Strength training for seniors: what the guidelines say and how to start safely

What do US guidelines say about strength training for older adults?

The Physical Activity Guidelines for Americans state that the key guidelines for adults also apply to older adults. For adults that means muscle-strengthening activity of moderate or greater intensity, involving all major muscle groups, on 2 or more days a week.¹ The CDC says the same for older adults: at least 2 days a week of activities that strengthen muscles.²

The guidelines add points that are just for older adults. Weekly activity should be multicomponent, which means it includes balance training as well as aerobic and muscle-strengthening activities. Older adults should set their effort relative to their own fitness. Those with chronic conditions should understand whether and how the conditions affect safe activity. And when a chronic condition makes the usual aerobic target out of reach, they should be as active as their abilities and conditions allow.¹

Two research bodies back the same direction. The American College of Sports Medicine position stand on exercise for older adults says that no amount of activity can stop the biological aging process, but regular exercise can limit the effects of an inactive lifestyle, and that ideally exercise for older adults includes aerobic, muscle-strengthening and flexibility work.⁸ The National Strength and Conditioning Association position statement says countering muscle disuse through resistance training is a powerful intervention against the loss of muscle strength and mass that comes with aging.⁹

Should you check with a health professional before you start?

Often, yes. MedlinePlus says to always talk to your health care provider before starting an exercise program, and that your provider can suggest exercises and activities that are right for you.⁵ A second MedlinePlus page advises checking first especially if you have trouble moving or balancing, or you worry that exercise might not be safe for you.⁴

The Physical Activity Guidelines say people with chronic conditions or symptoms should be under the care of a health care provider, and can consult a health professional or physical activity specialist about the types and amounts of activity that suit them.¹ For people with heart disease, MedlinePlus lists situations where checking is especially important: a recent heart attack, chest pain or pressure, shortness of breath, diabetes, or a recent heart procedure or surgery.⁶

A health professional is also the right person to ask about a balance program. MedlinePlus says it is sometimes best to learn balance exercises from a physical therapist before starting on your own.⁵ This guide does not replace that advice.

How do you start, step by step?

The Physical Activity Guidelines say inactive people should start low and go slow: begin with lower intensity activities and gradually increase how often and how long.¹ MedlinePlus gives the same advice to anyone who has not exercised in a while.⁴ The steps below follow those sources.

1. Talk to your provider. Ask whether strength training is suitable for you and whether any movement should be avoided. Mention any chronic condition or symptom.¹⁵
2. Choose a form of resistance you can control. The CDC lists resistance bands and weights as ways to strengthen muscles.³ MedlinePlus also lists your own body weight.⁴ Start with the lightest option that lets you control the movement.
3. Cover the major muscle groups. Pick one activity for each group: legs, hips, back, abdomen, chest, shoulders and arms.¹⁰
4. Do one set of 8 to 12 repetitions. The CDC says 8 to 12 repetitions of an activity counts as one set.³ If you cannot finish eight with good control, the load is too heavy for now.
5. Do it on 2 non-consecutive days if you can. The guidelines ask for 2 or more days a week.¹ Choose days that suit you, with a day between if your muscles feel sore.
6. Add load or repetitions slowly. Increase one thing at a time and only when the current load feels controlled. The aim is gradual increase.¹
7. Stop for warning signs. Pain, extreme shortness of breath or dizziness mean stop and seek help right away.⁴

How much is one session? A worked example

The CDC counts 8 to 12 repetitions of an activity as one set.³ The CDC also names seven muscle groups: legs, hips, back, abdomen, chest, shoulders and arms.¹⁰ Here is the arithmetic for a session with one activity per group and one set of each:

Seven activities at 8 to 12 repetitions is a short session when the load is light, which fits the advice to start low. Some people split the groups over the two days. The guidelines ask for the groups to be covered across the week and do not require them all in one session.¹

What equipment suits a home start?

You do not need a machine. MedlinePlus says you can build muscle strength by lifting weights or using a resistance band, and that everyday tasks such as carrying a full laundry basket can also work the muscles.⁵ The CDC lists resistance bands and weights as examples.³

If you later want a machine, the useful questions are practical: how low the lightest load goes, how small the steps are, and whether the equipment is stable. For example, the Chutex Model I lists motorized resistance from 4.4 to 110 lb, and it is wall-mounted, which needs a load-bearing wall.¹¹ See home gym equipment by goal and space and the home cable machine guide for checks before you buy.

If you are new to lifting, how to start strength training explains the basics, and sets and reps explains the vocabulary.

What about balance and falls?

The guidelines ask older adults to include balance training in their weekly mix.¹ The CDC gives examples such as walking heel-to-toe or standing from a sitting position.² MedlinePlus lists standing on one foot and walking heel-to-toe among balance exercises.⁵

Falls are a separate subject with their own pages. Strength training does not make a fall impossible, and nothing here promises otherwise. For risk factors, a risk check and what protective equipment does and does not do, read fall protection for seniors at home and fall risk assessment.

Which warning signs mean stop?

MedlinePlus says that if you do not feel right, or have pain, extreme shortness of breath or dizziness, you should stop exercising and seek help right away.⁴ For people with heart disease, MedlinePlus lists dizziness or lightheadedness, chest pain, an irregular heartbeat, shortness of breath and nausea as signs to stop and rest.⁶

The NHLBI lists the symptoms of a heart attack as chest pain, heaviness or discomfort; pain in one or both arms, the back, shoulders, neck, jaw or above the belly button; shortness of breath; heavy sweating for no reason; unusual tiredness; nausea or vomiting; light-headedness or sudden dizziness; and a rapid or irregular heartbeat. It says silent heart attacks are more common in older adults.⁷

If you think you might be having a heart attack, the NHLBI says to call 9-1-1 even if you are not sure, and not to drive to the hospital yourself.⁷ In a medical emergency in the United States, call 911.

Frequently asked questions