As You Age, What’s More Important—Stretching, Balance Work or Strength Training?

As You Age, What’s More Important—Stretching, Balance Work or Strength Training?

Strength, balance, and flexibility are key factors for people of all ages to live a quality life and are of even greater importance to older adults. The loss or lessening of any of these factors for people 65 and over can mean the difference between living independently or needing help with basic daily living activities.

It’s a fact that strength and muscle mass deteriorate due to the aging process. Health experts say that muscle mass and strength peak between the ages of 30 and 35 and begin to deteriorate steadily. The rate of decline intensifies for women around age 65 and for men at age 70, according to the National Institutes of Health (NIH). Not only are muscle mass and strength affected by age, but balance and flexibility decline due to changes in vision, joints, ligaments, and sensory nerves.

“Joints in the spine, hips, knees, and shoulders naturally become more arthritic with age, and our ligaments and the interfaces between our tendons and muscles become more rigid,” Dr. George Eldayrie, a sports medicine physician with the Orlando Health Jewett Orthopedic Institute in Winter Garden, Florida, told CNN Health. “It’s a very known process.”

So, is one factor more important than another for older adults? On a personal level, it all depends on the individual, according to Eldayrie.

“For a master’s athlete, most likely strength and flexibility are more important to help with performance and decrease injuries,” Eldayrie told CNN. “Someone who’s 85 and wants to be functional, though, will be focused on balance and strength to help decrease their fall risk.”

What’s more, Eldayrie says someone with arthritis should focus on joint flexibility first, someone who just had a knee replacement should concentrate on strength training, and someone with osteoporosis should work on balance to avoid falls.

Similarly, for people who want to improve their overall quality of life, aerobic exercise, followed by resistance training, and a mixture of balance and flexibility are the most important activities, according to Dr. John Higgins, a sports cardiologist at McGovern Medical School at the University of Texas Health Science Center at Houston.

“Think about it like a pyramid,” Higgins told CNN Health. “Aerobic exercise is the top of the pyramid, with the bricks supporting it being strength, balance, and flexibility. Without those basics, the pyramid will crumble. You can’t get by on one of those things alone.”

How to Get Started and Stay Active

Many older adults are aware of the importance of staying physically active, but knowing it and doing it are two different things. A 2016 study by the U.S. Centers for Disease Control and Prevention (CDC) found that 28 percent of Americans 50 and older are inactive, and the percentage increases with age. The study also showed that more than 35 percent of people 75 and older are inactive.

As the nation’s health protection agency, the CDC urges older adults to get moving since physical activity can prevent or delay many health problems associated with age. And keep in mind that any activity is better than none at all because strong muscles provide older adults the ability to carry out their daily activities and maintain their independence, according to the CDC.

When it comes to physical activity, the CDC recommends adults 65 and older need:

  • At least 150 minutes (2.5 hours) a week of moderate-intensity activity (for example, 30 minutes a day, five days a week).
  • At least 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity activity, such as jogging or running.
  • At least two days a week of muscle-strengthening activities. The goal is to work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
  • Activities to improve balance, such as standing on one foot, walking heel-to-toe, or standing from a sitting position.


While this may sound overwhelming, the CDC says there are a variety of ways seniors can meet the weekly physical activity recommendations. In fact, older adults could be meeting these goals without even realizing it.

For instance, brisk walking, walking the dog, playing golf, and gardening all count as moderate-intensity aerobic activity.

Muscle-strengthening activities can involve using hand-held weights, resistance bands, medicine balls, and even climbing the stairs. Those who want more of a challenge can do weight lifting with machines or “rucking,” a military-inspired activity of carrying a weighted backpack during a walk to combine strength training with cardiovascular exercise.

Also, stretching, whether standing or sitting, helps to keep muscles strong and flexible. Stretching can involve squats, arm circles, jumping jacks, leg swings, or holding your body in the same position for 10 to 60 seconds (called static stretches). Also, yoga is a low-impact exercise that not only involves stretching but promotes flexibility and activates core muscles of the body, such as the abdominals, lower back, and hips.

The CDC advises seniors with chronic health conditions that limit their ability to meet these recommendations to be as physically active as their abilities and conditions allow.

NIH officials suggest older adults be realistic about what they can do to stay strong and keep moving. For instance, NIH advises seniors to set realistic goals because everyone is unique and everyone ages differently—there is no “one size fits all.”

“Some people have a hard time gaining muscle no matter how much they lift, while others have a hard time losing weight even when focusing on aerobic activity,” NIA staff scientist Eric Shiroma.“This variability from person to person is another area of current research both at NIA and the institutions it supports.”

The bottom line is to keep it simple and be consistent.

“A lot of people like to complicate things by having a plan and measuring their progress, but it doesn’t need to be that complicated,” Eldayrie said. “Just incorporate these things into your day-to-day life and be consistent. The benefits will come over time.”

For people who may doubt whether strength training, balance, and flexibility work will really help, Higgins advises them to try it for a few months to see the difference it makes.

“You will probably find that you enjoy things more and that you are able to do regular aerobic work more easily and with fewer injuries, whether that’s playing with the grandkids or doing an exciting activity like zip lining,” he said.

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