Q&A: High Intensity Training for Seniors

This Q&A is a general response to several specific questions I’ve received through e-mail and comments on other posts regarding high intensity training for seniors.

Question:

Is high intensity strength training safe for seniors?

Answer:

Whether high intensity training is safe for any particular individual depends on their current health and physical condition. Certain conditions may increase the risk of injury. That being said, when properly performed using appropriate exercises high intensity strength training is safer and more beneficial for seniors than any other activity.

When an exercise is performed correctly using a slow, controlled speed of movement over an appropriate range of motion the level of force the body is exposed to is kept well within safe limits for even very frail subjects such as those with severe osteoporosis.

When breathing is done correctly, Val Salva’s maneuver and excessive gripping are avoided, and the head is kept above the remainder of the body during exercise blood pressure is maintained at a safe level.

In addition to being safer for your joints, high intensity strength training is also safer for the cardiovascular system than steady-state activities like jogging, cycling or using a stair climber or elliptical machine. The high intensity contractions that occur during resistance training enhance venous return which improves coronary artery blood flow (blood flow to the heart itself). Doug McGuff, MD explains this in detail in The Body by Science Question and Answer Book, and discusses an interesting study from the Journal of Cardiopulmonary Rehabilitation that showed circuit strength training was safer than treadmill walking; “30 of the 42 subjects had one or more cardiovascular complication (arrhythmia, angina, ischemia, hypertension, hypotension) during the aerobic exercises as compared to only 1 subject with complications during resistive exercises.” (Daub WD, et al. Strength training early after myocardial infarction. J Cardiopulm Rehabil. Mar-Apr;18(2):145-52.)

Over the past two decades I have trained dozens of seniors including several in their 70′s and 80′s with a variety of medical conditions including several with severe spine conditions (one with a grade 3 spondylolisthesis) and not one has been injured doing high intensity training.

Question:

How should high intensity training be performed by seniors?

Answer:

The same general principles that apply to athletes and bodybuilders apply to seniors, the only difference is that although everybody should always train as safely as possible seniors need to be especially cautious about which exercises they perform and how they perform them.  The following are a few general guidelines:

  1. Start out with just a few basic, multi-joint exercises working the major muscle groups. Perform only one work set of each exercise per workout. Some find their joints tolerate certain exercises better after a light warm up set, although for most this is unnecessary if proper form is used.
  2. Perform the exercises with only a light weight at first and focus on learning to move and reverse direction smoothly and breathe continuously.
  3. Be very conservative with repetition speed; take approximately 10 seconds to lift and 10 seconds to lower the weight. If you’re moving slowly enough 4 to 8 repetitions should require at least 80 to 160 seconds to complete.
  4. When you are able to perform 8 or more repetitions of an exercise in good form, the next time you perform the exercise add 5 pounds or 5% more weight, whichever is less. It is common to recommend higher repetition ranges for seniors both because of the perceived increase in safety and because of the conversion of type II to type I muscle fibers with age, however a range of 4 to 8 is fine when performed at a very slow speed.
  5. As the exercises begin to become more challenging you’ll start to experience elevated heart rate and breathing. At first, allow a minute or two between exercises for heart rate and breathing to return to normal before performing the next exercise. Over time as your conditioning improves gradually reduce the rest between exercises to improve the cardiovascular and metabolic effect.
  6. Train no more than three times a week the first few weeks while learning the exercises then cut back to training only twice a week. If your progress slows down reduce your frequency to once weekly. Some people may require even more recovery time/less frequent training than this. The amount of recovery time required between workouts increases with age and can vary considerably between individuals.
  7. It is normal for your muscles to burn, and for your breathing and heart rate to increase but if something hurts or if you begin to feel dizzy, nauseous, or faint or think you maybe starting to get a headache stop the exercise  immediately and carefully exit the machine or set down the weight.

Keep in mind these are only general guidelines. The specifics can vary significantly between individuals depending on age, genetic and environmental factors, current health, etc. The specific exercises and style of performance that is best for you may be different than what is appropriate for someone else.

Question:

My doctor told me not to lift a weight that is heavier than X, can I still do high intensity training?

Answer:

This depends on why your doctor made that recommendation. There may be a very good reason for it, or they might just be covering their ass.

Often, the advice to not lift more than some amount of weight is based on the assumption excessive weight is what causes injury during exercise. The real concern is not how much weight but how you attempt to move it. You can be injured lifting a very light weight if you do it in a careless or fast and jerky manner, however even a very heavy weight will not injure you if you attempt to lift it correctly and pay careful attention to form. If you follow the above advice to start with a light weight and only increase it when you are able to perform 10 or more repetitions in strict form you shouldn’t have any problems.

I trained an 85 year old man who started out only able to use a very light weight during pressing exercises due to shoulder problems. Within a year he was using nearly quadruple his starting weight on the chest and shoulder press and, more importantly to him, significantly increased the distance he could drive a golf ball.

Question:

I have a medical condition, can I still do high intensity training? Can high intensity training help?  What are the risks?

Answer:

I get a lot of questions from people with specific injuries and medical conditions asking if it is OK for them to do high intensity training. I am not a medical doctor and can not give you any kind of official clearance. Unless you are a one-on-one personal training or phone client who has signed a waiver I’m not going to give any specific advice related to training with any kind of medical condition either.

While I have no doubts about my ability to teach someone how to train safely, I have no control over how advice given out over the internet or by phone is implemented. If you aren’t sure about your health visit your doctor. Regular check ups will make you aware of any problems which might affect your ability to train safely. If you ask a doctor about exercise expect them to give very conservative recommendations, probably something “safe” like walking they figure you can’t hurt yourself doing and sue them over.

Question:

Can you recommend a trainer where I live?

Answer:

If I know and trust in the knowledge and competence of a trainer near where you live I will refer you to them. I do not, however, recommend just hiring any personal trainer because most of them haven’t the slightest idea what they’re doing and a lot of what I’ve seen personal trainers teaching seniors is an ineffective waste of time at best and dangerous at worst. Certifications are meaningless – most of what the major certifying organizations teach their trainers about exercise performance is utter nonsense.

I’ve directly observed personal trainers in several gyms and training studios who market themselves as specialists in “senior fitness” and they had no idea what proper exercise form was or how to teach it, had their clients doing numerous ineffective and/or inappropriate things, and generally  wasting their time and money. You would have a much better chance of getting it right on your own with just the general guidelines above than by hiring these “senior fitness specialists”.

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19 Responses to Q&A: High Intensity Training for Seniors

  1. Jeff October 31, 2010 at 9:31 pm #

    Awesome. Sent to my 68 year old Dad who is slow to adopt HIT. I think the comment about the 85 year old guy who is hitting his drives longer will help.

    thanks,

    jeff

    • Drew Baye October 31, 2010 at 9:54 pm #

      Jeff,

      If your father golfs a high intensity training program will help his performance and reduce his risk of injury while playing.

  2. Thomas October 31, 2010 at 11:15 pm #

    Drew-thanks for the article. Like I’ve said before, I train several seniors here in Arizona and they’re all doing very well with the HIT. They are all very excited about the continued progress they are seeing-and typically need a trainer to push them hard through their routine. It’s too bad more trainers don’t use this approach.

  3. Chris October 31, 2010 at 11:37 pm #

    I have a lady client that I train 1 time per week with 5 exercises who will turn one hundred and one Nov. 4!

  4. Paul Verizzo November 1, 2010 at 1:54 pm #

    While doing research on sarcopenia and resistance training, here comes your posting! (I had discovered you and your work a few days before.)

    I’m 64, I’ve never been into bodybuilding, weight training, or athletics generally. I’ve lost almost 100 pounds with a paleo diet and mountain bike riding. Then I discovered that I had NO upper body strength whatsoever. So, off into the research of what I can do.

    I bought Body by Science and read it a few times. I did internet research. Finally, I went to one of the city rec centers (read: free) and started figuring out the available machines and free weights. And then, in hindsight, I made a mistake…..to the good, I think.

    I didn’t find McGuff very clear on the exact protocol, so what I wound up doing and fine tuning is a single rep of 60-90 seconds, max or 90 degree contraction, to exhaustion as measured by “I can’t even wiggle this thing.” My breathing is intense and loud, and after the workout I feel like I’ve had a Near Death Experience.

    But, oy vey! I’ve gained 400% strength in five weeks on the horizontal row, other gains less but very good. My muscles are obviously flexing and popping as I move about now. My bike speeds have gone up.

    I can think of several reasons why this would be a good workout for seniors: It’s simple, no rep counting, no partners, no subjectivity (you do the goal time or you don’t), no joint injuries, once a week workout.

    Accepting that these goals are different from those of younger people and bodybuilders, am I missing anything to be concerned about?

    Since it seems every protocol needs a name, I’m calling it K.I.S.S.; Keep It Simple Seniors.

    PS, nice work and philosophies. Your idols and respected experts are the ones I’m learning to listen to, too.

    • Drew Baye November 1, 2010 at 6:08 pm #

      Paul,

      A single, very slow rep is fine as long as you breathe continuously. This is very similar to the “one minute chin ups” Ellington Darden, PhD recommends in some of his arm specialization routines.

  5. Dennis Rogers November 1, 2010 at 2:08 pm #

    Drew
    Great article, I have a few seniors that I train once a week. I have Medx for compound movements and Nautlus single joint leg machines.
    I am currently using a ‘hyper extension’ bench for back extensions,about 1/3 of the full range of motion. I found that it is easier to teach than varios forms of deadlift with free weights, but I do have a senior lady that gets a little light headed on this exercise,any thoughts on hyper extensions vs deadlifts w/ barbells or dumbells?

    • Drew Baye November 1, 2010 at 6:04 pm #

      Dennis,

      Assuming she’s breathing correctly and is only experiencing the lightheadedness on back extensions I recommend slowing down her positive speed, especially at the start of each rep, as well as instructing her not to go so low that her head is below the rest of the body. If this doesn’t help you may want to switch her to deadlifts if she doesn’t have any joint issues or conditions which would prevent her from performing them safely.

      If you start people out with a light weight and spend several workouts practicing form before gradually progressing the resistance most can learn to deadlift safely. I recommend getting an aluminum training bar (most weigh only 10 pounds and can be loaded up to 150) and a pair of 5 pound bumper plates which will allow you to have people learn to perform the exercise with as little as 20 pounds if necessary.

  6. Leo November 1, 2010 at 3:03 pm #

    Thank you very valuable.I am 75 training super slow with free weights for years and very happy with it.Also strong.

  7. Paul Verizzo November 1, 2010 at 9:30 pm #

    Oh yeah, I’m breathing like a grizzly is three feet behind me.

  8. Anthony Semone, PhD November 3, 2010 at 5:02 pm #

    I’m certainly qualified to talk about HIT as both an old person, 72, and also as having been involved for the past 6 years in using HIT in my (now sold) studio to train people . Age poses absolutely no limitation. PERIOD, end of story. Those limitations that do exist are also those which come from conditions that afflict younger people, dementia probably excepted. If there are no limitations associated with compromised joint function, so long as the movement cycles are controlled, especially at the turn-arounds; and, so long as care is taken to teach the requisite degree of control using resistance levels and a movement cycle pace that allows you as the trainer to observe carefully for discrepancies in form and pace, then “have at it.” I’m so sick and tired of this Silver Sneaker shit that has populated gyms around our area: sarcopenia in – sarcopenia out. These folks look like I looked when I was doing marathons and ultra-marathons 30 years ago: muscularly wasted. Wow, when I think of the time I put into those efforts and thought I was “in shape,” well, I shudder. (Even so, and what was most compelling about those efforts, and why in retrospect I did it was the camaraderie amongst fellow runners).

    Anyways, hope this helps,

    tony

  9. overfiftylifter November 6, 2010 at 6:33 pm #

    Is it possible that a more moderate form of training may be more beneficial for those with cardiovascular conditions especially if resistance training is used as their primary form of exercise?

    Br J Sports Med 2009;43:615-618

    Effect of 12 weeks of moderate–intensity resistance training on arterial stiffness: a randomised controlled trial in women aged 32–59 years

    Abstract
    Background: Resistance training has been increasingly incorporated into the overall exercise programme because of its effect on muscle strength, functional capacity and osteoporosis. High-intensity resistance training increases arterial stiffness. However, the effect of moderate-intensity resistance training on arterial stiffness is unknown.

    Objective: To determine whether 12 weeks of moderate-intensity resistance training increases arterial stiffness in middle-aged women.

    Methods: 35 middle-aged women (age range 32 to 59 years) volunteered to participate. The subjects were randomly assigned to one of three groups: resistance training (RT) group, aerobic exercise training (AET) group or control group. The RT and AET groups performed 12 weeks of moderate-intensity resistance training or aerobic exercise training (two days/week).

    Results: In the RT group, one-repetition maximum strength significantly increased after the intervention. Interestingly, aortic (carotid–femoral) pulse wave velocity (PWV; an index of arterial stiffness), and peripheral (femoral–ankle) PWV did not change with moderate-intensity resistance training. In contrast, in the AET group, carotid–femoral PWV significantly decreased after the intervention. Resistance training and aerobic exercise training did not affect blood pressure.

    Conclusions: This study found that moderate-intensity resistance training did not increase arterial stiffness in middle-aged women, which may have great importance for health promotion with resistance training.

    • Drew Baye November 7, 2010 at 12:14 pm #

      At first training should always be more moderate; the goal when starting out is to learn and practice exercising correctly and maximize skill. As they become skilled in the movements, proper breathing, etc., intensity should be gradually increased, with progression dependent upon individual response.

      I’m not surprised arterial stiffness didn’t increase with moderately intense resistance training and it shouldn’t increase much more with higher intensity resistance training either. Although heart rate and stroke volume increase, the blood vessels supplying the working muscles dilate, so there shouldn’t be as much peripheral resistance.

  10. mac August 9, 2011 at 12:28 pm #

    Would you please expound upon your statement in point #4, i.e.–that with age one type of muscle fiber converts to another. I do not believe that I’ve heard this previously. Thank you.

    • Drew Baye August 9, 2011 at 12:51 pm #

      Mac,

      Without strength training there will atrophy of both Type I and II fibers as we age, but mostly Type II, and there is some evidence some Type II fibers convert to Type I due to re-innervation by adjacent Type I fibers.

  11. mac August 13, 2011 at 11:21 am #

    Will proper HIT postpone or, at least, mitigate this retrogression?

    • Drew Baye August 13, 2011 at 11:24 am #

      Mac,

      Yes. Strength training will help maintain the larger, high threshold type IIB motor units as we age.

  12. Micheal March 8, 2014 at 3:40 am #

    Really excellent. I`m 42. I did bodybuilding. Now I want to restart. Is it possible to build muscle in this age ? Would you be kindly enough to guide me to achieve my goal (building muscle , a good physique). What should be my workout routine and diet plan ? Waiting for your advice.

    • Drew Baye March 17, 2014 at 7:00 pm #

      Michael,

      The older you get the more difficult it becomes to increase muscular strength and size, but it is still possible to do so. There are several workouts listed in the articles on this web site, and I have several books on the subject and am available for phone consultations if you need additional help.

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