Physio’s step-by-step guide to healthy ageing

In a world swirling with messages about healthy ageing and protecting your mental capacity, it’s easy to feel overwhelmed by the number of things you could work on and improve. Should you exercise more? Should you start doing Sudoku or Wordle? Should you sleep more or cut sugar out of your diet? Many people feel swamped by choice and end up changing nothing.

If you could choose just one thing however, one of the easiest places to start might be with your physical health. The top five diseases affecting older Australians in 2022 were coronary heart disease, dementia, back pain, chronic lung disease and anxiety disorders and the top two risk factors affecting Australians’ health in 2022 were smoking and obesity.

Increasing the amount of exercise you do can positively impact all five of those diseases and both risk factors.

The World Health Organization (WHO) recommends that people over the age of 65 should do at least 150 to 300 minutes of moderate intensity aerobic physical activity per week or at least 75 to 150 minutes of vigorous intensity physical activity per week.

They should also do muscle strengthening activities on at least two days a week and limit the time they are sedentary.

The WHO recently added to these guidelines by recommending older Australians should also add functional balance and functional strength training to their routine on several days of the week to prevent falls and improve functional capacity.

I don’t know about you, but just like having too much choice, that feels overwhelming to me. So, let’s break it down and see if we can make it more realistic.

Understanding exercise intensity

The easiest way to know the intensity of the activity you’re doing is to use the talk test – moderate intensity physical activity is exercise where you can talk comfortably but you can’t sing a song. Think general gardening, walking with a friend, aqua aerobics or doubles tennis.

Vigorous intensity physical activity is exercise where you can say only a few words before you need to pause for a breath. Think jogging or running, swimming, singles tennis, hiking, aerobics or heavy gardening.

About 150 to 300 minutes of moderate intensity physical activity is the same as about 20 to 40 minutes of moderate exercise per day. About 75 to 150 minutes of vigorous activity is the same as exercising intensely for only 10 to 20 minutes per day.

You can perform a combination of the two, double up on some days and give yourself a rest or a light day during the week. I walk my dogs every day to ensure I achieve the guidelines but then I add in a few sessions of the things I love such as a dance class and a game of tennis. I try to take the stairs instead of the lift and if I am feeling extra virtuous, I might jog up a hill with the dogs rather than walking.

Strength and balance exercises

Strength exercises become more important as we get older. Age-related changes have an impact on lean muscle mass and bone strength in both men and women resulting in less lean muscle, more adipose tissue and weaker bones.

Strength exercises are surprisingly easy to build into your weekly routine. Consider walking up and down stairs instead of using the lift, carrying groceries, digging and shifting soil in the garden or performing specific strength exercises such as squats and lunges.

Functional strength exercises are things like standing up and sitting down repeatedly (squats), stepping on to and off a step, lifting a weighted object a few times and walking on your toes. These only need to be performed on two to three days of the week so you can take it easy on the other days or choose to do your strengthening exercises on the days that are not too hot, or when you have a bit more time.

Balance exercises can be really challenging for some of us as we get older, but they are just as simple as strength exercises. Standing on one leg, heel-toe walking, calf raises and side leg lifts are all really quick and easy balance exercises.

The trick with these exercises, however, is that they need to challenge your balance without causing you to fall over. If it is too easy, you need to make it a tiny bit harder by adding a degree of difficulty (talk to someone at the same time, count backwards from 10 or look around the room) but make sure you have something to grab onto if you feel yourself falling.

Now that the recommendations make a little more sense, the next step is to set yourself up for success.

  1. Choose activities that you will enjoy, not things you think you should do. There is no point choosing gardening as your activity if you don’t like getting your hands dirty and an aerobics class would be horrible if you have two left feet.
  2. Start small and build up. If you are not a regular exerciser, start with 10 minutes and slowly build up from there. Do five repetitions of a strength exercise and slowly increase the repetitions as you get stronger.
  3. Keep track of when you exercise. Not only will this help to keep you on track, but it will also give you a sense of achievement when you get to the end of the week and can see how much you’ve done.
  4. Consider asking a friend to exercise with you or join a local exercise group. For some people, it’s more fun to exercise with other people and it’s harder to say no at the last minute if someone else is relying on you to show up.
  5. Get your gear ready the night before. Lay your clothes out and maybe have a back-up plan if you intend to exercise outdoors and the weather is looking grim.
  6. Don’t be afraid to try new things. You might like to try a course of yoga or tai-chi at your local community college. My mum loves her local Pilates studio, but my dad prefers to do activities that involve being on the water. Keep trying things until you find the activities that make you smile.
  7. Add the new activity to something that you already do – this is called habit stacking. Balance on one leg while you wait for the kettle to boil, perform 10 squats when you get up after eating breakfast and use the stairs when you go shopping.
  8. Notice the added benefits. Pay attention to how you feel when you’ve been exercising regularly for a while. Your mood might be lighter, your joints might be a little less creaky, you might make better food choices and you might even bounce out of bed in the morning.

Here is a summary of what your week might look like if you’re reaching the recommended guidelines for physical activity.

Day of WeekAerobic activityStrengthBalance
MONMorning walkHome-based strength exerciseBalance exercises while waiting for kettle to boil
TUESAqua aerobics Balance exercises while brushing teeth
WEDLaps at the poolStrength class at the gymBalance exercises while waiting for kettle to boil
THURMorning walk Balance exercises while brushing teeth
FRIGardeningGardeningBalance exercises while waiting for kettle to boil
SAT  Balance exercises while brushing teeth
SUNGolf Balance exercises while waiting for kettle to boil

If you take it slowly, make a plan and invite friends to join you, your goal to improve your physical health may last more than just a few weeks. In fact, with a little luck, it might lead to some life-long changes that make you both happier and healthier.

If you have any pre-existing conditions, you might like to check in with your GP before starting a new exercise program or if you have low back pain and have seen your GP, chiro or physio recently, you might like to volunteer for The Get Back to Healthy Study where the researchers will support you to stay active to help your back. Please check out the Sydney University website for more information or contact the study via email: [email protected]

Kate Roberts is an experienced physiotherapist and PhD candidate at the University of Sydney. She has a passion for helping older Australians manage their aches and pains.

Also read: Best way to treat low back pain

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