Takeaway
Encouraging patients, especially older adults, to engage in strength training is often overlooked. Specific advice about the how and why can significantly improve uptake and may bolster their quality of life.
Lifelong Learning in Clinical Excellence | May 8, 2025 | 2 min read
By Stasia Reynolds, MD, Johns Hopkins Medicine
Paul has taught me a lot about the importance of strength training—no matter the age or ability. He’s a 76-year-old with biventricular heart failure, AFib on chronic anticoagulation and disfiguring tophaceous gout, AND he does strength training with the exercises outlined below EVERY DAY. I am confident—and, more importantly, so is he—that this practice has helped keep him independent and out of the hospital.
Evidence suggests that patients are more likely to consider strength training if recommended by their physician. So, I ask about exercise in general, and recommend strength training in particular, at least once a year to every patient during the wellness visit when discussing mobility. Even brief advice can improve uptake, and the more specific the better.
Strength training is especially crucial in older patients, because we know that:
1. Improved muscle mass helps combat sarcopenia (age-related muscle loss).
2. It stabilizes muscles and reduces fall risk by >30%.
3. It helps slow or even reverse osteoporosis.
4. It improves mobility and independence in activities of daily living.
So, consider recommending a these four very simple exercises that require minimal or no equipment and are supported by research for improving strength, mobility, and quality of life:
1. Sit-to-stand from a chair
Sit in a sturdy chair. Without using your hands, stand up and then slowly sit back down. Repeat 10–15 times.
Benefits: Improves lower body strength, particularly quadriceps and glutes; enhances mobility and independence in daily activities.
2. Wall push-ups
Stand facing a wall, arms extended shoulder-width apart. Slowly bend elbows and lean toward the wall, then push back. Repeat 10–15 times.
Benefits: Builds upper body and core strength; supports shoulder and chest muscles; safer than floor push-ups for those with limited mobility.
3. Heel raises
Holding onto a sturdy surface for balance, lift your heels off the ground and slowly lower them. Repeat 10–15 times.
Benefits: Strengthens calf muscles, improves balance and walking ability, reduces fall risk.
4. Marching in place
While standing and holding onto a chair or countertop, lift one knee at a time as if marching. Aim for 30–60 seconds.
Benefits: Builds hip flexor and core strength; improves balance and coordination; can help with gait.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.