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1st Aug


The Most Successful Exercise Approach As We Age

Over the past five years, I have in different newsletters addressed how the human body changes physically as we age, what that can do to our quality of life and health, and how we can either affect it positively or negatively based on if and how we choose to exercise. I will try to summarize the key points in this letter.

First of all, there is little doubt that exercise can help us live a longer and healthier life. However, as we age, our physiology and physical state changes, which requires us to also gradually adapt our exercise methods to get the best results. Modifying our exercises may be the difference between building/maintaining tissues versus breaking down/losing healthy tissues. This can therefore also lead to either a more active life, less pain, better health and longer life, or a life which becomes more sedentary, painful, less enjoyable and which may set you up for more illness.

So why is this? For one, starting earlier but in particular in our 50s, we lose neuromusculoskeletal cells, resulting in less muscle mass and strength, bone strength, tendon/ligament strength, and balance or position sense. We also develop thinning of the cushioning cartilage in our joints and wear and tear changes of various tissues. An intelligently designed exercise program can significantly slow down many of these age related changes, and prevent pain or injuries associated with such physical findings.

Another very important reason is that the energy that we store in our muscles steadily decreases as we age, although such decline in energy available can also be slowed down by being more fit. There is only a certain amount of muscular energy store available for each of us, on a daily basis. The body keeps an energy reserve of 70% of its total energy, leaving 30% of the total energy store for work, activities of daily living, and exercise. The energy reserve is used for tissue recovery and repair, by building up or regenerating tissues.

If we consistently use more than the 30% of the total energy on a daily basis for activities and exercise, the available energy reserve decreases, and we get breakdown of tissues, leading to further degeneration, painful conditions and overuse injuries. This happens a lot in sports, but also in the aging exercising person, who in an attempt to “stay young” continues with too intense exercise or without sufficient rest. We know that exercise per say breaks down tissues, and it is the rest after exercise which increases our fitness.

Tapping into too much of the energy reserve also accelerates degenerative processes, such as joint osteoarthritis and spinal disc degeneration. These tissues, as well as tendons, have low metabolism, and are therefore affected the most. The result can be more joint pain, neck or back pain and even nerve impingement, and tendinitis problems.

Since we lose muscle fibers and the amount of energy reserve available to us as we age, and after illness or surgery, we must reduce the volume and especially intensity of exercise, in order to prevent such ill effects. As we gradually improve our fitness level, the loss of muscle mass and energy can be minimized. However, it will not return to the level we had in our 20s, 30s or 40s, if we exercised at that age.

High intensity strength training and power training are the most taxing on our energy reserves, even if training sessions are short. Lower intensity, endurance type exercise such as moderate level bicycling, swimming, elliptical trainer, or similar forms of predominantly aerobic exercise can be performed more often (even daily, if fit), and for longer periods, without tapping into the reserve energy storage.

As we get up in our 50s and 60s and beyond, most of us also need to consider the effect of loading or high impact, on our joints. This is especially true if we have a strong family history of arthritis, or if we know that we are developing this ourselves. Whereas low impact, high repetition movements can slow down the joint degeneration and lessen joint pain, high impact (e.g. jumping or running) or heavy joint loading (e.g. heavy resistance exercise) accelerates the wearing of the joints. Typical signs that joints have been over stressed are either pain or swelling over the next 24 hours.

Resistance training is of importance throughout life, to strengthen our muscles and tendons as well as bone, lubricate and stabilize joints, raise our metabolism and in general feel and perhaps look more vital. In particular as we approach old age, we lose more fast twitch muscle fibers responsible for strength, and our balance often declines. Therefore, strength training and agility exercises are important for the older population, to be able to stay active, and prevent falls.

In summary, we can positively affect our physical and likely also mental health by exercising regularly as we age. A combination of resistance and agility exercise at least twice a week, and cardiorespiratory exercise 2-3 times per week (or more) is recommended. As we get into our 50s and 60s and beyond, it is wise to modify our exercise approach by gradually decreasing the exercise intensity and joint loading-impact by e.g. decreasing the weight resistance that we use with exercise and instead increasing exercise repetitions to at least 15-20/set (for arthritic joints at least 25 repetitions), performing them with slower speed, and by including more low impact type of exercises. We also need more rest between exercise sessions and less total work output during workouts, for sufficient recovery afterwards.

Please feel free to forward this newsletter to anyone who you think could have an interest. For anybody interested in writing a Yelp review of our clinic, you can now go to We very much appreciate your opinion and your loyalty, and we hope to be able to serve you whenever the need arises in the future.

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