What makes lifting "dangerous" for everyone, including older people

The Question

Ahoy, Swole Woman/Beast!

I love your column and always recommend it (and now your newsletter) to fitness friends. Recently I’ve even forwarded your newsletters to my husband—who has terribly disordered eating and a strange relationship to exercise—to facilitate more productive conversations, and I think they’ve made a real difference. So thanks for all the advice and inspiration over the years!

My mother is a very active 72 years old. She’s a swimmer who also used to run before her knees protested (she’s had one fully replaced and will likely have the other replaced soon). She walks everywhere, loves hiking, and practices tai chi twice a week.

However, since the pandemic began, she has slowed down a bit. She has talked about how she doesn’t feel great, and we’ve seen the effect the extra weight has had on her stamina for hikes and other things she loves. On top of that, I feel like it makes her more prone to tripping and then more liable to get hurt if she falls.

I’ve shown her some bodyweight and dumbbell exercises, which she does intermittently. But she’s nervous about pushing too hard—specifically her joints. So we’ve been sticking with bodyweight or really light weights so far, and I’m not at all confident in guiding her about how to progress.

Short of finding a time machine to travel several decades into the future for copies of your very successful hologram newsletter, should I just send her a copy of Liftoff and have her do Phases 1 and 2?

Thanks for any guidance!

Kristen

Hi Casey, I am an occupational therapist who knows the basics of exercise. I stopped running and playing soccer at age 52 and mostly walk and hike on moderate trails and stretch.

I have some knee pain and hand/wrist pain from osteoporosis—typical aging stuff.

Have women my age been successful following your lifting program in your book Liftoff: Couch to Barbell?

I enjoyed your podcast episode on Why Is This Happening? with Chris Hayes.

Thank you!

Jan

Hey Casey,

I just signed up for LIFTOFF after watching your intro video. A little intimidated. I’m 66 years old and not in great shape. I took you at your word that this program is meant for any body! Hope you were serious. I once upon a time joined a gym, a CrossFit gym, and I feel like I didn’t get enough supervision and ended up trying to squat with too much weight and probably not with the right form. Don’t want that to happen again. I have arthritis in my knees. I’d like to try this, but I’ll probably be adding weight at a lower rate than others in the program who are younger.

Maria

The Answer

It’s a bit crazy-making to me that there are so many groups of people talking and thinking about bodies out there, and yet they are subscribed to totally different conclusions about how to manage them. We can laugh at Donald Trump saying that human bodies have only a finite amount of “life force” that has to be carefully budgeted and not wasted on frivolous things like exercise. But this is not so far off from how a lot of people think about their bodies or working out. They fixate on the risks of action: They know someone who hurt their shoulder benching, so they will never bench. They know someone else whose knees hurt when they squat (badly) or deadlift (badly), so they refuse to squat or deadlift themselves. They shy away from all of that stuff. Their concern is always: Why bother? Even if the risks are low, there are risks. Why risk the risks, when you could not risk the risks?

Well—it is easy to focus on the risks of doing something proactively. But the risks of inaction are sometimes as great or greater. As some damn pharmaceutical ad on TV told me just the other day, one in two women over the age of 50 suffers an osteoporosis-related fracture. Osteoporosis can be caused by a lot of things, but a couple of major contributing factors, especially in women, are poor nutrition (potentially as a result of disordered eating!) and lack of exercise, especially load-bearing, bone-density-building exercise such as, you guessed it, strength training.

Many chronic health issues are aided by exercise, and especially by strength training—muscular atrophy, diabetes, arthritis, heart disease, even mental and emotional health declines. But the world’s overriding attitude toward strength training is (extremely annoyingly, to me, and unfairly, generally) governed by this seething fear of acute injury.

This sucks, because lifting weights is not only not specifically harmful, but in many cases it is specifically corrective to a lot of the chronic health issues that come with age. Squats are actually good for your knees, because they help build muscles that direct stress away from your joints. Lifting is good for your bones, because it increases their density. Deadlifting is good for your back, because it builds the posterior chain muscles that should be used to bend down, instead of referring the entire movement to the relatively small muscles in your lower back.

Part of the reason we think working out is so stupid and optional is that a lot of the ways we talk about it, or do it, do not illuminate the long-range way in which it affects what it’s like to be in our bodies. Instead, they are like [“not-actually-low-impact-exercise” voice] “Sweat! Push! Burn off that breakfast! Tone those arms! Lift that butt!” I like strength training because it prioritizes progress in terms of skill and, well, strength, and has a structured approach to its long-range benefits that make its effect almost impossible to ignore.

Why the popularity of “low-impact exercise” continues to chap my ass

“Low-impact” does not actually mean “easy”: The false promises of the yogas, barres, spinnings, golfs, and HIIT circuits of the world.

She's A BeastCasey Johnston

This is where I pause and say: nothing I say supersedes an actual doctor who knows you. No one, especially anyone with health issues known or unknown, should start a new exercise regimen without clearance from their doctor. The reason older people are rarely addressed in a format like this is no one wants the risk of being the one to tell you it’s okay to lift weights, only for you to get injured. So I’m trusting you to do the smart thing and not take this as a prescription for you individually.

However, there are certain things about lifting weights that many medical professionals have outmoded or prejudiced ideas about. Some of those things, as above, are literally backward. If that’s your doctor, I DO NOT suggest just going out and defying them; I DO suggest seeking a second opinion from a doctor whose philosophies about exercise and caring for yourself are more aligned with your goals, which now include strength training as, among other things, a preventative measure for long-term health issues.

With that out of the way, these are the two questions people usually want answered. By answering them, I hope we will address the virtual Grand Canyon between the doctor who says, “Do not ever squat using heavy weights; you will blow out your knees” and strength training experts who say lifting is not only not dangerous but potentially the most helpful thing someone with chronic health issues could do.

Here we go:

Is strength training specifically risky to older people? Not really. You do have to attend to the elements of that make moving around in general risky or not for everyone, not just people with chronic health issues, like being responsive to relevant health conditions; prioritizing good form; eating enough and resting; and not overreaching your current level ability by too much. But if you do all that, as everyone should, lifting is as good for older people as anyone else, maybe even better, and the benefits outweigh the risks.

Does it have to be specifically strength training? Everyone can do whatever they want, and I’m not here to force anyone to do anything they don’t want to do. But strength training has many specific offerings to people with the conditions that tend to go with age, including muscular atrophy, diabetes, arthritis, heart disease, and even mental and emotional health declines.

So...

How do we make lifting "not dangerous"?