHING
PULLING
SPINE BENDING
SPINE STRAIGHTENING / EXTENSION
SPINE ROTATION
If you worked your squat, hip hinge, push, pull and one of the spine movement patterns each time you did a gym training session, you'd get yourself 80% of the possible health benefit from lifting weights without knowing a single muscle group.
Here's some examples of exercises which train each movement pattern.
SQUATTING: Bodyweight / Air Squat, Leg Press, Goblet Squat, Box Squat, Safety Bar Squat, Deadball Slam
HIP HINGE-ING: Roman Chair Back Extension, Romanian Deadlift, Step Up (kind of like a squat, too), Dumbbell Reverse Lunge, Hip Thrust
PUSHING: Machine Chest Press, Dumbbell Incline Chest Press, Bench Press, Barbell Incline Bench Press, Bent Knee Push Up
PULLING: Seated Row, Lat Pulldown - Supinated Grip, Machine Assisted Chin Up, Dumbbell Row
SPINE BENDING: Crunch, Cable Crunch
SPINE STRAIGHTENING: Roman Chair Back Extension, Seated Row
SPINE ROTATION: Cable Woodchop, Crunch & Punch
MUSCLES
If the movement pattern framework is not for you, then you probably want to stick to the traditional "muscles" paradigm.
This is when you select exercises to stress the major muscle groups of the body to make them stronger (and maybe even larger?).
Here's some examples of exercises which train the different major muscle groups of the body:
QUADS (FRONT OF THIGH): Machine Leg Extension, Dumbbell Front Squat, Wall Sit
HAMSTRINGS (BACK OF THIGH): Seated Hamstring Curl
GLUTES (BUTTOCKS): Hip Thrust
CAVLES: Standing Calf Raise
CHEST / PECTORALS: Machine Chest Press
LATS (BACK & SIDES OF RIBS TO ARM): Lat Pulldown - Supinated Grip
BICEPS: Dumbbell Bicep Curls
TRICEPS: Bench Dips
MID-BACK: Cable Machine Face Pull
LOWER BACK (Erector Spinae / Quadratus Lumborum): Roman Chair Back Extension
ABDOMINALS / HIP FLEXORS: Forearm Plank
HOW MANY REPS AND SETS?
First of all, a rep is lifting and lowering a weight once.
Secondly, a set is group of reps. 1 set of 10 reps = lifting and lowering a weight 10 times.
To get heaps of benefit with a modest time commitment, you should aim to do 3 sets of each exercise. 2 sets will still provide a lot of benefit, and 4 or more sets can be warranted if you want to push yourself (in time, once you've been at it for a few months).
So, if you were going to do a movement pattern based session, covering 5 different movements (squat, hip hinge, push, pull, spine rotation), then your weights session would include 15 sets.
The number of reps can vary, with excellent results being achieved at low reps (3-6) or high reps (15-20) and the range in between.
HOW HEAVY?
When you get started, you need to use light weights to establish a foundation of sound technique. This is to minimise injury risk. Also, some people can get really sore or fatigued when they start resistance training. Best to allow some time for your body to adapt to the training stress.
Once you can complete a strength training session and feel pretty fresh and energetic again 2 days later, it's time to increase the weights.
Ideally, once you've accumulated some experience, you should be able to push yourself to the following levels (working up slowly, mind you).
With compound, multi-joint movements like a squat, leg press, or machine chest press, you should aim to finish the set feeling like you could do no more than 2-4 more reps. This concept is known as "reps in reserve" and is widely used in resistance training research and practice.
With simple, single-joint movements (aka isolation exercises) you should aim to have 0-2 reps in reserve at the end of the set.
When training with a "reps in reserve" framework, its common to underestimate how many more reps you can squeeze out. You think you can only do two more but if someone really pushed you, you could complete four more.
This is fine as it allows for a safety margin and assists in injury prevention. As you accumulate more experience you become more adept at knowing how close you are to "failure" (the point at which you can't complete another rep).
As time goes on you can explore your limits - especially if you have a coach or experienced training partner with you who can assist in "spotting" - helping to lift the weight if you get stuck.
HOW MUCH REST BETWEEN SETS?
This varies depending on your goal. If you're looking to develop endurance and stamina in your muscles, you take shorter rests - somewhere between 30s - 60s. You’d also select lighter weights and do lots of rest.
If you're looking to grow your muscles (hypertrophy) then the rest period will increase to the 60-120s range.
When training for strength development (where strength equals lifting a really heavy weight once or a few times) you need quite a lot of rest between sets (3-5 minutes).
Most people can achieve all the accessible health benefits from lifting weights - and gain a tremendous amount of strength - by focussing on endurance and hypertrophy. It can be quite time consuming to train in such a way as to develop your maximum strength potential, given the high amount of rest needed between sets. But if you’re motivated to do that, go right ahead!
(Note: there's no clear boundaries between endurance and strength. Rather, these things exist on a continuum. The distinctions are, to a large degree, arbitrary. But they're still useful concepts to help people understand how training "works").
HOW MUCH REST BETWEEN SESSIONS?
In general, and especially when you're getting started, its good to leave 2-3 days between training sessions. As you gain experience, you can break this rule, or adopt other strategies to allow for more frequent sessions.
SHOULD I DO STRENGTH OR CARDIO FIRST?
This is one of those topics where people lose the wood for the trees.
The big picture perspective is: if you're simply looking to improve your health & longevity, and you're less fussed about performance, it doesn't matter.
You should do whatever is most enjoyable because that promotes adherence, which matters A GREAT DEAL.
Now, having said that, there's some evidence that doing fitness/cardio AFTER strength work can blunt the strength gains.
I suggest that each session you have a priority - strength or fitness. Then do your top priority FIRST. That way it gets your best effort and attention.
What About Fitness? How Do I Work On That?
That will be the topic of next article! Stay tuned.