As you map out your week, plan some form of movement every day and build in variety—balance biking with yoga, swimming with tai chi. The more varied your routine, the better. Variety reduces the risk of injury, keeps your body nimble, and helps you stay motivated. Even within your workouts, you can enjoy a yin-yang mentality. This happens naturally if you’re, say, biking over hilly terrain—a hill comes, you crank to get to the top, and then you’re back in a comfortable movement zone. Mimic this pattern with other types of exercise—which is to say, don’t worry about maintaining an elevated heart rate for a certain amount of time. It’s more effective to pop in moments of intensity (see Microbursts of physical intensity for more on this).
Most important is to move a lot without hurting your body. Cultivate the wisdom to know what’s normal, as far as your body’s capacity to tolerate certain types of exercise, and not to resist change—that’s the yin part. Also nurture the drive and motivation to do the most you can to be the healthiest you can be. There’s the yang part.
Running is okay if your form is good, but I do see a lot of patients who injure themselves running. There are other ways to push yourself that might be better for your joints and muscles, like biking or swimming.
No matter what, let your body guide you in how far to push on a particular day. Be alert: This is helpful in preventing injury and feeling your best. In a perfect world, you’d be able to follow your body’s lead on all things, letting it tell you when it wants to eat and when it’s ready to fast, when it needs to get in bed early and when it’s primed for a tough workout. As much as is practical, listen and heed what you hear.
If you like tracking technology, consider options like the Oura Ring; it can let you know when your body is ready for a stronger or lighter workout by noting your heart rate variability, which is a good measure of healthy function of the nervous system (your nervous system affects everything else). For the rest of us, it’s simply about tuning in, paying attention, and remembering that it’s much more important to do something physical than it is to do something strenuous.
Most of us lose about 1 percent of muscle mass each year after 40. So by the time we hit 70, we’re probably working with about half the muscle mass we had when we were in our 20s. It’s just a natural part of aging, called sarcopenia, and minimizing it is a priority for aging well.
Until your late 50s, you shouldn’t worry much about sarcopenia; as long as you’re taking good care of yourself and exercising, you should be okay. Beginning at around 60 or 65, many of us need to increase protein by about 25 percent (even if this necessitates consuming more animal protein).
The other piece of the puzzle is strength training; resistance exercise in your workout and resistance activities in daily life (hauling and lifting) are essential to maintaining muscle mass. Strength training is not just lifting weights. It’s any activity with resistance. Resistance can come from stretchy bands, balls, dumbbells, bars, cords, exercise machines, or your own body weight (holding plank or descending into a yoga push-up—that’s strength training).
As you get older, you want to be doing more reps with lighter weight. Exercise in a safe but challenging zone where you can feel your muscles working but you don’t have pain in your joints—work hard enough so that the next day you may be a little achy (again, in muscles, not joints!). At least twice a week, do some form of strength training.
Upping your strength training doesn’t mean sacrificing cardio workouts. Though cardio doesn’t necessarily help muscle mass, it increases blood flow, multiplies mitochondria in the cells, brings more oxygen to the muscles, builds endurance, and turns on (or “upregulates”) longevity genes. Do both, and mix things up as much as possible. Cross-training is like eating a lot of different vegetables: You get certain nutrients from certain foods, and various forms of movement nourish your body in different ways. Variety also helps you avoid injury, which is often caused by repetitive stress.
Protein and strength training are the key ingredients for maintaining muscle mass, but there are a couple of other factors too. A generally healthy lifestyle is going to help. Staying away from foods that cause inflammation is important. And ensuring that you get enough high-quality sleep really makes a difference. You can also ask for a check of testosterone from your doctor (both women and men produce testosterone). There are two measures: total testosterone and free testosterone; free testosterone is the one that’s important. If your level of free testosterone is low and you’re experiencing symptoms (general fatigue, a low sex drive), then bioidentical testosterone could be helpful (see Bioidentical hormones for more on this).
We can’t stress enough the importance of maintaining muscle mass. Losing too much muscle leads to frailty, and this is what you’re trying to avoid. So whatever it is you like to do—lifting, crunching, hiking, planking, handstands, boxing, swimming, cycling, squatting, pressing, pulling, pushing—keep it up. And take advantage of everyday opportunities for resistance work: moving furniture, hauling the hose, shifting boxes. Functional strength training counts.
Recovery becomes harder and slower with age. That’s why it’s so important to focus on preventing injury. You can still enjoy a challenging, sweaty workout and get that exercise high, but don’t push to your absolute limit. Exercising too hard is a form of stress on the body. And too much stress can not only lead to injury but can also strain the immune system.
Go a bit gentler in general, say to 80 percent of your ability. And if you have a feeling that something in your routine is causing damage, stop doing it. Here are some tips to keep you on track.
• Stretch, roll, and warm up—it’s not a waste of time. There’s a reason that a spate of stretching studios have cropped up in the past few years. We’re not doing enough stretching, and that can lead to tight muscles and restricted fascia, predisposing you to pain and injury. Stretched-out, limber muscles keep your joints comfortable, your posture healthy, and your gait easy. Stretch before exercise, then start slow, whether you’re swimming, biking, lifting, or practicing yoga. Give the body a chance to ramp up. Stretch again at the end of a workout. Foam-rolling (see Rolling out the fascia) deserves another shout-out here. Regular rolling will not only help your body feel more open and less achy but will also minimize the risk of injury.
• Notice what hurts and why. It’s easy to become used to aches and pains. Your body adjusts to protect itself. You turn your foot sideways on the stairs so the Achilles tendon doesn’t have to stretch as much or the knee takes less impact. You favor one arm when lifting something heavy. Investigate what you’re accommodating and possibly missing, so you can fix the problem instead of working around it. Because workarounds very often end up hurting something else. It starts in your foot, then gets to your hip and your back and then your shoulder—eventually you end up with a pile of imbalances and discomforts that are harder to untangle and address. A good physical therapist or someone who works with body mechanics (like a specialist in Alexander Technique) can help you figure out what might be affecting your gait, the way you carry your bag, how you do ordinary things like climb the stairs—and note imbalances in your body. The right exercises can help you avoid a cycle where compensating for one injury creates another.
• Don’t wait—treat it now. Staying strong and agile—and being able to continue to do the type of movement you love—is partly about catching problems before they turn into something more serious. If something hurts and taking a break doesn’t fix it, get help. Don’t wait. Go as soon as possible. An injury that’s not getting better needs intervention—whether it’s acupuncture, physical therapy, deep-tissue work, or something else, the sooner you treat it (and the younger you are when you address it), the better. Start with the least invasive form of help, then move to more invasive ones if you have to.
• Check your form and habits to prevent future injuries. Any repetitive movement done incorrectly is going to create damage in the body, at any age. But it matters much more as you get older, because recovery is harder. It’s not always easy to know what correct alignment looks like while exercising. And even if you do, you can’t see yourself if you’re not in front of a mirror. Making the situation even tougher is the fact that there are lots of folks leading fitness classes who don’t necessarily know body mechanics—and often they don’t even offer modifications. So you need to be in charge of your own body. A great gift to yourself is a session with a skilled trainer or physical therapist who can check your form and correct your workout. Ask questions. (“It hurts here when I do this—how can I work this muscle group instead?”) Even forms of exercise that have a reputation for being gentle, like yoga, can result in injuries. It’s not always easy to find an expert for an assessment, but if you can do it—and repeat the check-in process every year or so—you’ll be able to keep bad habits at bay. Minimizing misalignment and the ensuing damage is an investment in your current and future wellness. You want to be able to still do the stuff you love when you’re 90.
Case Study
The hard lesson of overexercising
Steve, 65, has run the New York City marathon twice and intends to do it again this year. He comes to see me hunched over, with lower back pain and shoulder pain. ‘I’m walking like an old guy,’ he says. ‘What happened?’ Steve prides himself on his strength and fitness level, and he’s shocked by what feels like his body betraying him.
Steve has collected a lot of injuries over the years. He hasn’t adapted his workouts to protect those injuries or shifted into a ‘preservation’ mindset, which is what we all need to do as we age. Instead he pushes and pushes, and then pops tons of Aleve at night.
Steve has particularly tight hips, and because of this, his hip muscles are not firing properly when he’s running. This makes the back muscles work harder—it puts an extra load on them. Steve’s upper back and shoulders are also tight, probably from years of sitting at a desk. I refer Steve to the chiropractor in my office for some Active Release Technique (ART) massage. The ART helps loosen the hips and upper back. In the office, we teach him foam-rolling techniques that focus specifically on releasing the hips and upper back and tell him to roll daily—twice if he can fit it in. Once Steve gets into rolling and loosens his hips, which he never realized were so tight, things improve. Now that the hip muscles are firing and doing their job, the lower back pain and shoulder pain disappear, as the extra load on those muscle groups lightens. Steve says, ‘I haven’t felt so loose in 20 years.’ I suggest tai chi to help keep his lower back stretched and agile, and he becomes a convert.
Steve begins to modify his exercise routine, namely to stop doing things that hurt. He changes his mindset—stops treating symptoms with Aleve, and instead focuses on preventing injury and taking care of what he’s got. We get him off the Aleve completely. He decides that he’s done enough marathons, and he gets into biking.
He begins going for weekly infrared saunas and regular massages. He embraces caring for his body in a gentler way. Although he talks about doing a Century Ride (that is, a 100-mile bike race), he’s listening to his body more than ever, he’s off the Aleve, and he’s on the mend.”
Opt for movement over stasis whenever you can. Shift positions at work—or anywhere you find yourself “stuck” for long periods of time. Some people say a standing desk is the solution, but if you stand in one spot for eight hours, that’s not much better than sitting still for eight hours. The point and the goal are to change positions often and to move, move, move. At work, if you can switch between sitting, standing, and even squatting (try it; you might like it), and walk or do a flight of stairs whenever possible, your whole body will feel better.
Micro movements matter too. Manual dexterity is something we don’t necessarily think about unless it becomes a problem. Making sure you mix it up in terms of micro movements—not just typing, but cooking, playing an instrument, gardening, kneading clay, knitting, or doing origami, say—helps keep hands nimble. This wouldn’t be the primary reason to do any of those activities, but it’s a benefit and might help motivate you. Variety prevents stiffening patterns. Since so much of modern life demands sameness, repetition, and stasis, it helps to keep an eye on this.
In general, using different parts of your brain and body is a key component to aging well: Seek variety in all things, from the vegetables on your plate to the generations of the people you hang out with to the workouts you choose to the macro and micro movements of your day.
If you already practice yoga, you probably have an appreciation for what it can do for your body, and you may have clarity on the vast range of options that fall under the heading “yoga.”
For the uninitiated, yoga can range from “restorative”—staying in poses that gently stretch the body, supported by props like blocks and blankets—to Ashtanga, an extremely active practice that involves more push-ups than you might experience in a boot camp class (and yoga-style push-ups are actually even harder than the classic type). In between are popular forms like Vinyasa, often called “flow” yoga, where poses are linked one to another and the sequence stretches and strengthens all parts of the body.
What’s common to all types of yoga is the marriage—or “yoking”—of body and breath. Take a moment right now to notice your breath. Is it shallow, landing in the chest, or deep, inflating the belly? Being in a class where someone is reminding you for an hour or so to extend your inhale and complete your exhale has more impact on you—your day, your week, your life—than you can imagine. That’s one of the many benefits of yoga—the gift of a full, deep breath.
As you age, yoga becomes even more valuable because it can counteract the potential shortening and tightening of muscles. It addresses the “tech neck” we experience from working on laptops and hunching over phones. It lengthens and loosens muscles that are tight from biking and swimming and running. And it comes with a body awareness and a philosophy that’s larger than the practice, showing you imbalances in your body, bringing your mind into your movement (the opposite of running with headphones on), and helping you tune in to the relationship between your body and your breath. For very physical people who love to challenge their limits, mellower forms of yoga can provide delicious balance.
Breathwork, which you may have heard of, is a practice that helps you manage stress, sleep better, and release tension all over your body. It’s simple and easy. The difference between breathwork and meditation is that in breathwork you’re manipulating your breath, and in meditation, more often, you’re just watching your breath—being aware of it without actually trying to change it. Breathwork doesn’t have to be anything fancy: It can be as simple as breathing in for a slow count of four and exhaling for a slow count of four. It’s exactly what your Apple Watch or Fitbit tells you to do, but you don’t need a device to make it happen. Here’s a simple exercise we like from breath facilitator Margaret Townsend (TheLivingBreath.com). Try it and sample the effects of a regular breath practice, which can deliver a sense of relaxation and expansiveness, effortlessly transforming a stressful moment or difficult day.
Sit for a moment and picture your breath as a sort of inner rain shower, cleansing and nourishing your body. Inhale as deeply as feels good, exhale all the way, then let the inhale rise like a gentle wave. Think of an easy flowing cycle. Imagine that your jaw and throat are as wide as your ribs and hips—that you’re an open channel for the flow of your breath. Introduce the thought of receiving nourishment as you inhale and cleansing as you exhale, clearing space for the next inhale. Stay with this flow for two or three minutes, or as long as you’re enjoying it. Then let your breath return to normal and just sit with the feeling. Maybe let your mouth curve into a light smile (this relaxes the muscles in the face). Notice how you feel.
You can also lie down on the floor or on the bed, turn on some mellow music, and let your breath and heart entrain to the rhythm. Rest your hands on your belly so you can feel it rise and fall (and if it doesn’t happen naturally, see if you can send your inhale all the way down so your belly fills up, then feel it deflate as you exhale). Conscious breathing is just a fuller version of the age-old advice to “take a deep breath.” It slows you down, feeds your cells, lightens your mood, and becomes a coping tool; eventually you go to it without even thinking. In an elevator, during your commute, on line for the ATM—these are all opportunities to experiment with your breath; stretch it a bit, extending the exhale and inhale; feel where it’s going in your body; and see if it can spread elsewhere. Even just 30 seconds of conscious breathing can bring benefits.
Adding sustainable healthy habits and practices to your life is the kind of thing that keeps you vital long term. Don’t wait. Start now. The fluid, low-impact martial art tai chi, in which relaxation is a core principle, is unparalleled in this department.
Tai chi is a set series of movements, practiced in a seamless flowing sequence known as “the form.” It’s smooth, slow, intentional, grounding, and deep—and something almost anyone can do, regardless of injury or other limitations. As a physical practice, it has a lot to offer. As with many Eastern practices, its principles also apply as a life philosophy. Soft, yielding, and rooted, it makes a lot of sense, especially when it comes to aging.
There are different traditions, including Yang, Chen, and Wu—some with longer or shorter forms. Don’t get hung up on the differences. See what’s available locally; if there’s a tai chi community near where you live and you’re able to learn in person from an experienced teacher, you’re probably more likely to stick with a practice.
This is a movement form that makes you stronger with very little risk of injury. Tai chi helps you build strength in your legs and core. It improves balance. It helps you see where you hold tension and learn how to drop it, to root yourself into the ground. It’s transportive. And it’s something you can take with you anywhere. Once you learn the form (the Yang short form, to give you a sense, is about a seven-minute sequence), you can do it just about anywhere: in the driveway, in a park, even at the airport, if you’re not shy.
One of the biggest issues of aging is frailty. It might be hard at this point to imagine becoming frail, but it can creep up on you. Modalities like tai chi, yoga, and foam-rolling all keep you nimble. They’re anti-frailty. They can help your body age in the best possible way, and stay with you as a form of gentle, sustainable fitness forever.
Much of what people think of as signs of aging are just signs that the body needs more (and better) regular recovery. Rather than wait till aches and pains show up, add something to your routine to help the body regularly recover. Our culture treats recovery—sleeping, bodywork, saunas, even lying down with a book—as indulgence. We need to stop thinking this way. If you’re active, anything that releases muscles, takes the weight off joints, and circulates the body’s chi (aka energy) is crucial to wellness.
There are a lot of things that get the body’s chi flowing, but Western doctors don’t necessarily look at all the options. Following are some we see great results with, whether for a general boost (a massage once or twice a month is fantastic for your health), to treat chronic pain like arthritis, or for help with a specific injury. Which modality is best for you? That’s for you to determine. Personality comes in, expense matters, insurance is an issue, and availability of well-trained practitioners is a factor (a reference from a friend or a trusted medical pro is best). The point is to begin to think about some sort of treatment as a regular part of your personal upkeep. Because going that extra mile to support function is part of best-case aging. Here are some ideas.
A massage session with a well-trained massage therapist, regardless of technique, offers you a whole-body reset. If it’s in the budget, regular massage can change your life. For specific problems, Active Release Technique (ART) is very effective. It’s a massage technique that combines targeted pressure on muscles and fascia with very specific movements while pressure is being applied. For example, the therapist might put manual pressure on a shoulder muscle while moving your arm, so that they can detect and release restrictions throughout the range of motion. ART works well for problems involving muscles, tendons, ligaments, fascia, and nerves, and ART-certified therapists are extremely well-trained. Myofascial release therapy is another type of deep-tissue work that involves slow, sustained manual pressure to release tension. Deep-tissue work can be painful while it’s happening, but the results can be significant.
Acupuncture is great for muscle pain, stress relief, insomnia, headaches, hormonal problems, and more. The concept behind it is that the body is a system of meridians—like rivers—through which energy flows; acupuncture unblocks congestion to restore flow (in Western terms, that would be releasing fascia constriction). The needles used are much finer than needles used to deliver medicine—and they’re soft and flexible, not rigid. Depending on the point, you may not feel the needles at all, or you might experience a little discomfort that generally disappears in a few seconds. Many people find acupuncture extremely relaxing.
Regular sauna or infrared sauna sessions reduce inflammation and are relaxing for body, mind, and spirit. They can help with chronic pain, like arthritis, and muscle aches from overuse, among other things. See Sauna sessions for more.
Alexander Technique is a system of body awareness. It’s all about using minimum effort in carrying out movements and maintaining healthy posture while standing, sitting, and just being. Sessions are conducted one-on-one or in small groups. Alexander can be effective in treating and preventing certain kinds of injury, especially problems from repetitive movement, and is also helpful if you carry a lot of stress in your body. It’s a great practice for general well-being.
There’s also a lot you can do on your own to address aches and keep serious pain from developing. A thorough daily routine of foam-rolling that gets at all your trouble spots is a lot like massage. Improving your work setup can have a significant impact. Is your chair the right height? Is there an ergonomics expert available at your workplace who can help improve the situation? If you drive a lot, is the seat in your car in the optimal position? For women especially, drivers’ seats are not necessarily designed to properly support the body. Do you need a lumbar pillow? A seat cushion? How about your bag? Do you lug around a heavy load on one shoulder? Often it’s the everyday stuff that’s causing stiffness and pain. Find it, fix it, and feel the difference.
Here’s a question: If something is bothering you, are you able to shut off your brain at a certain point in the day and put it away? Can you stop thinking about whatever the situation is, or does it stay with you and keep you up at night? This is not the only reason to meditate, but it’s one motivator. Having some sort of mind-quieting practice helps you find relief from thoughts that dog you—which are likely causing stress, shallow breathing, and tightness in your body.
But there are different ways to quiet the mind. You don’t have to meditate, per se, because if that isn’t something you look forward to, you won’t do it. It’s better to carve out 20 minutes a day for a peaceful practice that suits you: something simple that you enjoy, unplugged, without phone interruptions. Knit in a quiet place; play an instrument; listen to music you love, eyes closed; sketch a tree or a person across the way at the park; walk slowly (in nature or even in the city), being mindful of what’s around you. Dig in the garden, color in a coloring book, wander in the woods and collect a certain type of leaf; you can change your practice by the day, season, or circumstance, taking advantage of what’s around you. Watching fish in an aquarium works. Hunting for sea glass on the beach. Observing birds or bees in a garden.
Take this time seriously, and treat it like an appointment. Sneak off and shut the door, or slip outside. The point is not the formality of classic meditation. The point is to let your mind drop into a quiet place regularly for 20 minutes or so. You’ll experience a shift, sometimes subtle and sometimes obvious, if you give yourself this 20-minute block.
And if you want to try to sit and meditate, that’s fantastic. We are big fans. Meditation has a lot of proven benefits, short- and long-term. It slows aging of the brain, lowers blood pressure, and lengthens telomeres (those protective “aglets” on the ends of DNA strands). It gives you energy, improves concentration, and helps you sleep better. And it lifts your mood—it actually just makes you feel happier. (If it relaxes you, meditation at bedtime is fine. But many people find it energizing, and for those folks, daytime is best.)
There are great apps for beginners, including Headspace, Oak, Meditation, Calm, Breathe, and Brightmind. You can also find in-person guided meditation sessions at meditation spaces and yoga studios. Meditating in a group with a teacher can be extremely helpful as you develop a practice.
As with yoga, there are many styles of meditation, and classes or apps might mix elements from different sources. Some of the common types are mindfulness meditation, mantra meditation, and loving-kindness meditation. If the first approach or teacher or app doesn’t speak to you, find another—don’t dismiss meditation altogether. Keep looking till you find the method, voice, vibe that you connect to.
Case Study
When meditation is the missing piece
Jason, 50, works in finance. He’s been putting on a little bit of weight. He finds that he can’t exercise as hard as he used to. He says there are all these 30-year-olds joining his company, and he’s worried. His identity very much revolves around his success at work, and he feels things slipping. He has aches and pains he never had before, and his golf game has suffered. His sex drive is down. He’s feeling like things are not the same in the bedroom. Something’s happening, and it’s freaking him out.
Five years before, I had suggested meditation to Jason, but he wasn’t open to it. At that point, he was very keen on exercise—because it was concrete, and it made him feel stronger—but wouldn’t listen to advice about meditation. Things have changed, and people in his industry, especially his superiors, are meditating. Now Jason is opening up to the idea. We discuss it, but I want him to focus on food first, so I don’t push.
Dietwise, I say, give me two weeks: I want you to eliminate all sugar, all grains, all starchy carbs, all alcohol, and if you’re not feeling better, we can reassess. But after two weeks, he feels stronger. He comes to see me and says, ‘I’ve got my mojo back.’ He’s inspired. That subjective sensation of feeling better is very powerful. He’s ready for the next step. I say, ‘Okay, you feel better physically; now we’re going to work on you feeling better and performing better mentally—not only being a physical athlete but a mental athlete too.’
I tell him to try the Calm meditation app. To do this every day for 30 days, because it will take that long to really feel the difference. Just 15 or 20 minutes, once a day. When Jason comes back a month later, he’s lost 15 pounds, his golf game is better, the aches are gone, things are better sexually. He feels calmer and clearer and sharper at work. I ask how he’s sleeping. He hadn’t even noticed but confirms that yes, he’s sleeping better. Sleep underlies a lot of problems, and sometimes people come in complaining about the consequences of poor sleep without realizing that lack of quality rest—including not only sleep but meditation—could be an essential part of the problem.”