Starting Strength Training After 65? Add Balance, Too

The federal Physical Activity Guidelines for Americans give older adults the same core strength guidance as other adults, then add two recommendations: do multicomponent activity that includes balance training, and set your effort relative to your own fitness. The National Institute on Aging (NIA) adds practical examples.

1. What stays the same

The Physical Activity Guidelines state that their main recommendations for aerobic activity and muscle-strengthening activity are the same for adults and older adults. If you are over 65, the same targets for moving more, sitting less, and strengthening all major muscle groups apply to you.

2. What is added: two guidelines just for older adults

The guidelines list two extra recommendations for older adults:

1. Do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities, as part of your weekly activity.
2. Determine your level of effort relative to your own level of fitness.

The second point is easy to skip past, but it is important. It means "moderate" effort for a 70-year-old who is new to exercise may look very different from "moderate" effort for a lifelong athlete of the same age, and that is expected.

3. What "multicomponent" means

The guidelines define multicomponent physical activity as activity that includes more than one type, such as aerobic, muscle-strengthening, and balance training. They give an example of a program that could combine all three:

• Walking for aerobic activity
• Lifting weights for muscle strength
• Balance, added by walking backwards or sideways, or by standing on one foot while doing an upper-body strength exercise such as biceps curls

The guidelines say many studied programs combine all three types in one session, and that this has been shown to be effective. They also note that recreational activities such as dancing, yoga, tai chi, gardening, or sports can count as multicomponent, because they often include several types of activity. NIA makes the same point, adding that you can combine more than one type of exercise into the same session.

4. Why balance gets special attention

The guidelines explain that balance activities improve the ability to resist forces that cause falls. They report that fall-prevention programs that include balance training and other exercises can significantly reduce the risk of injury, such as bone fractures, if a fall does occur.

Strength and balance are linked. The guidelines note that strengthening the muscles of the back, abdomen, and legs also improves balance. NIA adds that muscle-strengthening activity helps slow the loss of muscle mass and helps prevent falls and fall-related injuries.

5. How often to train balance

NIA suggests aiming for about three sessions of balance exercises a week. That lines up with the guidelines, which note that studies of fall-prevention programs generally include about three sessions a week.

NIA's list of balance exercises includes:

• tai chi
• yoga
• standing on one foot
• the heel-to-toe walk
• walking backward or sideways
• practicing standing from a sitting position
• using a wobble board

6. Balance safety

NIA's safety tips for balance work are specific:

• Have a sturdy chair, person, or wall nearby to hold onto for support.
• Go slowly and mindfully to prevent falling.
• If you feel unsteady, take action to steady yourself.
• Wear comfortable, stable footwear, or go barefoot for grip on the floor or mat.
• If you are unsure about a movement, ask your doctor or a physical therapist.

7. A sample week

Using only the examples above, a beginner over 65 might plan a week like this. The layout is an illustration, not a prescription:

Monday, Thursday, and Saturday each include balance work, which matches NIA's suggestion of about three sessions a week, and the two strength sessions are not on back-to-back days.

8. The bigger reason to start

NIA notes that muscle-strengthening activities improve physical function and can make everyday activities easier, naming getting up from a chair, climbing stairs, and carrying groceries. Pairing them with balance work targets the same everyday goal: staying steady and independent.

9. Key takeaways

• The main strength and aerobic guidelines are the same for adults and older adults.
• Older adults should add multicomponent activity that includes balance training, per the Physical Activity Guidelines.
• Effort should be judged relative to your own fitness level, not someone else's.
• NIA suggests about three balance sessions a week, such as tai chi, heel-to-toe walking, or standing on one foot.
• Keep a sturdy chair or wall nearby for balance exercises and move slowly.

This article is general information, not medical advice. Talk with a doctor or physical therapist before starting a new exercise routine, especially if you have a health condition or injury.