Your Everyday Guide

from the National Institute on Aging

Exercise & Physical Activity

 National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
 Your Everyday Guide from the National Institute on Aging

Exercise & Physical Activity

IN THIS BOOK... 2
introduction get set
Why Is Physical Activity Such a Big Deal? 6
Identifying Your Starting Point 17
Using This Book 8
Setting Your Goals 18
Writing a Plan to Add Exercise and

1
Physical Activity to Your Life 20
Talking With Your Doctor About Exercise
and Physical Activity 20

get ready Safety First: When to Check with Your Doctor 22

What Kinds of Exercises and Physical Activities

Improve Health and Physical Ability? 12
Endurance
Strength
Balance
13
13
13
3
Flexibility 13
go!
Three Keys to Success 25
1. Include Physical Activity
in Your Everyday Life 25
2. Try All Four Types of Exercise 27
3. Plan for Breaks in the Routine
(Life Happens!) 28

Building up the Benefits 31

Reducing the Risks 32
4 5
sample exercises how am I doing?
Test Yourself 92
How to Improve Your Endurance 37
How Much, How Often 37 Other Ways to Measure Progress 93
Safety 38
Progressing 39
How to Improve Your Strength 41
About Strength Exercises 41
How Much, How Often 41
Safety 42
Progressing 43
How to Improve Your Balance 64
How Much, How Often 64
Safety 64
Progressing 64
Anytime, Anywhere Balance Exercises 64
How to Improve Your Flexibility 70
How Much, How Often 70
Safety 70
Progressing 70
6 7
healthy eating keep going
Tips for Healthy Eating 96 Activity Log 102
Drinking Enough Fluids 97 Goal-Setting Worksheet 103
Eating Out 97 Weekly Exercise and Physical Activity Plan 104
Endurance Daily Record 105
Strength and Balance Daily Record 106
Flexibility Daily Record 107
Monthly Progress Test 108
20 Frequently Asked Questions 109
Resources 116
Acknowledgments 119
 introduction

Welcome to Exercise & Physical Activity: Your Everyday Guide from the National
Institute on Aging! The National Institute on Aging (NIA) is part of the National Institutes of
Health, and the goal of our research is to improve the health and well-being of older adults.

Like most people, you’ve probably heard that physical activity, including
exercise, is good for you. If you’re already active, keep it up. It may even
be time to push yourself a little harder, try a new activity, or find new ways
to add exercise to your daily life.

Don’t worry if you’ve never exercised, or if you stopped exercising for

some reason. Let us help you get moving. By picking up this book and
looking through it, you’ve taken an important first step toward good health.

This guide is the centerpiece of Go4Life, NIA’s national campaign to help

you fit exercise and physical activity into your daily life. To find out more
about how Go4Life can help you be more active, visit our website at
www.nia.nih.gov/Go4Life.
6 EXERCISE & PHYSICAL ACTIVITY

Why Is Physical Activity

Such a Big Deal?
Regular exercise and physical activity One of the great things about physical activity
are important to the physical and mental is that there are so many ways to be active.
health of almost everyone, including older For example, you can be active in short spurts
adults. Being physically active can help you throughout the day, or you can set aside
continue to do the things you enjoy and stay specific times of the day on specific days of
independent as you age. Regular physical the week to exercise. Many physical activities
activity over long periods of time can produce — such as brisk walking, raking leaves, or
long-term health benefits. That’s why health taking the stairs whenever you can — are
experts say that older adults should be active free or low cost and do not require special
every day to maintain their health. equipment. You could also check out an
exercise video from the library or use the
In addition, regular exercise and physical fitness center at a local senior center.
activity can reduce the risk of developing
some diseases and disabilities that develop This guide shows you many types of exercise
as people grow older. In some cases, exercise and physical activity. It also has lots of tips
is an effective treatment for many chronic to help you be active in ways that suit your
conditions. For example, studies show lifestyle, interests, health, and budget,
that people with arthritis, heart disease, whether you’re just starting out, getting back
or diabetes benefit from regular exercise. to exercising after a break, or fit enough to
Exercise also helps people with high blood run a 3-mile race. It’s for everyone — people
pressure, balance problems, or difficulty who are healthy and those who live with an
walking. ongoing health problem or disability.

GO HERE FOR MORE INFO

For many people, “real life”— things like illness,
traveling, or an unexpected event — can get in the
way of being active. See page 28 for tips on how
to deal with breaks in your physical activity routine.
 INTRODUCTION 7

What’s the Difference Between

Physical Activity and Exercise?

Both terms refer to the voluntary movements

you do that burn calories. Physical activities
are activities that get your body moving
such as gardening, walking the dog, raking
leaves, and taking the stairs instead of the
elevator. Exercise is a form of physical
activity that is specifically planned,
structured, and repetitive such as weight
training, tai chi, or an aerobics class.

Physical activity and exercise are both

important and can help improve your
ability to do the everyday activities you
enjoy. (See Exercise and Everyday
Activities Go Together on page 15.)

The bottom line? There are many ways to

be active every day. Find something you
make it a priority
enjoy doing, include it in your regular Being active and exercising regularly can change your life.
routine, and try to increase your level of See how Greta has benefited from regular exercise:
activity over time.
“At age 67, I’m in the best physical condition of my life. Two
years ago, I joined a low-impact aerobics class at a nearby
senior center. The entire routine is done to music, planned
and led by an instructor. My balance has improved greatly,
and my osteoporosis has remained stable.”
8 EXERCISE & PHYSICAL ACTIVITY

Using This Book

This guide can help you take charge of an important part of your health. You may want to read
through the entire book first to learn about the benefits of exercise and physical activity, and to
find out how to get started, reduce your risks, and reward your progress. Then, keep it handy so
you can refer to the sample exercises and use some of the charts at the back of the book to record
your activities. From time to time, you may need to check the tips for getting back on track if
there’s a break in your routine or the tips for healthy eating. Throughout the guide, you’ll find
personal stories that we hope will inspire you to be more active every day.

Chapter 1: Get Ready talks about the

“why” of exercise and physical activity. It tells
you the benefits of being active and describes
the different types of exercise.

Chapter 2: Get Set guides you on getting

organized and reviewing your current activity
levels, setting short- and long-term goals, and
creating a realistic plan for becoming active
over time.

Chapter 3: Go! is all about the “how.” The

guide offers tips to help you get started. It
also has ideas to help you stick with your
decision to be active every day and to get you
back on track if you have to stop exercising
for some reason.
 INTRODUCTION 9

Chapter 4: Sample Exercises gives you some

specific activities and exercises, including exercises to
increase your strength, improve balance, become more SAMPLE
flexible, and increase endurance. All of the exercises EXERCISES
See pages 34-89
have easy directions to help you do them safely.

Chapter 5: How Am I Doing? offers you some

ways to test your progress and reward your success.

Chapter 6: Healthy Eating briefly discusses

another key to good health — nutritious eating habits.

Chapter 7: Keep Going includes worksheets to

keep track of your progress and answers to frequently
asked questions about exercise and physical activity for
older adults. You’ll also find a list of resources for more
information. Some of the resources are especially for
people with specific health problems or disabilities who
want to be active. In addition, there’s a form you can fill
out and send us after you’ve been active for at least a
month. We’ll send you a certificate from the National
Institute on Aging to recognize your commitment to
improve your health. KEEP GOING
WORKSHEETS
See pages 102-108
1
get ready
 CHAPTER 1: GET READY 11

Today, we know a lot more about older adults and their need to exercise. Regardless of their health and physical
abilities, older adults can gain a lot by staying physically active. Even if you have difficulty standing or walking,
you can still exercise and benefit from it. In fact, in most cases, you have more to lose by not doing anything.

Exercise and physical activity benefit every As you’ve probably noticed, the key word is
area of your life. They can: you. The benefits you gain from physical
activity will depend on your starting point
• Help maintain and improve your physical
and how much effort you put into it. You’ll
strength and fitness.
need to match your physical activity to your
• Help improve your ability to do the things own needs and abilities. For example, some
you want to do. people can swim a mile without thinking
twice about it. For others, a slow walk to the
• Help improve your balance.
corner and back is a big achievement. Exercise
• Help manage and prevent diseases like and physical activity are good for just about
diabetes, heart disease, breast and colon everybody, and there are many activities to
cancer, and osteoporosis. choose from. This guide has ideas to help you
• Help reduce feelings of depression, may be active and have fun.
improve mood and overall well-being, and
may improve or maintain some aspects of
cognitive function, such as your ability to GO HERE FOR MORE INFO
shift quickly between tasks, plan an See page 20 for more on talking with
activity, and ignore irrelevant information. your doctor about physical activity.
12 EXERCISE & PHYSICAL ACTIVITY

What Kinds of Exercises and Physical

Activities Improve Health and
Physical Ability?
Exercises generally fall into four main categories:
endurance, strength, balance, and flexibility.
Though we describe them separately, some
activities fit into several categories. For
example, many endurance activities also help
build strength, and strength exercises can help
improve balance.

make it fun
Having fun and socializing are major reasons active people
give when asked why they exercise. Ramesh can show you how:

“I started playing tennis 38 years ago for pleasure. After moving

south to get away from the cold and snow of the Midwest, I
started playing year round. I play with friends every weekend,
both singles and doubles. After tennis, we socialize over
refreshments. That’s the best part of our get-together. At age
65, I’m the oldest in the group; the youngest is 16. I love the
game and hope to play forever.”
 CHAPTER 1: GET READY 13

Endurance Strength
Endurance, or aerobic, activities increase your Even small increases in muscle strength can make a big difference
breathing and heart rate. These activities help in your ability to stay independent and carry out everyday activities
keep you healthy, improve your fitness, and help such as climbing stairs and carrying groceries. Some people call
you do the tasks you need to do every day. using weight to improve your muscle strength “strength training”
Endurance exercises improve the health of your or “resistance training.” Strength exercises include:
heart, lungs, and circulatory system. They also
delay or prevent many diseases that are common
• Lifting weights (see page 41)
in older adults such as diabetes, colon and breast • Using a resistance band (see page 44)
cancers, heart disease, and others. Physical
activities that build endurance include: Balance
Balance exercises help prevent falls, a common problem in older
• Brisk walking
adults. Many lower-body strength exercises also will improve your
• Yard work (mowing, raking) balance. Exercises to improve your balance include:
• Dancing • Standing on one foot (see page 65)
• Jogging • Heel-to-toe walk (see page 66)
• Swimming • Tai Chi
• Biking
Flexibility
• Climbing stairs or hills
Stretching can help your body stay flexible and limber, which
• Playing tennis gives you more freedom of movement for your regular physical
• Playing basketball activity as well as for your everyday activities. To increase your
flexibility, try:

• Shoulder and upper arm stretch (see page 73)

GO HERE FOR MORE INFO
• Calf stretch (see page 88)
Chapter 4, beginning on page 34, shows
you how to do the exercises mentioned • Yoga
on this page and many others.
14 EXERCISE & PHYSICAL ACTIVITY

QUICK TIP

When working outdoors, be sure to use

sunscreen. Also, wear sunglasses, protective
clothing, and a hat with a wide brim.

make it interesting
There are many ways to be active. For Pat, age 56, gardening
keeps her moving:

“I know some people think gardening isn’t really exercise, but I’m
here to say, “Are they kidding?” Maybe I’m only exercising my
imagination when I pore over plant catalogs to pick out seeds for
the garden, but when spring comes, all that changes. Working in
my garden means bending and lifting, moving and stretching, not
to mention digging and hauling! Anyone who’s ever had a garden
knows that shoveling compost, lifting 40-pound bags of mulch,
transplanting seedlings, dividing plants, and pulling weeds are
serious physical activities. For avid gardeners, there’s always
something to do, from spring planting and weeding to fall raking
and cleanup. It keeps a body moving!”
 CHAPTER 1: GET READY 15

Exercise and Everyday Activities Go Together

Exercise and physical activity are good for your health. In addition, improving
your endurance, strength, balance, and flexibility can help you do many of your
everyday activities. For example:

Endurance activities will make it Strength training can maintain

easier for you to: your ability to:

• Push your grandchildren • Carry a full laundry basket from

on the swings the basement to the second floor
• Vacuum • Carry your smaller grandchildren
• Rake leaves • Lift bags of mulch in the garden

Flexibility, or stretching, exercises Balance exercises can help you:

make it possible for you to:
• Stand on tiptoe to reach
• Look over your shoulder to see something on the top shelf
what’s behind you as you back
• Walk up and down the stairs
the car out of the driveway
• Walk on an uneven sidewalk
• Make the bed
without falling
• Bend over to tie your shoes
2
get set
 CHAPTER 2: GET SET 17

We hope you agree that regular exercise and physical activity are important and that you’re ready to take
action! This chapter is all about getting organized. It offers tips for setting short- and long-term goals,
choosing activities and fitting them into your daily life, and managing some of the practical things, such as
getting the right shoes or working with a personal trainer.

This guide’s main goal is to help you become To help you figure out your activity level,
more active, get the most from your activities, try filling in an activity log. For a couple of
and do them safely. The key is to know your weekdays and a weekend, keep track of how
starting point and build slowly from there. much time you exercise or are physically
Knowing your starting point will help you active. Write down how much time you
pick activities that are comfortable and spend doing each activity. The Activity Log
realistic for you. Starting out this way also on page 102 will get you started.
will help you be successful.
You can use the last column of the Activity
Log to write down some ways you think
Identifying Your Starting Point
you can add activities to your daily routine.
Think about a typical weekday and weekend If you’re not active yet, aim for a modest
day. How much time do you spend sitting? beginning and build from there. If you are
How much time are you active? When you’re already pretty active, then you can be more
up and moving, what kinds of activities are ambitious about adding to your activities.
you doing?

GO HERE FOR MORE INFO

If you need to jog your memory, go back to Chapter 1 and look at the examples of the four
types of exercise. Also, review Exercise and Everyday Activities Go Together on page 15.
18 EXERCISE & PHYSICAL ACTIVITY

QUICK TIP Setting Your Goals In addition to seeing how physically active
you are now, you can check how fit your body
Many people find that having a firm goal in
There are many ways to fit is. Several simple tests can help you see how
mind motivates them to move ahead on a
exercise and physical activity fit you are right now (see page 92). The results
into your regular routine: project. Goals are most useful when they are
can help you set realistic goals. They also will
specific, realistic, and important to you.
be useful later on to measure your progress.
Consider both short- and long-term goals.
Your success depends on setting goals that Short-term goals will help you make physical
Try something new: If you
baby-sit for your grandchildren, really matter to you. Write down your goals, activity a regular part of your daily life. For
how about walking to the park put them where you can see them, and review these goals, think about the things you’ll need
instead of playing video games? them regularly. to get or do in order to be physically active.
For example, you may need to buy walking
shoes or fill out an Activity Log so you can
Rethink your priorities: figure out how to fit physical activity into
How important is an entire your busy day. Make sure your short-term
afternoon of TV? How about a goals will really help you be active. Here are
walk after lunch instead? a few examples of short-term goals:

• Today, I will decide to be more active.

Work harder at the things you • Tomorrow, I will find out about exercise
already do: Rake the leaves classes in my area.
instead of using the leaf blower.
• By the end of this week, I will talk with my
friend about exercising with me a couple of
times a week.
• In the next 2 weeks, I will make sure I have
the shoes and comfortable clothes I need to
start walking.
 CHAPTER 2: GET SET 19

If you’re already active, think of short-term goals to

increase your level of physical activity. For example,
over the next week or two, you may want to move
gradually from walking to jogging, increase the
amount of weight you lift, or try a new kind of
physical activity. No matter what your starting
point, reaching your short-term goals will make
you feel good and give you confidence to progress
toward your long-term goals. Use the Goal-Setting
Worksheet on page 103 to help you get started.

After you write down your short-term goals, you

can go on to identify your long-term goals. Focus
on where you want to be in 6 months, a year, or
2 years from now. Long-term goals also should be
realistic, personal, and important to you. Here are
a few examples:

• By this time next year, I will swim a mile three make it routine
times a week.
For Sam, “being able to do the things I enjoy doing”
• Next summer, I will be able to play ball with my motivates him to exercise every day:
grandchildren.
“I started exercising regularly way back in 1960. A friend put
• In 6 months, I will have my blood pressure under
me in touch with a personal trainer at a nearby gym, and he
control by increasing my physical activity and
showed me how to lift weights. Today, at age 83, I’m still
following my doctor’s advice.
exercising to stay fit. I get up every day and exercise for 10 to
Add your own long-term goals to the Goal-Setting 15 minutes. I lift weights followed by stretching. In the evening,
Worksheet on page 103. I do the same routine for about 15 minutes. I’m a drummer by
profession, and I do about four gigs a month. Exercise keeps
my muscles strong and lets me continue to do my drumming.”
20 EXERCISE & PHYSICAL ACTIVITY

Writing a Plan to Add Exercise When it comes to motivation, the first few
QUICK TIP months are crucial. If you can stick with
and Physical Activity to Your Life
physical activities you enjoy, it’s a good sign
Don’t forget to build Some people find that writing an exercise and that you will be able to make exercise and
rewards into your plan. physical activity plan helps them keep their physical activity a regular part of your
For each goal you reach, promise to be active. See if this works for you.
treat yourself to some- everyday life.
Be sure the plan is realistic for you to do,
thing special — a movie,
a trip to a museum, a
especially as you gain experience in how to Talking With Your Doctor About
new CD, or a picnic in be active. You might even make a contract
Exercise and Physical Activity
the park. with a friend or family member to carry out
your plan. Involving another person can help Most older people don’t have health problems
Let us help you celebrate
you keep your commitment. that would prevent them from doing moderate
your progress! If you
increase your physical activity or the types of exercises described in
Make your plan specific and grounded in this guide. In fact, there’s a way for almost
activity for more than a
month, send us the form your goals. For each exercise or activity every older adult to exercise safely and get
included with this guide. you choose, include: meaningful health benefits.
We’ll send you a certificate
from the National Institute • What kind of activity you plan to do You may want to talk with your doctor,
on Aging to recognize
• Why you want to do it however, if you aren’t used to energetic
your commitment. activity and you want to start a vigorous
• When you will do it
exercise program or significantly increase
• Where you will do it your physical activity. You also should talk
Start out with realistic activities based with your doctor if you have any of the health
on how physically active you are now. problems mentioned on page 22. This does
Don’t expect to go from couch potato to not mean that exercise is dangerous. Doctors
super athlete right away. Regularly review rarely tell people not to exercise, but they
and update your plan and long-term goals may have certain safety tips for those who
so that you can build on your success. You have recently had hip or back surgery, those
can use the Weekly Exercise and Physical with uncontrolled health problems, or those
Activity Plan on page 104 to write down with chronic conditions such as diabetes,
your activities. heart disease, or arthritis.
 CHAPTER 2: GET SET 21

Your activity level is an important topic • Make sure your preventive care is up
to discuss with your doctor as part of your to date. For example, women age 65
ongoing preventive health care. Talk about and older should have regular tests for
exercise at least once a year if your health is osteoporosis. Weight-bearing exercises
stable, and more often if your health is getting — such as walking and lifting weights —
better or worse over time so that you can are especially helpful for those with
adjust your exercise program. Your doctor osteoporosis.
can help you choose activities that are best
• Understand how any ongoing health
for you and reduce any risks. Here are a
conditions affect exercise and physical
few things you may want to discuss:
activity. For example, people with
• Ask whether there are exercises or arthritis may need to avoid some types
activities you should avoid. An illness or of activity, especially when joints are
surgery may affect how you exercise. For swollen or inflamed. Those with diabetes
example, if you’ve had hip or back surgery, may need to adjust their daily schedule,
you may need to modify or avoid some meal plan, or medications when
exercises, or if you develop blood clots planning their activities.
in your legs, you will have to restrict your • Talk to your doctor if you think you
activity for a time. Your doctor can tell might have an uncontrolled medical
you how to increase your physical activity condition that might affect the type
gradually as you recover. of exercise you should be doing. For
• Talk about any unexplained symptoms, example, it is important to know how
such as chest pain or pressure, pain to exercise safely if your blood pressure
in your joints, dizziness, or shortness or diabetes is not under control.
of breath. Postpone exercise until the
problem is diagnosed and treated. (See
page 28 about getting back to regular
exercise after a break.)
22 EXERCISE & PHYSICAL ACTIVITY

QUICK TIP
Safety First: When to Check Getting the Right Shoes
with Your Doctor
Some people with Your shoes are an important part of your
Almost anyone, at any age, can do some type of
diabetes may need physical activity routine. Remember, you’re
exercise and physical activity. You can still be
special shoes or going to be wearing them a lot. Here are a
shoe inserts to
active even if you have a long-term condition
few pointers to keep in mind:
prevent serious foot like heart disease or diabetes. In fact, exercise
problems. Medicare and physical activity may help. But, talk with • Choose shoes that are made for the type
may pay some of the your doctor if you aren’t used to energetic of physical activity you want to do (walking,
costs. Your doctor activity. Other reasons to check with your running, dancing, bowling, tennis).
or podiatrist can tell
doctor before you exercise include:
you how to get these • Look for shoes with flat, non-skid soles;
special shoes.
• Any new symptom you haven’t good heel support; enough room for your
yet discussed toes; and a cushioned arch that’s not too
high or too thick.
• Dizziness or shortness of breath
• Chest pain or pressure • Make sure your shoes fit well and provide
proper support for your feet. This is
• The feeling that your heart is skipping,
especially important if you have diabetes
racing, or fluttering
or arthritis. Shoes should feel comfortable
• Blood clots right from the start.
• An infection or fever with muscle aches
• Think of your shoes as safety equipment
• Unplanned weight loss for your feet. Check them regularly, and
• Foot or ankle sores that won’t heal replace them when they’re worn out.
You can tell you need new shoes when:
• Joint swelling
• A bleeding or detached retina, eye surgery, › The tread on the bottom is worn down
or laser treatment › Your feet (especially your arches)
• A hernia feel tired after activity
• Recent hip or back surgery › Your shins, knees, or hips hurt after
activity
 CHAPTER 2: GET SET 23

TR
AINER
Finding a Personal Trainer Who’s Right For You
If you’re not used to exercising, you may want to work with a personal fitness trainer. One of the best
ways to find a personal trainer is to get a referral from someone you know who has a great trainer. Ask
your friends and family or your health care provider. You also can check with a local health club or
senior center. Once you have a couple of names, here are a few questions to help you pick the right
person. If you can answer YES to most of these questions, you’re probably on the right track.
Yes No
Education and Experience
Does the trainer have a certification from an accredited organization? For groups that certify personal trainers,
exercise specialists, and fitness instructors, see National Commission for Certifying Agencies on page 118.
Does the trainer have education or experience in exercise science, aging, and program design?
Does the trainer have at least 2 years of experience, including experience training people your age?
Will the trainer be able to develop an exercise program based on your goals, abilities, and health?
Has the trainer worked with people with your medical conditions?
Does the trainer know how to personalize your exercises based on medications you take?

Personality
Did the trainer listen carefully to you and answer your questions?
Does the trainer have a sense of humor and a personality that you like?

Business Practices
Has the trainer told you what to expect from the sessions?
Are the costs of the sessions and the cancellation policy clearly stated?
Is the trainer insured or bonded?
Will the trainer give you a list of clients so you can check references?
3
go!
 CHAPTER 3: GO! 25

Now that you know about the many types of physical activity and you’ve set your goals, you’re ready to go!
This chapter has tips to help you get started, resume your activity if you’ve stopped, stay active, and even
increase your activity level over time.

Three Keys to Success Make it a priority. Many of us lead busy

lives, and it’s easy to put physical activity
To help you get started and keep going,
at the bottom of the “to do” list. Remember,
here are three ways to approach exercise
though, being active is one of the most
and physical activity.
important things you can do each day to
maintain and improve your health. Make
1. Include Physical Activity in
a point to include physical activities
Your Everyday Life
throughout your day. Try being active first
Physical activity needs to be a regular, thing in the morning before you get busy.
permanent habit to produce benefits. Think of your time to exercise as a special
Again, the key word is you. Set yourself up appointment, and mark it on your calendar.
to succeed right from the start by choosing
Make it easy. If it’s difficult or costs too
activities that appeal to you, exercising safely,
much, you probably won’t be active. You
charting your progress to see your success, are more likely to exercise if it’s easy to do.
and making your activity routine fit your Put your 2-pound weights next to your easy
personal lifestyle. Here are a few ways to chair so you can do some lifting while you
make physical activity a regular part of watch TV. Walk up and down the soccer
your daily life. field during your grandchild’s game.
26 EXERCISE & PHYSICAL ACTIVITY

GOAL Walk the entire mall or every aisle of the Above all, make it an active decision. Seize
grocery store when you go shopping. When opportunities. Choose to be active in many places
you go out to get the mail, walk around the and many ways:
STICKING WITH IT: block. Join a gym or fitness center that’s
close to home. You can be active all at
• When you unload the groceries, strengthen your
What Works arms by lifting the milk carton or a 1-pound can
once, or break it up into smaller amounts
a few times before you put it away.
You’re more likely to stay throughout the day. Do more of the activities
active if you: you already like and know how to do. • When you go shopping, build your endurance
• Think you will benefit from
by parking the car at the far end of the parking
Make it social. Enlist a friend or family lot and walking briskly to the store. Or, get off
your activities
member. Many people agree that having the bus one or two stops earlier than usual.
• Include activities you enjoy an “exercise buddy” keeps them going.
Take a yoga class with a neighbor. If you • I nstead of calling or e-mailing a colleague at
• Feel you can do the don’t already have an exercise partner, work, go in person —
activities correctly find one by joining a walking club at your and take the stairs!

• Believe the activities

local mall or an exercise class at a nearby • Take a few extra
are safe senior center. Take a walk during lunch trips up and down
with a co-worker. the steps at home
• Have regular access to to strengthen
the activities Make it interesting and make it fun.
your legs and
Do things you enjoy and pick up the pace
build endurance.
• Can fit the activities into a bit. If you love the outdoors, try biking,
your daily schedule fishing, jogging, or hiking. Listen to music or • Try to do some of your
a book on CD while walking, gardening, or errands on foot rather
• Find that the activities are
raking. Plan a hiking trip at a nearby park. than in the car.
affordable

• Can see the benefits of

regular exercise and GO HERE FOR MORE INFO
physical activity To learn how to do the exercises mentioned on this page,
see Chapter 4 beginning on page 34.
 CHAPTER 3: GO! 27

• Multi-task the active way:

› While you’re waiting in line, practice your
balancing skills by standing on one foot
for a few seconds, then the other.
Gradually build up your time.

› While you’re talking on the phone, stand

up and do a few leg raises or toe stands to
strengthen your legs.

› Take advantage of small bits of “down

time” to do an exercise or two. For
example, while you’re waiting for the
coffee to brew or for your spouse to get
ready to go out, do a few wall push-ups or
calf stretches.

2. Try All Four Types of Exercise

make it easy
Most people tend to focus on one activity or
type of exercise and think they’re doing Finding enjoyable ways to add exercise to your life can be the ticket
enough. The goal is to be creative and choose to success. See how Marian made it work for her:
exercises from each of the four types we’ve “I’m an active 62-year-old, but a family history of heart disease
talked about — endurance, strength, balance, and high cholesterol convinced me that I needed more exercise.
and flexibility. Mixing it up will help you reap After I tried walking on a treadmill at a nearby community center,
the benefits of each type of exercise, as well as I knew I’d be happier outside. So, I got a step counter and started
reduce boredom and risk of injury. You can use walking in my neighborhood. I’ve seen purple tulips bloom in
the Weekly Exercise and Physical Activity Plan spring and red dogwood leaves drop in the fall. I always come
on page 104 to write down your activities. home with more energy for the rest of my day.” (For more on step
counters, see page 37.)
28 EXERCISE & PHYSICAL ACTIVITY

QUICK TIP If you lift weights, alternate these exercises Don’t be too hard on yourself. Recognize that
with time on the treadmill or stationary bike. there will be times when you won’t want to
If you’re thinking of End your routine with stretching exercises. exercise, or it feels too hard. You are not alone;
moving to a retirement everyone has those feelings. Just try to get back
or assisted-living If you focus mainly on endurance activities,
community, ask whether
to your activities as soon as possible. The sooner
be sure to add stretching, balance, or strength
the community has a you resume some sort of activity, the better
exercises to your routine. If you want to do
pool, exercise classes, you’ll feel, and the easier it will be to get back into
walking trails, a golf
strength exercises every day, alternate muscle
your routine.
course, or personal groups, or exercise all of your muscle groups
trainer. Does it have every other day. (See Weekly Exercise and Talk with your doctor about when you can
well-lit sidewalks so Physical Activity Plan on page 104.) resume your regular routine if you stopped
you can walk safely in exercising because of an illness or new
the evening as well as
3. Plan for Breaks in the Routine symptoms.
during the day? Are
there parks nearby? (Life Happens!)
Think about the reasons you started exercising
Getting older can mean more time for trips and the goals you set for yourself. Remembering
to see children and grandchildren or vacations your motivations and how much you’ve already
away from home. People retire and move to accomplished may help recharge your batteries
new houses or even new parts of the country. and get you started again.
Sometimes the unexpected happens — family
Ask family and friends to help you get back on
illness, caregiving responsibilities, or the death
track. Sometimes, you may want an exercise
of a loved one. All of these events can interrupt
buddy. At other times, all you may need is a word
your physical activity routines.
of support.
These breaks can make it hard or even
Try something easier or an activity you haven’t
impossible at times to stick with your regular
done recently if you don’t like the activity you
activities. But you can start again. Here are a
started. You might even want to try something
few ideas to help you stay active or start again
you’ve never done before. Mastering something
if you’ve had to stop:
simple or new may give you the confidence you
need to resume a regular exercise program.
 CHAPTER 3: GO! 29

Talk with your doctor or trainer. You Walking Safely in Rural Areas
may get the boost you need to move past
the hurdle.
Rural areas may have less traffic than big cities,
Start again at a comfortable level if you but “a walk in the country” does require special
haven’t exercised for several weeks. Then care. Often the vehicles on rural roads travel at
gradually build back up. With a little time, much higher speeds than pedestrians are used
you’ll be back on track. to, and drivers won’t expect to see someone
walking on or near the side of the road. So,
Think creatively about other ways to remember the following safety rules, and enjoy
exercise if you can’t do your regular your walk!
physical activities because of bad weather
or a change in your routine. For example, • Always walk facing oncoming traffic.
if caring for a loved one is keeping you
• Look for a smooth, stable surface alongside
indoors, try an exercise video, jog in place,
the road.
dance around your living room, or walk up
and down the stairs a few extra times. Just • If there are guardrails, see if there’s a smooth,
keep moving! flat surface behind the barrier where you can
walk.
Be flexible. When your grandchildren
come for a visit, reschedule your exercise • If you need to walk on a paved shoulder, stay
during their nap time, or take them with as far away from traffic as possible.
you for a walk. • Watch for bridges and narrow shoulders.
Believe in yourself! Feel confident that • Be sure drivers can see you. Wear brightly
even if your activity is interrupted, you colored clothing, and if you walk during
can start again and be successful. Don’t low-light hours — dusk or dawn — be sure
worry about the time you missed. What’s you have reflective material on your jacket
important is to focus on your fitness goals or walking shoes and carry a flashlight.
and start again at whatever level is • Take along a cell phone and an ID, especially
possible for you. if walking alone.
30 EXERCISE & PHYSICAL ACTIVITY

A few more tips on coping with breaks

in your exercise routine
Sometimes the reason you have to stop exercising is temporary; sometimes it’s permanent. There may be a change in your living
arrangements or in your health, for example. Some are happy occasions; some are sad. Here are some ways to manage these breaks.

Temporary Permanent

You’re on vacation: Your usual exercise buddy moves away:

• Many hotels now have fitness centers. Check out • Ask another friend to go with you on your daily walk.
the facilities where you’ll be staying, and bring
• Ask other older adults in your area where they go for walks
along your exercise clothing or equipment
or what physical activity resources are available nearby.
Your Situation

(resistance band, bathing suit, or walking shoes).

A Change in

• Join an exercise class at your local community center or

• Get out and see the sights on foot rather than
senior center. This is a great way to meet other active people.
just by tour bus.
You move to a new community:
Caring for an ill spouse is taking up much of your time:
• Check out the fitness centers, parks, and recreation
• Work out to an exercise video when your spouse
associations in your new neighborhood. Look for activities
is napping.
that match your interests and abilities.
• Ask a family member or friend to come over
• Get involved!
so you can go for a walk.

The flu keeps you out of action for a few weeks: You are recovering from hip or back surgery:
A Change in
Your Health

• Wait until you feel better and then start your • Talk with your doctor about specific exercises and
activity again. activities you can do safely when you’re feeling better.
• Gradually build back up to your previous level of • Start slowly and gradually build up your activities as you
activity. become stronger.
 CHAPTER 3: GO! 31

Building Up the Benefits • Review your goals. If you are able, do your activities
longer, farther, or harder. If you walk 30 minutes at
Once you start exercising and becoming more
lunch time every day, make it 40 minutes. If you only
physically active, you’ll begin to see results in
have 30 minutes for lunch, pick up the pace so you’re
just a few weeks — you’ll feel stronger and
walking faster and farther in the same amount of
more energetic. You’ll notice that you can do
time. Try using a pedometer, or step counter, to track
things easier, faster, or for longer than before.
your progress. Seeing the number of steps add up can
This tells you that your body is getting used
be great motivation. If you usually swim half a mile,
to a higher level of activity. Now is the time
build up to three-quarters of a mile. Use a harder
to build on those benefits by doing more.
resistance band when you do strength exercises.
Keep your starting point in mind, though. For
some people, switching from 1- to 2-pound • Do the activities more often. Spend time in your
weights is a big step forward. For others, garden more often. Head over to the gym three
building up to walking briskly or even running times a week instead of two. Walk every day.
is a reasonable goal.
GO HERE FOR MORE INFO
No matter what your starting point:
Healthy eating and physical activity go hand in
hand. See Chapter 6, starting on page 94, for
• Add new physical activities. Be creative!
more on this topic.
Try some new activities to keep your
interest alive. Sign up for dance lessons.
Talk to your friends about bowling
together once a week. Join a water aerobics
class. Save gas by walking to your nearby
grocery store. Can you trade in any of your
electric appliances for muscle-powered
versions: How about your electric can
opener? Your electric lawn mower? Your
electric leaf blower?
32 EXERCISE & PHYSICAL ACTIVITY

Reducing the Risks

Many people hesitate to exercise for one reason
or another. In fact, exercise and moderate
physical activity, such as brisk walking, are safe
for almost all older adults. Even so, avoiding
injury is an important thing to keep in mind,
especially if you’re just starting a new activity

make it safe or you haven’t been active for a long time. Talk
to your doctor if you have an ongoing health
For many people, even those who exercise regularly, breaks condition or certain other health problems (see
in the routine mean the end of daily exercise and its benefits. page 33) or if you haven’t seen your doctor for
Freddi tells how she carefully got started again: a while. Ask how physical activity can help you,
whether you should avoid certain activities, and
“For more than 10 years, I jogged every day to clear the how to modify exercises to fit your situation.
cobwebs and get my blood flowing. Imagine how awful I felt
when I fell down the stairs and broke my ankle. At 54, I wasn’t You may feel some minor discomfort or muscle
ready to be a couch potato. After the cast came off, I had soreness when you start to exercise. This should
physical therapy. I worried about hurting my ankle again, but I go away as you get used to the activities. However,
wasn’t going to let the injury keep me down. At first, I walked if you feel sick to your stomach or have strong
slowly in my neighborhood, but I didn’t want to trip on uneven pain, you’ve done too much. Go easier and then
pavement. My physical therapist suggested I try a treadmill gradually build up.
instead. Now, I go to the gym after work. I set the treadmill
incline high, turn on my headphones, and walk. Sometimes, I
listen to music or a book on CD. I miss the fresh air, but I don’t
think about falling, and my stamina is back. Plus, I’ve added
strength and balance exercises to my routine. In many ways, GO HERE FOR MORE INFO
I’m in better shape now than before the fall and that feels great!” See Chapter 4 for more safety tips.
 CHAPTER 3: GO! 33

Preventing Injury

The health benefits of exercise far outweigh Stop exercising if you:

any risks of injury. However, you can take
some precautions to exercise safely.
• Have pain or pressure in your chest,
neck, shoulder, or arm
Follow these tips to avoid injury:
• Feel dizzy or sick to your stomach
• When starting an exercise program, begin • Break out in a cold sweat
slowly with low-intensity exercises.
• Have muscle cramps
• Wait at least 2 hours after eating a large
meal before doing strenuous exercise. • Feel severe pain in joints,
feet, ankles, or legs
• Wear appropriate shoes for your activity
and comfortable, loose-fitting clothing that
allows you to move freely but won’t catch
on other objects.
• Warm up with low-intensity exercises at
the beginning of each exercise session.
• Drink water before, during, and after your
exercise session.
• When exercising outdoors, pay attention
to your surroundings — consider possible
traffic hazards, the weather, uneven
walking surfaces, and strangers.
4
sample exercises
 CHAPTER 4: SAMPLE EXERCISES 35

Many different exercises can improve your health and independence. Whether you do the exercises shown
in this chapter or other physical activities that accomplish the same goals, gradually work your way up to
include endurance, strength, balance, and stretching exercises.

It’s important to spend about 5 minutes at the • Do a few exercises to work the muscles and
beginning and end of your routine to warm up joints you’ll be using in your activity. For
and cool down. Warming up and cooling down example, if you’re going to be swimming, do
give your muscles a chance to get ready to a few arm exercises first to warm up your
work and gradually return to rest at the end. arms and shoulders.
These “before-and-after” activities help
• If you’re going to include stretching
prevent injury and reduce muscle soreness
exercises as part of your routine,
later. Here are a few suggestions:
do them afterwards.
• Do some light endurance activity first, such
as walking for 5 minutes. If you’re going to
be walking briskly or running, gradually
build up to that pace. At the end of your
activity, gradually slow down and let your
body cool down.
36 EXERCISE & PHYSICAL ACTIVITY

endurance
make it rewarding
Regular endurance exercise has helped Tom stay healthy after
major heart surgery:

“At age 45 I had quadruple bypass surgery. I was shocked because

I was so young. Those months after my surgery are a blur to me
now. After several months of cardiac rehab, I knew my heart health
was in my hands. So, now I run regularly at my neighborhood
YMCA — around the track in nice weather and on the treadmill
during the winter. I admit I was nervous at first to push myself.
I worried I might do more harm than good. But, it’s been 12 years
and I feel great! This year, I will celebrate my daughter’s graduation
from college, continue to root for the Aggies, and maybe even
teach my wife to play golf. I believe exercise has made all of that
possible for me.”
 CHAPTER 4: SAMPLE EXERCISES 37

How to Improve Your Endurance Counting Your Steps

Endurance exercises are activities — walking,
jogging, swimming, raking, sweeping, dancing, Step counters can help you keep track
playing tennis — that increase your heart rate of your endurance activity, set goals,
and breathing for an extended period of time. and measure progress. Most inactive
They will make it easier for you to walk farther, people get fewer than 5,000 steps a
faster, or uphill. They also should make everyday day, and some very inactive people
activities such as gardening, shopping, or playing get only 2,000 steps a day.
a sport easier.
Wear the step counter for a few days to see how you’re doing.
You can use the Endurance Daily Record on page 105 to record
How Much, How Often your steps. If you get:
Refer to your starting goals, and build up your
endurance gradually. If you haven’t been active • Fewer than 5,000 steps a day, gradually
for a long time, it’s especially important to try to add 3,000 to 4,000 more steps a day.
work your way up over time. It may take a while • About 8,000 steps a day, you’re probably
to go from a longstanding inactive lifestyle to meeting the recommended activity target.
doing some of the activities in this section. For
example, start out with 5 or 10 minutes at a • 10,000 or more steps a day, you can be
time, and then build up to at least 30 minutes of confident that you’re getting an
moderate-intensity endurance activity. Doing adequate amount of endurance activity.
less than 10 minutes at a time won’t give you • 10,000 steps a day comfortably, try
the desired heart and lung benefits. for 15,000 steps a day, which would
put you in the high-activity group.
Try to build up to at least 30 minutes of
moderate-intensity endurance activity on
most or all days of the week. Every day is best.
Remember, though, that these are goals, not
rules. Some people will be able to do more.
38 EXERCISE & PHYSICAL ACTIVITY

Others, however, may not be able to exercise Older adults can be affected by heat and cold
QUICK TIP
for 30 minutes at a time. It’s important to set more than others. In extreme cases, too
realistic goals based on your own health and much heat can cause heat stroke, and very
Some people are afraid
to exercise after a heart abilities. cold temperatures can lead to a dangerous
attack. But regular drop in body temperature. If you are going to
physical activity can help Safety be outdoors, dress in layers so you can add or
reduce your chances of remove clothes as needed. When it’s not
having another heart Listen to your body. Is the activity making you
possible to be outdoors, you may want to
attack. feel unwell or too tired? Endurance activities
try indoor activities:
should not make you breathe so hard that you
If you’ve had a heart
can’t talk. They should not cause dizziness, • If you have stairs at home, go up and
attack, talk with your
doctor to be sure you’re chest pain or pressure, or a feeling like down the steps a few times in a row.
following a safe, effective heartburn.
physical activity program.
• Walk at the mall or grocery store.
Do a little light activity, such as easy walking,
Ask about cardiac rehab • Go for a swim at your local fitness or
programs, which include before and after your endurance activities to
recreation center.
exercise, education, and warm up and cool down.
counseling to help you Whatever activity you choose, stay safe.
return to an active life. As you get older, you may not feel thirsty even To prevent injuries, be sure to use safety
though your body needs fluids. Be sure to drink equipment. For example, wear a helmet when
liquids when doing any activity that makes you bicycling. When you’re walking, watch out for
sweat. By the time you notice you are thirsty, low-hanging branches and uneven sidewalks.
you probably are already low on fluid. This Walk during the day or in well-lit areas at
guideline is important year round, but it’s
Making especially important in hot weather. If your
night, and be aware of your surroundings.
Ask someone to go with you. Wear the
It REAL doctor has told you to limit your fluids, be sure proper shoes (see page 22).
to check before increasing the amount of fluid
Walking 2 miles a day
you drink while exercising. For example, people
at the mall will help
with congestive heart failure or kidney disease GO HERE FOR MORE INFO
you keep up with your
may need to limit fluids. For more about drinking enough
grandchildren during
fluids, see page 97.
a trip to the park.
 CHAPTER 4: SAMPLE EXERCISES 39

Progressing Ways to Gauge Your Effort

When you’re ready to do more, build up the
amount of time you spend doing endurance The amount of effort you need to do an activity will
activities first, then build up the difficulty of depend on your starting point, including your
your activities. For example, gradually fitness level, how strong you are, and how active
increase your time to 30 minutes over several you’ve been. For example, walking a mile in
days to weeks (or even months, depending on 15 minutes will be a lot easier for someone who does
your condition) by walking longer distances. it every day compared with someone who has never
Then walk more briskly or up steeper hills. See done it. You can use these informal guidelines to
page 13 for more examples of physical activities estimate how much effort you are putting into your
that build endurance. To record your activities, endurance activities:
use the Endurance Daily Record on page 105.
• Brisk walking is an example of moderate
activity, while jogging is a vigorous activity.
• Talking is easy during moderate activity.
During vigorous activity, talking is difficult.
• If you tend to sweat, you probably won’t
sweat during light activity (except on hot
days). You will sweat during vigorous or
sustained moderate activity. Remember
to drink fluids even if you don’t sweat.
One doctor who specializes in exercise for older
adults tells her patients the following about how
hard they should work during endurance activities:
“If you can’t talk while you’re exercising, it’s too
difficult. If you can sing a song, it’s too easy!”
40 EXERCISE & PHYSICAL ACTIVITY

strength
make it affordable
Exercising at home is just one way to be active. We feature it
because most older people can do it, but you also might try
Bonita’s example:

“I’m 69 and live on my Social Security income. My kids try to spoil

me, but I’d rather do things on my own as much as possible. When
looking for a fitness center where I could use strength-building
equipment, I bargained the owner down to a monthly fee that I
could afford. I started with 1-pound weights and gradually moved
on to heavier weights. I also added stretching to my routine. I’ve
always been active, but never as much as I am now. Joining the
fitness center has done me a world of good. The owner of my club
holds me up as an example, and my family is so proud of me.”
 CHAPTER 4: SAMPLE EXERCISES 41

How to Improve Your Strength About Strength Exercises

Even very small changes in muscle strength To do most of the strength exercises in this book,
can make a real difference in function, you need to lift or push weights. You can use
especially in people who have already lost a lot weights, resistance bands, or common objects
of muscle. An increase in muscle that you can’t from your home. Or, you can use the
even see can make it easier to do everyday strength-training equipment at a fitness
things like get up from a chair, climb stairs, center or gym. Start with light weights and
carry groceries, open jars, and even play with gradually increase the amount of weight you use.
your grandchildren. Lower-body strength
exercises also will improve your balance. How Much, How Often
Try to do strength exercises for all of your
major muscle groups on 2 or more days per
week for 30-minute sessions each, but don’t
exercise the same muscle group on any 2 days
in a row. (Use the Weekly Exercise and
Physical Activity Plan on page 104.)

• Depending on your condition, you might

need to start out using 1- or 2-pound
weights, or no weight at all. Your body
needs to get used to strength exercises.
• Use a light weight the first week, then
gradually add more weight. Starting out
with weights that are too heavy can
cause injuries.
42 EXERCISE & PHYSICAL ACTIVITY

• Gradually add more weight in order to • Don’t hold your breath during strength
QUICK TIP benefit from strength exercises. You exercises. Holding your breath while straining
need to challenge your muscles to get the can cause changes in blood pressure. This is
A repetition, or rep, is especially true for people with heart disease.
most benefit from strength exercises.
one complete movement
(The Progressing section on page 43 will
of an exercise, and a set • Breathe regularly. Breathe in slowly through
is one group of reps. tell you how.) your nose and breathe out slowly through
In this guide, a set of your mouth. If this is not comfortable or
strength exercises is
• It should feel somewhere between hard
and very hard for you to lift or push the possible, breathe in and out through either
10 to 15 repetitions. You
can use the Strength and weight. It shouldn’t feel very, very hard. your nose or mouth.
Balance Daily Record on If you can’t lift or push a weight 8 times • Breathe out as you lift or push, and breathe
page 106 to keep track of in a row, it’s too heavy for you. Reduce in as you relax. For example, if you’re doing
the number of strength
the amount of weight. leg lifts, breathe out as you lift your leg, and
exercises you do.
• Take 3 seconds to lift or push a weight into breathe in as you lower it. This may not feel
place, hold the position for 1 second, and natural at first, and you probably will have
take another 3 seconds to return to your to think about it for a while as you do it.
starting position. Don’t let the weight drop; • Proper form and safety go hand-in-hand.
returning it slowly is very important. For some exercises, you may want to start
alternating arms and work your way up to
• Try to do 10 to 15 repetitions for each
Making exercise. Think of this as a goal. If you can’t
using both arms at the same time. If it is
It REAL do that many at first, do as many as you
difficult for you to hold hand weights, try
using wrist weights.
can. You may be able to build up to this
Want to be able to lift
goal over time. • To prevent injury, don’t jerk or thrust weights
your carry-on bag into into position. Use smooth, steady movements.
the overhead bin of the Safety
• Avoid “locking” your arm and leg joints in
airplane or get in and
out of the car more
• Talk with your doctor if you are unsure about a tightly straightened position. To straighten
easily? Keep doing
doing a particular exercise. For example, if your knees, tighten your thigh muscles.
those strength exercises, you’ve had hip or back surgery, talk about This will lift your kneecaps and protect them.
and you’ll get there. which exercises might be best for you.
 CHAPTER 4: SAMPLE EXERCISES 43

• For many of the sample exercises in this Progressing

guide, you will need to use a chair. Choose QUICK TIP
Muscle strength is progressive over time.
a sturdy chair that is stable enough to
Gradually increase the amount of weight Challenge yourself, but
support your weight when seated or
you use to build strength. When you can do listen to your body, and
when holding on during the exercise.
2 sets of 10 to 15 repetitions easily, increase use common sense when
• Muscle soreness lasting a few days and slight the amount of weight at your next session. you exercise.
fatigue are normal after muscle-building
exercises, at least at first. After doing these Here’s an example of how to progress
If you feel sick or have
exercises for a few weeks, you will probably gradually: Start out with a weight that you can pain during or after
not be sore after your workout. lift only 8 times. Keep using that weight until exercise, you’re doing
you become strong enough to lift it easily 10 to too much.
15 times. When you can do 2 sets of 10 to 15
repetitions easily, add more weight so that,
Exhaustion, sore joints,
again, you can lift it only 8 times. Keep
and painful muscle
repeating until you reach your goal, and then pulling mean you’re
maintain that level as long as you can. overdoing it. None of
the exercises should
cause severe pain.

FOR HOUSEHOLD Over-exercising can

HANDWEIGHTS cause injury, which
See page 45 may lead to quitting
altogether. A steady
rate of progress is
the best approach.
44 EXERCISE & PHYSICAL ACTIVITY

Resistance bands are stretchy elastic bands that come in

Working with a Resistance Band
several strengths, from light to heavy. You can use them in
some strength exercises instead of weights.

Wrapping
a resistance
band

1. Lay the band flat in your hand with 2. Wrap the long end of the 3. Grasp firmly.
the end toward your pinky finger. band around the back of
your hand.

If you are a beginner, try exercising without the band until you are comfortable, then add the band. Choose a
TIP light band if you are just starting to exercise, and move on to a stronger band when you can do 2 sets of 10 to
15 repetitions easily. Hold on to the band tightly (some bands have handles), or wrap it around your hand or
foot to keep it from slipping and causing possible injury. Do the exercises in a slow, controlled manner, and
don’t let the band snap back.
 CHAPTER 4: SAMPLE EXERCISES 45

Working with Weights Hand Grip

You don’t have to go out and buy weights for
strength exercises. Find something you can hold
on to easily. For example, you can make your own This simple exercise should help if you have
weights from unbreakable household items: trouble picking things up or holding on to
them. It also will help you open things like
• Fill a plastic milk jug with sand or water and that pickle jar more easily. You can even do
tape the opening securely closed. this exercise while reading or watching TV.
• Fill a sock with dried beans, and tie up the
open end. 1. Hold a tennis ball or other small rubber
or foam ball in one hand.
• Use common grocery items, such as bags
of rice, vegetable or soup cans, or bottled 2. Slowly squeeze the ball as hard as you
water. can and hold it for 3-5 seconds.
3. Relax the squeeze slowly.
4. Repeat 10-15 times.
5. Repeat 10-15 times with other hand.
6. Repeat 10-15 times more with each hand.
46 EXERCISE & PHYSICAL ACTIVITY

This exercise will strengthen your wrists. It also will help

ensure good form and prevent injury when you do upper
Wrist Curl body strength exercises.

1. Rest your forearm on the arm of a

sturdy chair with your hand over
the edge.
2. Hold weight with palm facing upward.
3. Slowly bend your wrist up and down.
4. Repeat 10-15 times.
5. Repeat with other hand 10-15 times.
6. Repeat 10-15 more times with
each hand.
 CHAPTER 4: SAMPLE EXERCISES 47

This exercise will strengthen your shoulders and arms. It

should make swimming and other activities such as lifting
and carrying grandchildren easier. Overhead Arm Raise

1. You can do this exercise while standing

or sitting in a sturdy, armless chair.
2. Keep your feet flat on the floor,
shoulder-width apart.
3. Hold weights at your sides at shoulder
height with palms facing forward.
Breathe in slowly.
4. Slowly breathe out as you raise both
arms up over your head keeping your
elbows slightly bent.
5. Hold the position for 1 second.
6. Breathe in as you slowly lower
your arms.
7. Repeat 10-15 times.
8. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP weight and alternate arms until
you can lift the weight comfortably
with both arms.
48 EXERCISE & PHYSICAL ACTIVITY

This exercise for your shoulders can help you put things up
Front Arm Raise on a shelf or take them down more easily.

1. Stand with your feet shoulder-width

apart.
2. Hold weights straight down at your
sides, with palms facing backward.
3. Keeping them straight, breathe out
as you raise both arms in front of
you to shoulder height.
4. Hold the position for 1 second.
5. Breathe in as you slowly lower arms.
6. Repeat 10-15 times.
7. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP weight and alternate arms until
you can lift the weight comfortably
with both arms.
 CHAPTER 4: SAMPLE EXERCISES 49

This exercise will strengthen your shoulders and make

lifting groceries easier.
Side Arm Raise

1. You can do this exercise while standing

or sitting in a sturdy, armless chair.
2. Keep your feet flat on the floor,
shoulder-width apart.
3. Hold hand weights straight down at
your sides with palms facing inward.
Breathe in slowly.
4. Slowly breathe out as you raise both
arms to the side, shoulder height.
5. Hold the position for 1 second.
6. Breathe in as you slowly lower your
arms.
7. Repeat 10-15 times.
8. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP weight and alternate arms until
you can lift the weight comfortably
with both arms.
50 EXERCISE & PHYSICAL ACTIVITY

After a few weeks of doing this exercise for your upper arm
Arm Curl muscles, lifting that gallon of milk will be much easier.

1. Stand with your feet shoulder-width

apart.
2. Hold weights straight down at your
sides, palms facing forward. Breathe
in slowly.
3. Breathe out as you slowly bend your
elbows and lift weights toward chest.
Keep elbows at your sides.
4. Hold the position for 1 second.
5. Breathe in as you slowly lower
your arms.
6. Repeat 10-15 times.
7. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP weight and alternate arms until
you can lift the weight comfortably
with both arms.
 CHAPTER 4: SAMPLE EXERCISES 51

This variation of the Arm Curl uses a resistance band instead Arm Curl
of weights. (See Working with a Resistance Band on page 44.)
with Resistance Band

1. Sit in a sturdy, armless chair with

your feet flat on the floor, shoulder-
width apart.
2. Place the center of the resistance band
under both feet. Hold each end of the
band with palms facing inward. Keep
elbows at your sides. Breathe in slowly.
3. Keep wrists straight and slowly breathe
out as you bend your elbows and bring
your hands toward your shoulders.
4. Hold the position for 1 second.
5. Breathe in as you slowly lower
your arms.
6. Repeat 10-15 times.
7. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP strength band.
52 EXERCISE & PHYSICAL ACTIVITY

Seated Row This exercise to strengthen upper back, shoulder, and neck muscles
should make everyday activities such as raking and vacuuming
with Resistance Band easier. (See Working with a Resistance Band on page 44.)

1. Sit in a sturdy, armless chair with

your feet flat on the floor, shoulder-
width apart.
2. Place the center of the resistance band
under both feet. Hold each end of the
band with palms facing inward.
3. Relax your shoulders and extend
your arms beside your legs. Breathe
in slowly.
4. Breathe out slowly and pull both
elbows back until your hands are
at your hips.
5. Hold position for 1 second.
6. Breathe in as you slowly return your
hands to the starting position.
7. Repeat 10-15 times.
8. Rest; then repeat 10-15 more times.

As you progress, use a heavier

TIP strength band.
 CHAPTER 4: SAMPLE EXERCISES 53

These push-ups will strengthen your arms, shoulders, and chest.

Try this exercise during a TV commercial break.
Wall Push-Up

1. Face a wall, standing a little farther

than arm’s length away, feet shoulder-
width apart.
2. Lean your body forward and put your
palms flat against the wall at shoulder
height and shoulder-width apart.
3. Slowly breathe in as you bend your
elbows and lower your upper body
toward the wall in a slow, controlled
motion. Keep your feet flat on the floor.
4. Hold the position for 1 second.
5. Breathe out and slowly push yourself
back until your arms are straight.
6. Repeat 10-15 times.
7. Rest; then repeat 10-15 more times.
54 EXERCISE & PHYSICAL ACTIVITY

This exercise will strengthen your upper arms. If your

Elbow Extension shoulders aren’t flexible enough to do this exercise, try

the Chair Dip on page 55.

1. You can do this exercise while standing

or sitting in a sturdy, armless chair.
2. Keep your feet flat on the floor,
shoulder-width apart.
3. Hold weight in one hand with palm
facing inward. Raise that arm toward
ceiling.
4. Support this arm below elbow with
other hand. Breathe in slowly.
5. Slowly bend raised arm at elbow and
bring weight toward shoulder.
6. Hold position for 1 second.
7. Breathe out and slowly straighten your
arm over your head. Be careful not to
lock your elbow.
8. Repeat 10-15 times.
9. Repeat 10-15 times with other arm.
10. Repeat 10-15 more times with each arm.

If it’s difficult for you to hold hand

TIP weights, try using wrist weights.
 CHAPTER 4: SAMPLE EXERCISES 55

This pushing motion will strengthen your arm muscles even

if you are not able to lift yourself up off the chair. Chair Dip

1. Sit in a sturdy chair with armrests

with your feet flat on the floor,
shoulder-width apart.
2. Lean slightly forward; keep your
back and shoulders straight.
3. Grasp arms of chair with your hands
next to you. Breathe in slowly.
4. Breathe out and use your arms to
push your body slowly off the chair.
5. Hold position for 1 second.
6. Breathe in as you slowly lower
yourself back down.
7. Repeat 10-15 times.
8. Rest; then repeat 10-15 more times.
56 EXERCISE & PHYSICAL ACTIVITY

This exercise strengthens your buttocks and lower back. For an

added challenge, you can modify the exercise to improve your
Back Leg Raise balance. (See Progressing to Improve Balance on page 68.)

1. Stand behind a sturdy chair, holding

on for balance. Breathe in slowly.
2. Breathe out and slowly lift one leg
straight back without bending your
knee or pointing your toes. Try not
to lean forward. The leg you are
standing on should be slightly bent.
3. Hold position for 1 second.
4. Breathe in as you slowly lower
your leg.
5. Repeat 10-15 times.
6. Repeat 10-15 times with other leg.
7. Repeat 10-15 more times with each leg.

As you progress, you may want

TIP to add ankle weights.
 CHAPTER 4: SAMPLE EXERCISES 57

This exercise strengthens hips, thighs, and buttocks. For an added

challenge, you can modify the exercise to improve your balance.
(See Progressing to Improve Balance on page 68.) Side Leg Raise

1. Stand behind a sturdy chair with

feet slightly apart, holding on for
balance. Breathe in slowly.
2. Breathe out and slowly lift one
leg out to the side. Keep your back
straight and your toes facing
forward. The leg you are standing
on should be slightly bent.
3. Hold position for 1 second.
4. Breathe in as you slowly lower
your leg.
5. Repeat 10-15 times.
6. Repeat 10-15 times with other leg.
7. Repeat 10-15 more times with
each leg.

As you progress, you may want

TIP to add ankle weights.
58 EXERCISE & PHYSICAL ACTIVITY

Walking and climbing stairs are easier when you do both the
Knee Curl and Leg Straightening exercises. For an added
Knee Curl challenge, you can modify the exercise to improve your balance.
(See Progressing to Improve Balance on page 68.)

1. Stand behind a sturdy chair, holding

on for balance. Lift one leg straight
back without bending your knee or
pointing your toes. Breathe in slowly.
2. Breathe out as you slowly bring
your heel up toward your buttocks
as far as possible. Bend only from
your knee, and keep your hips still.
The leg you are standing on should
be slightly bent.
3. Hold position for 1 second.
4. Breathe in as you slowly lower
your foot to the floor.
5. Repeat 10-15 times.
6. Repeat 10-15 times with other leg.
7. Repeat 10-15 more times with
each leg.

As you progress, you may want

TIP to add ankle weights.
 CHAPTER 4: SAMPLE EXERCISES 59

This exercise strengthens your thighs and may reduce

symptoms of arthritis of the knee.
Leg Straightening

1. Sit in a sturdy chair with your back

supported by the chair. Only the balls
of your feet and your toes should rest
on the floor. Put a rolled bath towel at
the edge of the chair under thighs for
support. Breathe in slowly.
2. Breathe out and slowly extend one leg
in front of you as straight as possible,
but don’t lock your knee.
3. Flex foot to point toes toward the
ceiling. Hold position for 1 second.
4. Breathe in as you slowly lower leg back
down.
5. Repeat 10-15 times.
6. Repeat 10-15 times with other leg.
7. Repeat 10-15 more times with each leg.

As you progress, you may want to

TIP add ankle weights.
60 EXERCISE & PHYSICAL ACTIVITY

This exercise, which strengthens your abdomen and thighs, will make
it easier to get in and out of the car. If you have knee or back
Chair Stand problems, talk with your doctor before trying this exercise.

1. Sit toward the front of a sturdy,

armless chair with knees bent and feet
flat on floor, shoulder-width apart.
2. Lean back with your hands crossed
over your chest. Keep your back
and shoulders straight throughout
exercise. Breathe in slowly.
3. Breathe out and bring your upper body
forward until sitting upright.
4. Extend your arms so they are parallel
to the floor and slowly stand up.
5. Breathe in as you slowly sit down.
6. Repeat 10-15 times.
7. Rest; then repeat 10-15 more times.
 CHAPTER 4: SAMPLE EXERCISES 61

TIP People with back problems should start the exercise from the sitting upright position.
62 EXERCISE & PHYSICAL ACTIVITY

This exercise will help make walking easier by strengthening your

calves and ankles. For an added challenge, you can modify the
Toe Stand exercise to improve your balance. (See Progressing to Improve
Balance on page 68.)

1. Stand behind a sturdy chair, feet

shoulder-width apart, holding on
for balance. Breathe in slowly.
2. Breathe out and slowly stand on
tiptoes, as high as possible.
3. Hold position for 1 second.
4. Breathe in as you slowly lower heels
to the floor.
5. Repeat 10-15 times.
6. Rest; then repeat 10-15 more times.

As you progress, try doing the

TIP exercise standing on one leg at
a time for a total of 10-15 times
on each leg.
 CHAPTER 4: SAMPLE EXERCISES 63

balance
make it a habit
Lian, age 68, has found that regular tai chi classes have improved
her balance and flexibility:

“Early every morning, I join a group of my neighbors, and we

practice tai chi for about an hour. We start out with a gentle
warm-up and breathing exercises. Then our teacher shows us
how to do certain poses and leads us step by step through the
slow, flowing movements. We end with cooling down exercises.
This exercise routine has boosted my confidence and reduced
my fear of falling. It also keeps my arthritis under control.”
64 EXERCISE & PHYSICAL ACTIVITY

How to Improve Your Balance Progressing

Each year, more than 1.6 million older These exercises can improve your balance
Americans go to the emergency room because even more if you modify them as you progress.
of fall-related injuries. A simple fall can cause Start by holding on to a sturdy chair for
a serious fracture of the arm, hand, ankle, or support. To challenge yourself, try holding
hip. Balance exercises can help you prevent on to the chair with only one hand; then with
falls and avoid the disability that may result time, you can try holding on with only one
from falling. finger, then no hands. If you are steady on
your feet, try doing the exercise with your
How Much, How Often eyes closed. (See Progressing to Improve
Balance on page 68.) You can use the Strength
You can do the balance exercises in this
and Balance Daily Record on page 106 to keep
section as often as you like. They overlap with
track of your balance exercises.
the lower-body strength exercises, which also
can improve your balance. Do the strength
exercises 2 or more days per week, but not on
Anytime, Anywhere Balance
any 2 days in a row. Exercises
You can do exercises to improve your balance
Safety almost anytime, anywhere, and as often as
Making • Have a sturdy chair or a person nearby you like, as long as you have something
sturdy nearby to hold on to if you become
It REAL to hold on to if you feel unsteady.
unsteady. In the beginning, using a chair or
• Talk with your doctor if you are unsure the wall for support will help you work on
You’re walking in the about doing a particular exercise.
neighborhood and you
your balance safely.
hear a bicycle bell behind
you. Knowing you can turn
around quickly and move
out of the way without
losing your balance is a
great feeling!
 CHAPTER 4: SAMPLE EXERCISES 65

You can do this exercise while waiting for the bus or standing in line at
the grocery. For an added challenge, you can modify the exercise to
improve your balance. (See Progressing to Improve Balance on page 68.) Stand on One Foot

1. Stand on one foot behind a sturdy

chair, holding on for balance.
2. Hold position for up to 10 seconds.
3. Repeat 10-15 times.
4. Repeat 10-15 times with other leg.
5. Repeat 10-15 more times with each leg.
66 EXERCISE & PHYSICAL ACTIVITY

Having good balance is important for many everyday activities,

Heel-to-Toe Walk such as going up and down stairs.

1. Position the heel of one foot just in

front of the toes of the other foot.
Your heel and toes should touch or
almost touch.
2. Choose a spot ahead of you and focus
on it to keep you steady as you walk.
3. Take a step. Put your heel just in front
of the toes of your other foot.
4. Repeat for 20 steps.

If you are unsteady on your feet, try

TIP doing this exercise near a wall so you
can steady yourself if you need to.
 CHAPTER 4: SAMPLE EXERCISES 67

Good balance helps you walk safely and avoid tripping

and falling over objects in your way.
Balance Walk

1. Raise arms to sides, shoulder height.

2. Choose a spot ahead of you and focus
on it to keep you steady as you walk.
3. Walk in a straight line with one foot in
front of the other.
4. As you walk, lift your back leg. Pause
for 1 second before stepping forward.
5. Repeat for 20 steps, alternating legs.

As you progress, try looking from

TIP side to side as you walk, but skip this
step if you have inner ear problems.
68 EXERCISE & PHYSICAL ACTIVITY

Progressing to Improve Balance

The exercises in this guide — especially those to strengthen your legs and Back Leg Raise (page 56)
ankles — can help improve your balance. As you progress, try adding the Side Leg Raise (page 57)
challenges shown below to help even more. For example, start by holding on Knee Curl (page 58)
to a sturdy chair with both hands for support. To challenge yourself further, Toe Stand (page 62)
try holding on to the chair with only one hand. As you feel steady, try using
just one finger to balance you. Then, try balancing without holding on. When
you are steady on your feet, try doing the exercises with your eyes closed.
You can use these modifications with the following exercises:
 CHAPTER 4: SAMPLE EXERCISES 69

flexibility
make it happen
Grace, age 66, has found that stretching exercises have become
an important addition to her new exercise routine:

“I grew up on a farm and continued farming after I married. So,

I was used to hard work and plenty of physical activity. When
my son and his family took over running the farm, I needed to
start a new exercise routine. Now, I begin most mornings with a
walk and stretches. Good thing, too! The stretching keeps me
limber, and the walking gives me plenty of stamina to keep up
with my seven grandchildren. Exercise helps me stay active in
their lives, and that makes it all worthwhile.”
70 EXERCISE & PHYSICAL ACTIVITY

Making How to Improve Your Flexibility minutes of easy walking first. Stretching
your muscles before they are warmed up
It REAL Stretching, or flexibility, exercises are an
may result in injury.
important part of your physical activity
program. They give you more freedom of • Always remember to breathe normally
How easy is it for you movement for your physical activities and for while holding a stretch.
to turn around and
everyday activities such as getting dressed • Stretching may feel slightly uncomfortable;
look behind you before
backing out of a parking
and reaching objects on a shelf. Stretching for example, a mild pulling feeling is
space? What about exercises can improve your flexibility but will normal.
bending down to tie not improve your endurance or strength.
your shoes? Flexibility • You are stretching too far if you feel sharp
exercises will help you or stabbing pain, or joint pain — while
How Much, How Often
do both more easily! doing the stretch or even the next day.
• Do each stretching exercise 3 to 5 times at Reduce the stretch so that it doesn’t hurt.
each session.
• Never “bounce” into a stretch. Make slow,
• Slowly stretch into the desired position, steady movements instead. Jerking into
as far as possible without pain, and hold the position can cause muscles to tighten,
stretch for 10 to 30 seconds. Relax, breathe, possibly causing injury.
then repeat, trying to stretch farther.
• Avoid “locking” your joints. Straighten your
Safety arms and legs when you stretch them, but
don’t hold them tightly in a straight
• Talk with your doctor if you are unsure position. Your joints should always be
about a particular exercise. For example, if slightly bent while stretching.
you’ve had hip or back surgery, talk with
your doctor before doing lower-body Progressing
exercises.
You can progress in your stretching exercises.
• Always warm up before stretching For example, as you become more flexible, try
exercises. Stretch after endurance or reaching farther, but not so far that it hurts.
strength exercises. If you are doing only You can use the Flexibility Daily Record on page
stretching exercises, warm up with a few 107 to keep track of your flexibility exercises.
 CHAPTER 4: SAMPLE EXERCISES 71

This easy stretch can help relieve tension in your neck. Try to
stretch after strength training and during any activity that makes
you feel stiff, such as sitting at a desk. Neck

1. You can do this stretch while standing

or sitting in a sturdy chair.
2. Keep your feet flat on the floor,
shoulder-width apart.
3. Slowly turn your head to the right until
you feel a slight stretch. Be careful
not to tip or tilt your head forward or
backward, but hold it in a comfortable
position.
4. Hold the position for 10-30 seconds.
5. Turn your head to the left and hold the
position for 10-30 seconds.
6. Repeat at least 3-5 times.
72 EXERCISE & PHYSICAL ACTIVITY

This exercise to stretch your shoulder muscles will help

Shoulder improve your posture.

1. Stand back against a wall, feet

shoulder-width apart and arms at
shoulder height.
2. Bend your elbows so your fingertips
point toward the ceiling and touch the
wall behind you. Stop when you feel a
stretch or slight discomfort, and stop
immediately if you feel sharp pain.
3. Hold position for 10-30 seconds.
4. Let your arms slowly roll forward,
remaining bent at the elbows, to
point toward the floor and touch the
wall again, if possible. Stop when you
feel a stretch or slight discomfort.
5. Hold position for 10-30 seconds.
6. Alternate pointing above head,
then toward hips.
7. Repeat at least 3-5 times.
 CHAPTER 4: SAMPLE EXERCISES 73

This exercise to increase flexibility in your shoulders and upper Shoulder and
arms will help make it easier to reach for your seatbelt. If you have
shoulder problems, talk with your doctor before trying this stretch. Upper Arm

1. Stand with feet shoulder-width apart.

2. Hold one end of a towel in your right
hand.
3. Raise and bend your right arm to drape
the towel down your back. Keep your
right arm in this position and continue
holding on to the towel.
4. Reach behind your lower back and
grasp the towel with your left hand.
5. To stretch your right shoulder, pull
the towel down with your left hand.
Stop when you feel a stretch or slight
discomfort in your right shoulder.
6. Repeat at least 3-5 times.
7. Reverse positions, and repeat at least
3-5 times.
74 EXERCISE & PHYSICAL ACTIVITY

This exercise increases the flexibility of your arms, chest, and

shoulders, and will help you reach items on the upper shelves of
Upper Body your closet or kitchen cabinet.

1. Stand facing a wall slightly farther

than arm’s length from the wall, feet
shoulder-width apart.
2. Lean your body forward and put your
palms flat against the wall at shoulder
height and shoulder-width apart.
3. Keeping your back straight, slowly walk
your hands up the wall until your arms
are above your head.
4. Hold your arms overhead for about
10-30 seconds.
5. Slowly walk your hands back down.
6. Repeat at least 3-5 times.

As you progress, the goal is to

TIP reach higher.
 CHAPTER 4: SAMPLE EXERCISES 75

This exercise, which stretches the chest muscles, is also is good

for your posture.
Chest

1. You can do this stretch while standing

or sitting in a sturdy, armless chair.
2. Keep your feet flat on the floor,
shoulder-width apart.
3. Hold arms to your sides at shoulder
height, with palms facing forward.
4. Slowly move your arms back, while
squeezing your shoulder blades
together. Stop when you feel a stretch
or slight discomfort.
5. Hold the position for 10-30 seconds.
6. Repeat at least 3-5 times.
76 EXERCISE & PHYSICAL ACTIVITY

This exercise is for your back muscles. If you’ve had hip or back
Back 1 surgery, talk with your doctor before trying this stretch.

1. Sit securely toward the front of a

sturdy, armless chair with your feet flat
on the floor, shoulder-width apart.
2. Slowly bend forward from your hips.
Keep your back and neck straight.
3. Slightly relax your neck and lower your
chin. Slowly bend farther forward and
slide your hands down your legs toward
your shins. Stop when you feel a stretch
or slight discomfort.
4. Hold for 10-30 seconds.
5. Straighten up slowly all the way to the
starting position.
6. Repeat at least 3-5 times.

As you progress, bend as far forward

TIP as you can and eventually touch your
heels.
 CHAPTER 4: SAMPLE EXERCISES 77

This exercise will help you do activities that require you to twist or
turn to look behind you, such as backing out of a parking space or
swinging a golf club. If you’ve had hip or back surgery, talk with
your doctor before trying this stretch.
Back 2

1. Sit up toward the front of a sturdy

chair with armrests. Stay as straight
as possible. Keep your feet flat on the
floor, shoulder-width apart.
2. Slowly twist to the left from your waist
without moving your hips. Turn your
head to the left. Lift your left hand and
hold on to the left arm of the chair.
Place your right hand on the outside
of your left thigh. Twist farther, if
possible.
3. Hold the position for 10-30 seconds.
4. Slowly return to face forward.
5. Repeat on the right side.
6. Repeat at least 3-5 more times.

As you progress, try lifting your left

TIP arm and resting it comfortably on
the back of the chair. Hold on to the
left armrest with your right arm.
Repeat on right side.
78 EXERCISE & PHYSICAL ACTIVITY

Upper Back This exercise is good for your shoulders and upper-back muscles.

1. Sit in a sturdy, armless chair with your

feet flat on the floor, shoulder-width
apart.
2. Hold arms in front of you at shoulder
height with palms facing outward.
3. Relax your shoulders, keep your upper
body still, and reach forward with your
hands. Stop when you feel a stretch or
slight discomfort.
4. Hold position for 10-30 seconds.
5. Sit back up.
6. Repeat at least 3-5 times.

As you progress, cross your arms

TIP and interlace fingers.
progression
 CHAPTER 4: SAMPLE EXERCISES 79

This exercise stretches your ankle muscles. You can stretch both
ankles at once or one at a time.
Ankle

1. Sit securely toward the edge of a

sturdy, armless chair.
2. Stretch your legs out in front of you.
3. With your heels on the floor, bend your
ankles to point toes toward you.
4. Hold the position for 10-30 seconds.
5. Bend ankles to point toes away from
you and hold for 10-30 seconds.
6. Repeat at least 3-5 times.
80 EXERCISE & PHYSICAL ACTIVITY

About Floor Exercises

To Get Down on the Floor:

1. Stand facing the seat of a sturdy chair.

2. Put your hands on the seat, and lower
yourself down on one knee.
3. Bring the other knee down.
4. Put your left hand on the floor. Leaning
on your hand, slowly bring your left hip
to the floor. Put your right hand on the
floor next to your left hand to steady
yourself, if needed.
5. You should now be sitting with your
weight on your left hip.
6. Straighten your legs.
7. Bend your left elbow until your weight
is resting on it. Using your right hand
as needed for support, straighten your
left arm. You should now be lying on
your left side.
8. Roll onto your back.

You don’t have to use your left

TIP side. You can use your right side,
if you prefer.
 CHAPTER 4: SAMPLE EXERCISES 81

If you have trouble getting down on or up from the floor by yourself, try using the buddy system. Find someone
TIP who will be able to help you. Knowing how to use a chair to get down on the floor and get back up again also may
be helpful. If you’ve had hip or back surgery, talk with your doctor before using the following method.

To Get Up from the Floor:

1. Roll onto your left side.

2. Place your right hand on the floor at
about the level of your ribs and use it
to push your shoulders off the floor.
Use your left hand to help lift you up,
as needed.
3. You should now be sitting with your
weight on your left hip.
4. Roll forward, onto your knees, leaning
on your hands for support.
5. Reach up and lean your hands on the
seat of a sturdy chair.
6. Lift one of your knees so that one leg
is bent, foot flat on the floor.
7. Leaning your hands on the seat of
the chair for support, rise from this
position.

You don’t have to use your left side.

TIP You can use your right side, if you
prefer.
82 EXERCISE & PHYSICAL ACTIVITY

This exercise stretches the muscles in the back of your legs. If

Back of Leg you’ve had hip or back surgery, talk with your doctor before
trying this stretch. (See About Floor Exercises on page 80.)
Floor

1. Lie on your back with left knee bent

and left foot flat on the floor.
2. Raise right leg, keeping knee slightly
bent.
3. Reach up and grasp right leg with
both hands. Keep head and shoulders
flat on the floor.
4. Gently pull right leg toward your
body until you feel a stretch in the
back of your leg.
5. Hold position for 10-30 seconds.
6. Repeat at least 3-5 times.
7. Repeat at least 3-5 times with left leg.
 CHAPTER 4: SAMPLE EXERCISES 83

Here’s another exercise that stretches the muscles in the back of

your legs. If you’ve had hip or back surgery, talk with your doctor
before trying this stretch. Back of Leg

1. Sit sideways on a bench or other

hard surface, such as two chairs
placed together.
2. Keeping back straight, stretch one leg
out on the bench, toes pointing up.
3. Keep other foot flat on the floor.
4. If you feel a stretch at this point,
hold position for 10-30 seconds.
5. If you don’t feel a stretch, lean forward
from hips (not waist) until you feel
stretching in the leg on the bench.
6. Hold position for 10-30 seconds.
7. Repeat at least 3-5 times.
8. Repeat at least 3-5 times with your
other leg.
84 EXERCISE & PHYSICAL ACTIVITY

This exercise stretches your thigh muscles. If you’ve had hip or back

Strength
Thigh surgery, talk with your doctor before trying this stretch. If you have
trouble getting down on the floor or back up again, try the Thigh
Elbow Extension
Floor Standing stretch. (See About Floor Exercises on page 80.)

1. Lie on your side with legs straight

and knees together.
2. Rest your head on your arm.
3. Bend top knee and reach back and
grab the top of your foot. If you can’t
reach your foot, loop a resistance
band, belt, or towel over your
foot and hold both ends.
4. Gently pull your leg until you feel
a stretch in your thigh.
5. Hold position for 10-30 seconds.
6. Repeat at least 3-5 times.
7. Repeat at least 3-5 times with your
other leg.
 CHAPTER 4: SAMPLE EXERCISES 85

Here’s another exercise that stretches your thigh muscles.

If you’ve had hip or back surgery, talk with your doctor before Thigh
trying this stretch.
Standing

1. Stand behind a sturdy chair with

your feet shoulder-width apart and
your knees straight, but not locked.
2. Hold on to the chair for balance
with your right hand.
3. Bend your left leg back and grab your
foot in your left hand. Keep your
knee pointed to the floor. If you can’t
grab your ankle, loop a resistance
band, belt, or towel around your foot
and hold both ends.
4. Gently pull your leg until you feel
a stretch in your thigh.
5. Hold position for 10-30 seconds.
6. Repeat at least 3-5 times.
7. Repeat at least 3-5 times with
your right leg.
86 EXERCISE & PHYSICAL ACTIVITY

This exercise will stretch your hip and inner thigh muscles. If
you’ve had hip or back surgery, talk with your doctor before
Hip trying this stretch. (See About Floor Exercises on page 80.)

1. Lie on your back with your legs

together, knees bent, and feet flat on
the floor. Try to keep both shoulders
on the floor throughout the stretch.
2. Slowly lower one knee as far as you
comfortably can. Keep your feet
close together and try not to move
the other leg.
3. Hold position for 10-30 seconds.
4. Bring knee back up slowly.
5. Repeat at least 3-5 times.
6. Repeat at least 3-5 times with your
other leg.
 CHAPTER 4: SAMPLE EXERCISES 87

This exercise stretches the muscles of your lower back. If you’ve

had hip or back surgery, talk with your doctor before trying this
stretch. (See About Floor Exercises on page 80.) Lower Back

1. Lie on your back with your legs

together, knees bent, and feet flat
on the floor. Try to keep both arms
and shoulders flat on the floor
throughout the stretch.
2. Keeping knees bent and together,
slowly lower both legs to one side
as far as you comfortably can.
3. Hold position for 10-30 seconds.
4. Bring legs back up slowly and repeat
toward other side.
5. Continue alternating sides for at
least 3-5 times on each side.
88 EXERCISE & PHYSICAL ACTIVITY

Because many people have tight calf muscles, it’s important

Calf to stretch them.

1. Stand facing a wall slightly farther

than arm’s length from the wall, feet
shoulder-width apart.
2. Put your palms flat against the wall
at shoulder height and shoulder-width
apart.
3. Step forward with right leg and bend
right knee. Keeping both feet flat on the
floor, bend left knee slightly until you
feel a stretch in your left calf muscle.
It shouldn’t feel uncomfortable. If you
don’t feel a stretch, bend your right
knee until you do.
4. Hold position for 10-30 seconds, and
then return to starting position.
5. Repeat with left leg.
6. Continue alternating legs for at least
3-5 times on each leg.
 CHAPTER 4: SAMPLE EXERCISES 89

This is a good over-all stretch that’s fun to do with a partner. It stretches

your shoulders, arms, back, and legs. If you’ve had hip or back surgery,
talk with your doctor before trying this stretch. (See Working with a Buddy Stretch
Resistance Band on page 44 and About Floor Exercises on page 80.)

1. Sit on the floor facing your buddy

and place your feet against your
partner’s feet.
2. Both of you should grab one end of a
resistance band or towel. Depending on
each person’s flexibility, you may need to
loop two bands or towels together.
3. Slowly pull the band or towel so that
your buddy bends forward and you lean
backward.
4. Hold position for 10-30 seconds.
5. Slowly return to starting position.
6. Now it’s your buddy’s turn to pull the
band or towel so that you bend forward
and your buddy leans backward. Hold
for 10-30 seconds, and then return to
starting position.
7. Repeat at least 3-5 times.

As you progress, try holding the

TIP band so that your hands are closer to
your buddy’s, or try using a heavier
strength band. Some people may be
able to do the stretch by reaching out
and holding hands during the stretch.
5
how am I doing?
 CHAPTER 5: HOW AM I DOING? 91

If you’ve been exercising regularly, you’ll soon be able to tell when it’s time to move ahead in your activities.
For example, when you can lift a weight easily more than 10 times, it’s time to add more weight in your
strength exercises. And when your endurance activity no longer feels challenging, it’s time to exercise a little
longer, or make it a little more difficult, such as by walking up steeper hills.

The simple tests shown in this chapter will Also remember that each person is different.
show you just how far you’ve come. You might Some will be able to progress with time; for others,
want to test yourself every month or so. Write reaching a certain level of activity and staying
down your scores each time so you can see there is right for their age and ability level.
your improvement the next time you test
yourself. You can record your scores on the If you’re not ready to do these tests, don’t
Monthly Progress Test on page 108. worry, just keep working on your current
exercises and activities until you are. Whether
You might want to do these tests for a couple
of reasons. For one, most people make rapid you are testing yourself or actually exercising,
progress soon after they start to exercise, your pace should never make you feel dizzy,
and it’s encouraging to see your scores light-headed, or sick to your stomach, and you
improve after just a month. For another, shouldn’t feel pain.
these tests are a good way to let you know
And one last tip: Whether or not you do these
if you are continuing to progress and you
need to update your goals. For example, you tests, don’t forget to congratulate yourself
may want to walk farther or lift heavier for your efforts. Tell your family and friends
weights. But remember, it is normal for about your achievements. You’ve made a
your improvement to slow down at times. lot of progress, and you’re ready for more!
92 EXERCISE & PHYSICAL ACTIVITY

Test Yourself Balance. Time yourself as you stand on one foot,

without support, for as long as possible. Stand
Endurance. Pick a fixed course — the distance
near something sturdy to hold on to, in case you
from your house to the corner, once around the
lose your balance. Record your score. Repeat
track at your local high school, or from one end of
the test while standing on the other foot. Test
the mall to the other — whatever is convenient.
yourself again in 1 month. The amount of time
See how long it takes to walk that distance. Do
you can stand on one foot should increase.
this test every month or so. As your endurance
improves, it should take less time. Flexibility. If you’ve had hip or back surgery,
talk with your doctor before you do this test.
Upper-body Strength. Count the number of
Sit securely toward the front of a sturdy
arm curls (see page 50) you can safely do in
chair, and stretch one leg straight out
2 minutes. If you are just starting to exercise,
in front of you with your heel on the
you may have to stop and rest before the
floor, toes pointing upward. Bend
2 minutes are up. That’s okay; it still gives you
the other leg so that your foot is flat
a great starting point to measure your progress.
on the floor. With your elbows slightly
Repeat the test 1 month later. The number of
bent and your hands palms down,
arm curls you can do should increase.
slowly bend forward from your hips
Lower-body Strength. Count the number of (not your waist) and reach as far as
chair stands (see page 60) you can safely do in you can toward your toes. How
2 minutes. You may have to stop and rest before far down can you reach until
the 2 minutes are up if you are just starting to you feel a stretch? Test
exercise. That’s okay; you will be able to measure yourself again in 1 month.
your progress from this starting point. Repeat Eventually, you should
the test 1 month later. The number of chair be able to reach closer
stands you can do should increase. to your toes.

GO HERE FOR MORE INFO

Review the safety guidelines on
page 22 before testing yourself.
 CHAPTER 5: HOW AM I DOING? 93

Other Ways to Measure Progress

As you become more active, you’ll probably
notice other signs that you’re getting more fit:

• You have more energy.

• Your overall mood and outlook on life have
improved.
• It’s easier to do your usual daily activities.
• Climbing a couple of flights of stairs
is easier.
• It’s easier to get in and out of the car. make it social
• You can get down on the floor and play a Marty’s “exercise buddies” keep him going:
game with your grandchildren, and get
“Every morning I head out to the mall — not to shop, but to
back up again more easily when the game
join my mall-walkers group. At 75, I’m one of the youngest
is over.
members. When I retired, my wife Harriet insisted that
• You’re sleeping better at night. we walk every morning. Some of us move at a steady clip
through the mall, while others take a slower pace. We count
• You have less pain when you
move around. our laps and keep a daily record of our progress — pushing
ourselves to go a little faster, a little farther.
• Symptoms of an ongoing
health condition When Harriet died unexpectedly, it was quite a blow, but
may improve. the walkers were my lifeline. They kept me moving when
all I wanted to do was sit. At first, I walked because it was
something to do each morning. But now, I realize that I like
how it feels to be moving. Measuring how fast I can walk
gives me goals, something to work toward. I walk and feel
stronger every day. I often think of Harriet and silently
thank her for insisting that we walk together.”
6
healthy eating
 CHAPTER 6: HEALTHY EATING 95

Following a healthy eating plan and being physically active are keys
to a healthy lifestyle. But just what does “healthy eating” mean?

The answer is found in the Dietary Guidelines • Is low in saturated fats, trans fats,
for Americans from the U.S. Department of cholesterol, salt, and added sugars
Agriculture (USDA) and the U.S. Department
• Balances the calories from foods and beverages
of Health and Human Services (the National
with calories burned through physical
Institute on Aging is part of this Department).
activities to maintain a healthy weight
According to the Guidelines, a healthy diet:
MyPyramid.gov, a website developed by the
• Emphasizes vegetables, fruits, whole
USDA, offers personalized eating plans, tools
grains, and fat-free or low-fat milk
to help you plan and assess your food choices,
and milk products
and advice to help you make smart choices
• Includes lean meats, poultry, fish, from every food group and get the most
beans, eggs, and nuts nutrition out of your calories.

GO HERE FOR MORE INFO

www.mypyramid.gov shows you how to make healthy food choices. It’s easy to use: simply
type in your age, gender, height, weight, and physical activity level to get suggestions about
how to meet your nutrition needs.
96 EXERCISE & PHYSICAL ACTIVITY

Tips for Healthy Eating • Look for foods that are low in cholesterol and
fat, especially saturated fat (mostly in foods
Here are some recommendations for
that come from animals) and trans fats (found in
healthy eating:
many cakes, cookies, crackers, icings, margarines,
• Eat a variety of fruits and vegetables. and microwave popcorn). Saturated fats and
Eating fruits and vegetables of different trans fats can increase blood cholesterol levels.
colors gives your body a wide range of
• Choose and prepare foods with little salt.
valuable nutrients, including fiber, folate,
potassium, and vitamins A and C. Some • Choose lean cuts of meat and poultry. Trim away
examples are green spinach, orange sweet extra fat and remove the skin from chicken and
potatoes, black beans, yellow corn, purple turkey before cooking. Broil, roast, bake, steam,
plums, blueberries, red watermelon, and microwave, or boil foods instead of frying.
white onions. Have them with meals or for • Reaching and maintaining a healthy weight are
a snack. Leave skins on your fruits and important for your overall health and well-being.
vegetables, if possible. For example, eat the The secret is to balance your “energy in” and
skin when you have a baked potato, and “energy out” over the long run. “Energy in” is
snack on unpeeled apples, pears, and the calories from foods and beverages you have
peaches. Don’t forget to rinse fruits and each day, and “energy out” is the calories you
vegetables before eating. burn for basic body functions and during physical
• Eat a diet rich in foods that contain fiber activity. Your weight will stay the same when
such as dry beans, fruits, vegetables, and the calories you eat and drink equal the calories
whole-grain foods. Breakfast is a good time you burn. On the other hand, you will gain
to enjoy foods with fiber. For example, try weight when the calories you eat and drink are
unsweetened, whole wheat or bran cereals, greater than those you burn. Physical activity
and add fruit such as berries and bananas. can help you reach and keep a healthier weight.

• Season your foods with lemon juice, herbs,

or spices, instead of butter and salt.
 CHAPTER 6: HEALTHY EATING 97

• Watch your portion size. Controlling Eating Out

portion size helps limit calorie intake,
Eating out is enjoyable, but restaurants often
especially when eating foods that are high
serve large meals, which can be high in
in calories.
calories, fat, and salt. Here are a few tips to
Drinking Enough Fluids help make your meal both delicious and
nutritious:
It’s important to drink enough liquids to
keep your body working properly. This is • Order foods such as salads with lean meats,
particularly true for older adults because they low-fat or fat-free cheeses, and other
often don’t feel thirsty even if their bodies toppings. Choose low-fat or fat-free salad
need fluids. Drinking enough fluids every day dressing, and ask for the dressing on the
is essential for those who exercise regularly, side to control how much you use.
eat large amounts of protein, use laxatives, or • Choose foods that are baked, broiled,
live in areas with high temperatures. Check braised, grilled, steamed, sautéed,
with your doctor, however, if you’ve been told or boiled instead of fried. With these
to limit how much you drink. cooking methods, little or no fat is added
to the food. QUICK TIP
Drink plenty of liquids such as water and
other drinks without added sugar. Fat-free or Do you have a urinary
low-fat milk, 100% juice, coffee, and tea also control problem? If the
are good sources of fluids, as are foods with answer is yes, don’t
high moisture content such as fruits, stop drinking liquids.
vegetables, and low-sodium broth-based Talk with your doctor
GO HERE FOR MORE INFO about treatment.
soups. Those who choose to drink alcoholic
To learn more about portion sizes
beverages should do so sensibly and in and have some fun at the same time,
moderation, which means up to one drink take the Portion Distortion Quiz from
per day for women and up to two drinks per the National Heart, Lung, and Blood
day for men. Institute. For details, see the listing on
page 118 of the Resources section.
98 EXERCISE & PHYSICAL ACTIVITY

QUICK TIP
• Hold the “special sauces.” Ask the kitchen What Are Dietary Supplements?
not to top your dish with butter or whipped
cream. Dietary supplements are substances you might
Beware of diets that
make big promises about • Choose foods with a tomato-based or red use to add nutrients to your diet or to lower
losing weight, regaining sauce instead of a cream-based or white your risk of health problems such as osteo-
youth, or achieving high porosis or arthritis. Dietary supplements come
sauce. Cream-based and white sauces
energy.
usually are made with butter, milk, and in the form of pills, capsules, powders, gel tabs,
cream, and are high in calories and extracts, or liquids. They might contain fiber,
If it sounds too quick, too saturated fat. Tomato-based sauces usually vitamins, minerals, amino acids, herbs or other
easy, or too good to be plants, or enzymes. Sometimes, the ingredients
contain more vitamins, less fat, and fewer
true, it probably is.
calories. in dietary supplements are added to foods,
including drinks. You do not need a prescription
To maintain and improve
• Use portion control: Skip the “super sizes,”
to buy most dietary supplements.
ask for “small,” or share a portion.
your health, follow the
Dietary Guidelines and Some ads for dietary supplements seem to
• Ask for food to be prepared without added
be physically active promise that they will make you feel better,
salt, and don’t add salt at the table.
every day. keep you from getting sick, or even help you live
• Drink water, fat-free or low-fat milk, or longer. Sometimes, there is little, if any, good
other drinks without added sugars. scientific research to support these claims.
• Instead of french fries, try a small baked
potato, side salad with low-fat or fat-free
dressing, or fruit.
• Order an item from the menu instead of
heading for the “all-you-can-eat” buffet.
 CHAPTER 6: HEALTHY EATING 99

Are Dietary Supplements Safe? Do I Need a Supplement?

Although certain dietary supplements may Eating healthy foods is the best way to
help some people, sometimes supplements get the nutrients you need. For example,
can be harmful. For example: fruits and vegetables provide a variety of
important nutrients, including fiber, folate,
• Taking a combination of supplements,
potassium, and vitamins A and C.
using supplements together with
prescription or over-the-counter People who eat the recommended amount
medications, or using them in place of a nutrient in food and who do not have
of medicines prescribed by your problems absorbing that nutrient will
doctor could lead to harmful, even not gain any additional health benefit by
life-threatening side effects. Be alert taking the nutrient as a supplement. For
to any warnings about these products. example, people who eat enough fruits and
vegetables don’t need extra vitamin C.
• Some supplements can have unwanted or
harmful effects before, during, or after Certain dietary supplements, however,
surgery. For example, vitamin E and the can help some older adults with specific
herbal supplement ginkgo biloba can each nutrient needs that cannot be met by their
thin the blood and increase the potential daily diet. For example, some older adults
for bleeding. It’s important to let your may not get enough calcium, vitamin D, or
doctor know about the vitamins, minerals, vitamin B12. Supplements containing these
herbals, and any other supplements you nutrients help them stay healthy.
are taking, especially before surgery.
The best way to find out if you need to
take a supplement is to talk with your
doctor or a registered dietitian. Together,
you can review your diet, prescription
medicines, and health needs, and decide
whether a supplement is right for you.
7
keep going
 CHAPTER 7: KEEP GOING 101

Physical activity is a great way to have fun, be with friends and family, enjoy the outdoors, improve your
fitness for your favorite sport, and maintain your independence. Older adults also gain substantial health
benefits from regular physical activity, and these benefits last even into old age. The best way to be
physically active is to make it a lifelong habit. Once you get started, keep going.

Often, people decide to become more active On the following pages, you will find a
and follow a healthy eating plan because they number of worksheets you can use to
want to control their weight. For many people, help you meet your exercise and physical
these healthy habits do result in weight loss, activity goals. Choose and use the ones
but that’s only part of the big picture. Healthy that work for you.
eating and physical activity help you become
physically fit and stay healthy.

Think about other lifestyle changes you can

make, too. For example, smoking leads to a
variety of serious diseases and can keep you
from being active. So does drinking too much
alcohol. Together, habits like physical activity,
a healthful diet, drinking in moderation, and
not smoking will help you achieve the main
goal: the best of health.

TIP Make copies of the blank worksheets so you can update them as you progress.
102 EXERCISE & PHYSICAL ACTIVITY

Activity Log
For a couple of weekdays and a weekend, write down how much time you are physically active (for example,
walking, gardening, playing a sport, dancing, lifting weights). The goal is to find ways to increase your activity.

Activity Number of Minutes Ways to Increase Activity

Weekday 1

Total Minutes
Weekday 2

Total Minutes
Weekend

Total Minutes
 CHAPTER 7: KEEP GOING 103

Goal-Setting Worksheet
Your success depends on setting goals that really matter to you. Write down your goals, put them where you
can see them, and renew them regularly.

Short-term Goals

Write down at least two of your own personal short-term goals. What will you do over the next week or two that will help you
make physical activity a regular part of your life?

1.

2.

3.

Long-term Goals

Write down at least two long-term goals. Focus on where you want to be in 6 months, a year, or 2 years from now. Remember,
setting goals will help you make physical activity part of your everyday life, monitor your progress, and celebrate your success.

1.

2.

3.
104 EXERCISE & PHYSICAL ACTIVITY

Weekly Exercise and Physical Activity Plan

Use this form to make your own exercise and physical activity plan — one you think you really can manage.
Update your plan as you progress. Aim for moderate-intensity endurance activities on most or all days of the
week. Try to do strength exercises for all of your major muscle groups on 2 or more days a week, but don’t
exercise the same muscle group 2 days in a row. For example, do upper-body strength exercises on Monday,
Wednesday, and Friday and lower-body strength exercises on Tuesday, Thursday, and Saturday. Or, you can
do strength exercises of all of your muscle groups every other day. Don’t forget to include balance and
flexibility exercises.

Week of Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Endurance

Upper-Body
Strength

Lower-Body
Strength

Balance

Flexibility
 CHAPTER 7: KEEP GOING 105

Endurance Daily Record

You can use these forms to record your endurance activities. Try to build up to at least 30 minutes of
moderate-intensity endurance activity on most or all days of the week. Every day is best.

Week of Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Endurance Activity

How Long Did You Do It?

Week of Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Number of Steps
106 EXERCISE & PHYSICAL ACTIVITY

Strength and Balance Daily Record

You can use this form to keep track of the strength exercises you do each day. Try to do strength exercises
for all of your major muscle groups on 2 or more days a week for 30-minute sessions each, but don’t
exercise the same muscle group on any 2 days in a row. Record the number of repetitions and the amount of
weight you use.

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Week of Lbs. Reps Lbs. Reps Lbs. Reps Lbs. Reps Lbs. Reps Lbs. Reps Lbs. Reps
Hand Grip
Wrist Curl
Overhead Arm Raise
Upper-Body

Front Arm Raise

Side Arm Raise
Arm Curl
Seated Row
Wall Push-Up
Elbow Extension
Chair Dip

Back Leg Raise

Lower-Body

Side Leg Raise

Knee Curl
Leg Straightening
Chair Stand
Toe Stand
 CHAPTER 7: KEEP GOING 107

Flexibility Daily Record

You can use this form to keep track of your flexibility exercises. Record the number of repetitions you do.

Week of Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Neck
Shoulder
Upper-Body

Shoulder/Upper Arm
Upper Body
Chest
Back 1
Back 2
Upper Back

Ankle
Back of Leg
Lower-Body

Thigh
Hip
Lower Back
Calf
Buddy Stretch
108 EXERCISE & PHYSICAL ACTIVITY

Monthly Progress Test

Take the tests on page 92 monthly, record your scores, and watch your progress.

Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

Endurance — Pick a fixed course, such as the

distance from your house to the corner, and
see how long it takes you to walk that far.

Upper-Body Strength — Count the number of

arm curls you can safely do in 2 minutes.

Lower-Body Strength — Count the number of

chair stands you can safely do in 2 minutes.

Balance — Time yourself as you stand on one

foot, without support, for as long as possible.
Repeat with the other foot.

Flexibility — Note how far you can reach until

you feel a stretch.
 CHAPTER 7: KEEP GOING 109

1 2

20 Question:
I’m not particularly active, and
I haven’t exercised in years.
Is it safe for me to start now?
Question:
I have a medical condition
(such as arthritis, high blood
pressure, diabetes, heart
disease). Is it safe for me
Answer: to exercise?

Frequently If you haven’t been active for a

long time, it’s important to start Answer:
Asked out at a low level of effort and
work your way up slowly.
Exercise is safe for almost
everyone. In fact, studies show
Questions Beginning slowly will help you that people with arthritis, high
become more fit without straining blood pressure, diabetes, or heart
your body. For example, you may disease benefit from regular
want to start with walking, biking, exercise and physical activity.
or swimming at a comfortable In some cases, exercise actually
pace and then gradually do more, can improve some of these
or start strengthening exercises conditions. You may want to talk
with 1- or 2-pound weights and with your doctor about how your
gradually add heavier weights. You health condition might affect your
may want to talk with your doctor ability to be active. (See page 20
if you decide to start a vigorous for more information.)
exercise program or significantly
increase your physical activity.
110 EXERCISE & PHYSICAL ACTIVITY

3 4 5

Question: Question: Question:

Isn’t it better for older adults How much physical activity do How hard should I exercise?
to “take it easy” and save I need?
their strength? Answer:
Answer: We can’t tell you exactly how
Answer: The goal is to achieve at least many pounds to lift or how steep
Regular physical activity is very 30 minutes of moderate-intensity a hill you should climb to reach a
important to the health and endurance activity on most or moderate or vigorous level of
abilities of older people. In fact, all days of the week. Every day is exercise because what’s easy for
studies show that “taking it easy” best, but doing anything is better one person might be difficult for
is risky. For the most part, when than doing nothing at all. Try to another. You should match your
older people lose their ability to do all four types of exercises — activity to your own needs and
do things on their own, it doesn’t endurance, balance, flexibility, abilities. Start from where you are
happen just because they’ve aged. and strength. Try to do strength and build up from there. Listen to
It’s usually because they’re not exercises for all of your major your body. During moderate
active. According to the U.S. muscle groups on 2 or more days activity, for instance, you can
Surgeon General’s Report on a week for 30-minute sessions sense that you are pushing
Physical Activity and Health, each, but don’t do strength yourself but that you aren’t near
inactive people are nearly twice as exercises of the same muscle your limit. As you become more
likely to develop heart disease as group 2 days in a row. fit, gradually make your activities
those who are more active. Lack more difficult. Generally, the more
of physical activity also can lead vigorous the activity and the more
to more visits to the doctor, more time you spend doing it, the more
hospitalizations, and more use of health benefits you will receive.
medicines for a variety of illnesses.
 CHAPTER 7: KEEP GOING 111

6 7 8

Question: Question: Question:

How long do I need to be Do I get enough physical I’m healthy now. Why do I
active before I see results? activity in my regular need to be active?
day-to-day activities?
Answer: Answer:
Once you start being physically Answer: Research shows that exercise
active, you’ll begin to see results One way to find out is to check and physical activity can
in just a few weeks. You may feel your Activity Log (see page 102). maintain and even improve
stronger and more energetic than Did you list physical activities your health. For example,
before. You may notice that you that get your body moving, such exercise and physical activity
can do things more easily, faster, as yard work, walking the dog, can help you manage and even
or for longer than before. As you raking leaves, or climbing stairs? prevent diseases such as heart
become more fit, you may need How about weight training or an disease, diabetes, and
to make your activities more aerobics class? There are many osteoporosis.
challenging to see additional results. ways to be active every day.
The key is to do all four of the
major types of exercises regularly
and increase your level of effort
over time.
112 EXERCISE & PHYSICAL ACTIVITY

9 10 11

Question: Question: Question:

I find it hard to make myself How do I find time to be active? What kind of equipment do
be active. What can I do? I need? I can’t afford exercise
Answer: equipment.
Answer: There are a number of ways to fit
You’re more likely to keep going exercise and physical activity into Answer:
if you choose activities you enjoy, your schedule. For example, For many activities, you don’t
if you can fit them into your exercise first thing in the morning need any equipment or special
schedule, if you believe you’ll before your day gets too busy, or clothing. All you need for brisk
benefit from them, and if you combine physical activity with a walking, for example, is a pair
feel you can do them safely and task that’s already part of your of comfortable, non-skid shoes.
correctly. Making a contract with day, such as walking the dog or For strength training, you can
a friend or family member also doing household chores. If you make your own weights from
may help you keep your don’t have 30 minutes in your unbreakable household items
commitment. Setting small, daily routine to be active, look (see page 45). Many communities
realistic goals, checking your for three 10-minute periods. offer free or low-cost programs
progress, and rewarding yourself for seniors. Check with your local
when you reach your goal also parks and recreation department
can help. If you can stick with or senior center about the facilities
an exercise routine or physical and programs in your area. In
activity for at least 6 months, addition, some local fitness centers
it’s a good sign that you’re on your may offer senior discounts.
way to making physical activity
a regular habit.
 CHAPTER 7: KEEP GOING 113

12 13 14

Question: Question: Question:

What if I have an injury or I get tired easily. What is the I’ve been exercising for some
health problem that keeps me best physical activity for me? time now. Why am I not seeing
from exercising for a while? any more real improvements?
How do I know if it’s safe for
Answer:
me to start again? Answer:
Once you become active, you’re
As your body gets used to a level
likely to have more energy than
Answer: of exercise, you’ll need to vary
before. As you do more, you also
If you miss a few days or weeks your exercise or do more in order
may notice that you can do
of exercise because of an injury to see additional progress. If you
things more easily, faster, and
or illness, don’t be discouraged. are able, do your activities longer,
for longer than before. Regular,
Once you recover, you can start farther, or harder. Do the activities
moderate physical activity can
again and be successful. Talk with more often, or add new physical
help reduce fatigue and even
your doctor about when you can activities to your routine.
help you manage stress.
resume your regular routine.
When you start again, begin at
about half the effort you were
putting in when you stopped, then
gradually build back up. With a
little time, you’ll be back at the
same, or a better, fitness level.
114 EXERCISE & PHYSICAL ACTIVITY

15 16 17

Question: Question: Question:

I’m 81 years old. Should I be What kinds of shoes are best Do I need to do other
exercising, and will it make a for walking or other types of exercises in addition to my
difference at my age? physical activity? usual walking routine?

Answer: Answer: Answer:

Yes, staying active is important Look for sensible shoes that Most people tend to focus on one
throughout life. Regular exercise support your feet. Make sure they type of exercise or activity and
and physical activity help you stay have flat, non-skid soles and are think they’re doing enough. Try to
strong and fit enough to keep comfortable. Avoid shoes with do all four types — endurance,
doing the things you enjoy. No thick, heavy soles. If tying laces strength, flexibility, and balance
matter what your age, you can is difficult, look for shoes with — because each one has different
find activities that meet your Velcro® fasteners. When you buy benefits. Doing one kind also can
fitness level and needs. shoes, try on several pairs so that improve your ability to do the
you’re sure to get a pair that fits others. In addition, variety helps
well. (See page 22 for more on reduce boredom and risk of injury.
getting the right shoes.)
 CHAPTER 7: KEEP GOING 115

18 19 20

Question: Question: Question:

Is it better to join an exercise If I’m overweight or obese, I don’t do any kind of physical
class or group, or exercise on what kinds of physical activity activity, but I watch my diet
my own? can I do? and I’m not overweight. Isn’t
that enough?
Answer: Answer:
There are many ways to be active. You can do all kinds of physical Answer:
The key is to find activities you activities, including the four types Eating a nutritious diet and
truly enjoy. If you prefer individual of exercise shown in this guide. maintaining a healthy weight are
activities, try swimming, gardening, Try walking, water exercises, only part of a healthy lifestyle.
or walking. Dancing or playing dancing, or weight lifting. Regular physical activity is
tennis may be for you if you enjoy Anything that gets you moving important to the physical
two-person activities. If group — even for only a few minutes and mental health of almost
activities appeal to you, try a a day in the beginning — is a everyone, including older adults.
sport such as basketball or join an healthy start. Very large people Being physically active can help
exercise class. Some people find may face special challenges. For you stay strong and fit enough
that going to a gym regularly or example, you may not be able to to keep doing the things you
working with a fitness trainer bend or move easily, or you may enjoy and to stay independent as
helps them stay motivated. feel self-conscious. Facing these you get older. Together, healthy
challenges is hard — but it can habits such as physical activity, a
be done. Feel good about what balanced diet, and not smoking
you can do, and pat yourself on will help you achieve the best
the back for trying. It should of health.
get easier.
116 EXERCISE & PHYSICAL ACTIVITY

Resources
National Institute on Aging For more information on health and
For more information about exercise and aging, contact:
physical activity, visit NIHSeniorHealth, the
senior-friendly website from the National National Institute on
Institute on Aging and the National Library Aging Information Center
of Medicine. You can read exercise stories P.O. Box 8057
Gaithersburg, MD 20898-8057
featuring older adults and the diverse
activities they enjoy. The website is easy 800-222-2225 (toll free)
to use. You can make the text bigger 800-222-4225 (TTY/toll free)
and the contrast better. You www.nia.nih.gov
can even make it talk. Visit
Many groups have information about
www.NIHSeniorHealth.gov.
physical activity and exercise for older
adults. The following list of resources
will help you get started.

Administration on Aging
Washington, DC 20201
202-619-0724
www.aoa.gov

American Academy of Family

Physicians
P.O. Box 11210
Shawnee Mission, KS 66207-1210
800-274-2237 (toll free)
www.familydoctor.org
Exercise & Seniors
 RESOURCES 117

American Academy of American Podiatric Medical Department of Agriculture Federal Trade Commission
Orthopaedic Surgeons Association Food and Nutrition 600 Pennsylvania Avenue NW
6300 North River Road 9312 Old Georgetown Road Information Center Washington, DC 20580
Rosemont, IL 60018-4262 Bethesda, MD 20814-1621 National Agricultural Library 877-382-4357 (toll free)
847-823-7186 301-581-9200 10301 Baltimore Avenue www.ftc.gov
www.aaos.org www.apma.org Room 105 Avoiding the Muscle Hustle:
Seniors and Exercise 2009 Walking Guide Beltsville, MD 20705-2351 Tips for Buying Exercise
Exercise for Persons 60 Years Walking Tips for Seniors 301-504-5414 Equipment
and Older www.nal.usda.gov/fnic
Centers for Disease Control www.MyPyramid.gov Food and Drug Administration
American College of Sports and Prevention Dietary Guidelines for Center for Food Safety and
Medicine 1600 Clifton Road Americans Applied Nutrition
P.O. Box 1440 Atlanta, GA 30333 5100 Paint Branch Parkway
Indianapolis, IN 46206-1440 800-232-4636 (toll free) Department of HFS-009
317-637-9200 www.cdc.gov Transportation Federal College Park, MD 20740-3835
www.acsm.org Growing Stronger: Strength Highway Administration 888-723-3366 (toll free)
Training for Older Adults! Office of Safety www.cfsan.fda.gov
American Council on How to Avoid Portion Size 1200 New Jersey Avenue SE
Exercise Pitfalls to Help Manage Washington, DC 20590 International Council
4851 Paramount Drive Your Weight 202-366-8029 on Active Aging
San Diego, CA 92123 http://safety.fhwa.dot.gov/ 3307 Trutch Street
888-825-3636 (toll free) Centers for Medicare & ped_bike Vancouver, BC V6L-2T3
www.acefitness.org Medicaid Services Pedestrian and Bicycle Safety Canada
7500 Security Boulevard 866-335-9777 (toll free)
American Physical Therapy Baltimore, MD 21244-1850 Environmental Protection www.icaa.cc
Association 800-MEDICARE (toll free) Agency
1111 North Fairfax Street www.medicare.gov 1200 Pennsylvania Avenue NW National Cancer Institute
Alexandria, VA 22314-1488 Mail Code 1107A 6116 Executive Boulevard
800-999-2782 (toll free) Room 2512 Ariel Rios North Room 300
www.apta.org Washington, DC 20460 Bethesda, MD 20892-8322
For the Young at Heart: 202-564-2188 1-800-4-CANCER (toll free)
Exercise Tips for Seniors www.epa.gov/aging/index.htm www.cancer.gov
Building Healthy Communities Physical Activity and Cancer
for Active Aging Fact Sheet
118 EXERCISE & PHYSICAL ACTIVITY

National Center for National Institute of Office of Dietary Weight-Control

Complementary and Arthritis and Musculoskeletal Supplements Information Network
Alternative Medicine and Skin Diseases National Institutes of Health 1 WIN Way
P.O. Box 7923 1 AMS Circle 6100 Executive Boulevard Bethesda, MD 20892-3665
Gaithersburg, MD 20898 Bethesda, MD 20892-3675 Room 3B01, MSC 7517 877-946-4627 (toll free)
888-644-6226 (toll free) 877-226-4267 (toll free) Bethesda, MD 20892-7517 www.win.niddk.nih.gov
www.nccam.nih.gov www.niams.nih.gov 301-435-2920 Active At Any Size
Tai Chi for Health Purposes Exercise for Your Bone Health www.ods.od.nih.gov Young at Heart: Tips for Older
Living with Arthritis Dietary Supplement Fact Adults
National Commission for Sheets Fit and Fabulous as You Mature
Certifying Agencies National Institute of Walking…A Step in the Right
2025 M Street NW, Suite 800 Diabetes and Digestive Office of Disease Prevention Direction
Washington, DC 20036 and Kidney Diseases and Health Promotion
202-367-1165 National Diabetes 1101 Wootton Parkway YMCA
www.credentialingexcellence.org/ Information Clearinghouse Suite LL100 101 North Wacker Drive
Resources/NCCAAccreditation/ 1 Information Way Rockville, MD 20852 Chicago, IL 60606
tabid/82/Default.aspx Bethesda, MD 20892-3560 240-453-8280 800-872-9622 (toll free)
800-860-8747 (toll free) www.odphp.osophs.dhhs.gov www.ymca.net
National Council on Aging www.diabetes.niddk.nih.gov Physical Activity Guidelines for
1901 L Street NW, 4th Floor What I Need to Know About Americans YWCA USA
Washington, DC 20036 Physical Activity and Diabetes Be Active Your Way: A Guide 2025 M Street NW, Suite 550
202-479-1200 for Adults Washington, DC 20036
www.ncoa.org National Library of Medicine 202-467-0801
MedlinePlus President’s Council on www.ywca.org
National Heart, Lung, 8600 Rockville Pike Physical Fitness and Sports
and Blood Institute Bethesda, MD 20894 Department W
Health Information Center www.medlineplus.gov Tower Building, Suite 560
P.O. Box 30105 Search “Health Topics” for 1101 Wootton Parkway
Bethesda, MD 20824-0105 exercise and fitness information. Rockville, MD 20852
301-592-8573 240-276-9567
www.nhlbi.nih.gov www.fitness.gov
Portion Distortion Quiz
Your Guide to Physical Activity
and Your Heart
 ACKNOWLEDGMENTS 119

Acknowledgments
The National Institute on Aging Panel Members Colin Milner, Chief Executive Officer
brought together some of the Nation’s International Council on Active Aging
best-informed experts on the topic of Steven N. Blair, PED, Professor
Department of Exercise Science, Marcia Ory, PhD, MPH, Professor
exercise for older adults to discuss
Arnold School of Public Health, Social and Behavioral Health and
the writing of this book. Each of these
Director, Active for Life National
experts is a major force in research University of South Carolina
Program Office, School of Rural Public
devoted to improving the health and
David Buchner, MD, MPH, Chief Health, Texas A & M University
independence of older adults, and
their work is reflected throughout Physical Activity and Health Branch,
Marco Pahor, MD, Director
this guide. We are grateful to them Division of Nutrition and Physical Institute on Aging, University of
and to other leaders in the field for Activity, National Center for Chronic Florida Health Science Center
sharing their expertise. Disease Prevention and Health
Promotion, Centers for Disease Thomas Prohaska, PhD, Co-director
Panel Co-chairpersons for Research on Health and Aging
Control and Prevention
Institute for Health Research and Policy,
Chhanda Dutta, PhD, Chief Wojtek Chodzko-Zajko, PhD, Head University of Illinois at Chicago
Clinical Gerontology Branch, Division
Department of Kinesiology, University
of Geriatrics and Clinical Gerontology, James Whitehead, Executive Vice
of Illinois at Urbana-Champaign President, American College of
National Institute on Aging
Abby C. King, PhD, Professor Sports Medicine
Jack Guralnik, MD, PhD, Chief
Epidemiology, Demography, Health Research & Policy and Donald A. Williamson, PhD, John S.
and Biometry Program, Medicine, Stanford University McIlhenny Endowed Professor
National Institute on Aging School of Medicine Pennington Biomedical Research Center
120 EXERCISE & PHYSICAL ACTIVITY

Special thanks Thanks also go to Jane Hirshberg Personal Trainer

and Susanne C. Larsen from the Michele Ryon
The following members of the
Liz Lerman Dance Exchange for their
American College of Sports Medicine
help recruiting the participants for the Writer
reviewed the sample exercises in
photoshoot for the sample exercises. Anne Brown Rodgers
the guide:
Participants Editor
Grace DeSimone, Director, Fitness Karen M. Pocinki, MA
Kelly-Marie Berry
Programming, Plus One Health NIA Office of Communications
Ruth Cohen
Management and Public Liaison
Joaquin Corrillo
Ralph Glenmore Health Communications
Michael E. Rogers, PhD, CSCS, FACSM
Doris Kennedy Consultant
Research Director, Center for Physical
Nora Lopez Marcia Pruzan
Activity and Aging, Wichita State
Bodil Meleney Academy for Educational
University
Quincy Northrup Development
Paul Ramos
Walter R. Thompson, PhD, FACSM
Peg Schaefer Design
Professor, Department of Kinesiology
Andy Torres Levine & Associates
and Health, Georgia State University
Bea Wattenberg
Photography
Doug Sanford, Photogroup
 NATIONAL INSTITUTE
ON AGING

NATIONAL INSTITUTES OF HEALTH

Publication No. 09-4258

January 2009
Reprinted September 2010