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 seventies and eighties with a variety of medical conditions including several with severe spine conditions (and one middle-aged man with a grade-three spondylolisthesis) and not one has been injured doing high intensity training.

Ellington Darden, Drew Baye, Jim Flanagan

Ellington Darden (left) and Jim Flanagan (right) are both in their sixties and still stay in great physical condition with 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 at least three seconds to lift and three seconds to lower the weight, reversing direction as smoothly as possible without bouncing, yanking, or jerking the weight. Pause for a second or two in the fully-contracted position on compound pulling exercises and simple exercises. If you’re moving slowly enough six to ten repetitions should take you around fifty to eighty seconds to complete.
  4. When you are able to perform ten or more repetitions of an exercise in good form, the next time you perform the exercise add five pounds or five percent 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 six to ten is fine when performed at a slow speed.
  5. As the exercises 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. For more detailed guidelines read High Intensity Workouts.

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 have no 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” who had no idea what proper exercise form was or how to teach it, had their clients doing numerous ineffective and 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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