How can I improve or maintain my mobility as I age?

DEAR DOCTOR K:

I’m in my 80s. I recently stopped driving, and now I can get around independently only by walking. Can you tell me how to improve, or at least maintain, my mobility?

DEAR READER:

Mobility is one of those things most of us take for granted until we begin to lose it. That’s when we realize that even a simple, relatively uneventful day requires a great deal of physical stamina, strength, balance, coordination and range of motion.

The single most important thing you can do to remain mobile and independent is to engage in regular physical activity. I can’t emphasize this enough: You need to be active to stay active.

When I give this advice to my older patients, they sometimes reply that “it’s too late.” They say they haven’t really been physically active since they were in their 20s, and ask what good it would do if they started now.

For the vast majority of my older patients, the answer is that it is never too late to start. The evidence shows that starting a regular exercise program even after decades of inactivity brings great health benefits.

People who are older and out of shape will need to start slowly and increase their exercise program incrementally. Sometimes I recommend that they start with a trainer to get them going on a program they can maintain themselves. But that usually is not necessary.

You can start by doing more physical activities throughout your day. For example, take the stairs instead of the elevator, do some gardening, or walk around your living room while talking on the phone. Several of my patients deliberately replaced their traditional home phones with cordless home phones to make this easier. (And some have replaced home phones entirely by cellphones.)

You’ll also want to start, or continue, a regular exercise routine. Aim for 30 minutes of moderate aerobic exercise a day, at least five days a week. Good options include walking, swimming, water aerobics and riding a stationary bike.

Try to do strength-training exercises twice a week. Strength training protects against bone loss and builds muscle. It also provides the functional strength you need for everyday activities like lifting groceries or rising from a chair. Doing yoga and climbing stairs involve strength training. However, it’s best to perform a group of strength-training exercises that use different muscle groups. You can also incorporate elastic resistance bands, free weights or weight machines into your strength-training routine.

Finally, be sure to make balance exercises a part of your exercise program. Better balance reduces your risk of falls, which can be disabling or even fatal in older adults. Below, I’ve put photos and descriptions of balance exercises you can do at home, without any special equipment. Or learn yoga or tai chi. Both activities also improve balance.

Ideally, we’d all like to keep walking as long as possible. But remember, losing the ability to walk doesn’t mean the end of your mobility. You can still remain mobile by using a wheelchair or other assistive devices.

 Stand up, sit down:

BB0614-7

Reps: 10
Sets: 1–3
Intensity: Moderate to high
Tempo: 4–2–4
Starting position: Sit in a chair with your hands crossed on your chest or held out in front of you at chest level.
Movement: Slowly stand up. Hold. Slowly sit down with control.
Tips and techniques:

  • Press your heels into the floor and squeeze your buttocks as you stand up to help you balance
  • Steady yourself before you sit down
  • Exhale as you stand, inhale as you sit

Too hard? Use your hands to assist you as you stand up and sit down, or do fewer reps.
Too easy? Extend your right leg out in front of you with your knee slightly bent, ankle flexed, and heel on the floor. Stand up and sit down. Finish all reps, then repeat with the left leg

Heel Raises:

BB0614-8

Reps: 10
Sets: 1–3
Intensity: Light to moderate
Tempo: 2–2–2
Starting position: Stand up straight behind a chair, holding the back of it with both hands. Position your feet hip-width apart and evenly distribute your weight on both feet.
Movement: Lift up on your toes, letting your heels rise off the floor until you’re standing on the balls of your feet. Try to balance evenly without allowing your ankles to roll inward or outward. Hold. Lower your heels to the floor, maintaining good posture as you do.

Tips and techniques:

  • In the starting position, think of each foot as a room and stand evenly on all four corners. When lifting, try to balance evenly on the front two corners.
  • Zip your abdominal muscles up and in as if you were wearing a tight pair of jeans while contracting your buttocks, squeezing your inner thighs, and balancing on the balls of your feet.
  • Imagine you have a string at the top of your head pulling you up.

Too hard? Sit down in a chair. Lift your heels off the floor. Hold. Lower your heels to the floor.

Too easy? While holding on to the back of a chair, bend your left knee slightly to lift your foot a few inches off the floor. Do heel lifts with your right foot. Finish all reps, then repeat on the other side.

Standing hamstring curls

BB0614-10

Reps: 10 on each side
Sets: 1–3
Intensity: Light to moderate
Tempo: 2–2–2
Starting position: Stand up straight behind a chair, holding the back of it with both hands. Extend your right leg behind you with your toes touching the floor.
Movement: Bend your right knee and try to bring the heel toward your right buttock. Hold. Slowly lower your foot to the floor. Finish all reps, then repeat with the left leg. This completes one set.

Tips and techniques:

  • Maintain good posture throughout.
  • Keep your hips even, squeezing the buttock of the standing leg to help you balance.

Too hard? Lift your leg less, or do fewer reps.
Too easy? Close your eyes.