Exercise: the big four

Created date

February 27th, 2020
Four people are sitting and stretching on yoga mats. A smiling young black woman is in the front, siting next to an older man, with two more people behind them.

Research has shown that seniors get the best results if they do exercises that fall into each of these four categories: endurance, strength, flexibility, and balance.

Exercise may not be your favorite topic, but by now you have heard about the importance of exercising to improve your health and maintain your independence.

You might think taking a daily walk is enough, and for some seniors it may be all their doctor recommends. But research has shown that seniors get the best results if they do exercises that fall into each of these four categories: endurance, strength, flexibility, and balance.

Sounds like a tall order, and it may seem as if having four types to think about would make exercise very arduous, unpleasant, and time-consuming. In practice, however, it is much easier than it appears.

First of all, you do not have to cram all four types into each day. Mixing it up will give you more variety and help you avoid boredom. Even better, some exercises fall into more than one category. For example, many endurance exercises build strength, and strength exercises can improve balance.

The National Institute on Aging’s Go4Life® campaign has numerous resources and common-sense advice for seniors who want to exercise, including suggestions, advice, and videos in each exercise category. 


These types of exercises are called “aerobic,” or sometimes “cardio.” They benefit your whole body but especially your heart, lungs, and circulation. Examples include brisk walking, doing yard work (like gardening, raking, digging, mowing), heavier housework (like vacuuming, carrying laundry), and recreational activities (like bowling, dancing, or tossing a ball around with the grandkids).

With endurance exercises, it is best to start very slow and increase the time you exercise by small amounts in order to let your body adjust. 


Muscles tend to get weaker with age, which can make it difficult to carry out daily activities that used to be easy. Also called strength training or resistance exercises, they can include lifting weights (using something as simple as a soup can), working with a resistance band, or using senior-friendly equipment at a gym.

Many strength exercises require no special equipment, however. “You can sit and stand from a chair, or, while holding on to a sturdy chair or countertop, do leg lifts to the front, side, and back,” says Dan Kim, D.P.T., physical therapist at the Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore, Md. “These exercises are great for strengthening your legs and hips.”


Flexibility exercises can help you stay limber and increase your range of motion. Being more flexible makes doing other types of exercises easier, and also makes it easier to do daily things such as getting dressed and driving. “A lot of flexibility exercises can be done from a chair or counter like you used for your strength exercises,” Kim says. 

You can also stretch practically any muscle group from your neck to your toes on the floor using a rug or floor mat. Yoga and tai chi are two other excellent ways to flex your entire body. 


Balance exercises have been shown to help prevent falls—a very serious concern for people over age 65. The strength exercises you do for your lower body can also help improve balance. Other examples include heel-to-toe walking, or, while using a sturdy chair back or countertop to hold onto, lift one foot a few inches off the ground and hold it for a few seconds, then do the same for the other foot. 

Even more so than yoga, tai chi has been shown to improve balance in seniors. 

Get started safely

For any type of exercise, a physical therapist (PT) is one of your best resources. You do not have to experience a medical event or injury to see a PT, just get a referral from your doctor.

“Most seniors don’t need a long, intensive PT program,” Kim says. “You might see a PT once or twice just to get you on track. They can help determine which types of exercises will benefit you the most, discuss your preferences, and teach you how to perform them safely.”

About Go4Life®

Go4Life is an exercise and physical activity campaign from the National Institute on Aging. It is designed to help you fit exercise and physical activity into your daily life. 

Visit go4life.nia.nih.gov to find information and free resources about exercise benefits, safety, and how to stay motivated.