Back Strengthening Exercises for Seniors

Back Strengthening Exercises for Seniors was written by Nicole Pabalan and reviewed/edited by Katie Dodd, MS, RDN, CSG, LD, FAND. Nicole is a personal trainer, certified through the National Academy of Sports Medicine (NASM). She is also a freelance writer and dietetic intern at Oregon Health Sciences University.

Back Strength in Older Adults

According to the Centers for Disease Control and Prevention (CDC), in 2012, more than half of the older adult population had muscle weakness-related difficulty doing movements such as rising up from a chair.

Muscle weakness in older adults can lead to health problems such as sarcopenia, osteoporosis, and kyphosis (we’ll discuss this later). In addition, low bone mass is another concern. Based on a study completed in 2008, there was approximately 58% of people over the age of 50 who had either low bone mass, osteoporosis, or both.

Below is data provided by the CDC in which includes statistics of low bone mass and three levels of muscle strength amongst the senior population, respectively.

Skeletal status of persons aged 50 years and over: United States, 2005–2008

Percent of adults aged 60 and over with difficulty rising from a chair, by muscle strength in the U.S., 2011-2012

Studies show that there’s a growing population of older adults affected by osteoporosis and sarcopenia. In other words, it’s critical that we strengthen the bones and muscles in our back.

Understanding the Importance of Back Strength in Older Adults

The human back is designed to provide support for the entire upper body, stabilization, and weight-bearing capacity (Waxenbaum et al., 2020). Understanding the role of the major back muscles will help us learn about the importance of keeping these muscles strong.

Below is a table that explains the functions of each major muscle group of the human back.

Data shows that older adults with chronic low back pain have significantly lower muscle strength, and more muscle weakness, which is associated with a history and risk of falling.

It’s essential for seniors to take preventative action such as participating in back strengthening exercises. Physical activity and exercise can strengthen the body’s bones and muscles.

A study that evaluated the effects of strength exercises and older adults with low back pain revealed that the benefits may include pain relief, help older adults with disabilities, and improved functional performance (Ishak et al., 2016). Exercise has been a widely applied treatment strategy.

Back Strength in Seniors

Bones and muscles work together to generate movement.  Both sarcopenia and osteoporosis can contribute to back problems in seniors.

Sarcopenia

Sarcopenia refers to an age-related decrease in muscle mass. Ultimately, sarcopenia can increase risk for injuries and can lead to the inability to perform everyday tasks independently.

Contributing factors of sarcopenia include:

• Age
  • Can affect individuals as early as the 3rd or 4th decade of life
  • Progressively, approximately 50% of muscle mass can be lost by the 8^th decade of life
• Loss of neuromuscular junction (voluntary control of muscles)
• Hormonal changes
• Increased inflammation
• Environmental causes (i.e. sedentary lifestyle and poor nutrition)
• Chronic illness (i.e. obesity, heart disease, type 2 diabetes, etc.)

Weak back muscles can often damage the spine. For instance, weak back muscles may cause older adults to have kyphosis, which commonly is associated with symptoms such as back stiffness and pain. Kyphosis can affect posture and increase risks of falls and fracture (Hsu et al., 2014).

Evidence shows that hip fracture risks increase after age 70. Overall, risk for low-trauma fractures will increase with age (Vondracek and Linnebur, 2009). Approximately 50% of seniors who reach the age of 85 years or older will at least fall once per year with reoccurrence of half of those falls.

Limited activities associated with back muscle weakness includes bending, reaching, reduced walking speed, greater difficulty to climb stairs, and poorer balance (Hsu et al., 2014)

Osteoporosis

Osteoporosis is defined as a bone disease, which causes decrease in bone mass and deterioration of bone tissue. The effects of osteoporosis may lead to frail bones and increase the risks of fractures of the spine, hip, and wrist.  Osteoporosis can also weaken the vertebrae and cause kyphosis, which may lead to vertebrae fractures, poor balance, and increased risk of falls (Hsu et al., 2014).

More women than men are affected by osteoporosis and risks of falls.

Image source: https://www.bones.nih.gov/health-info/bone/SGR/surgeon-generals-report

Contributing factors of osteoporosis include:

• Sedentary lifestyle
• Low dietary intake of protein
• Chronic inflammation
• Hormonal changes (i.e. menopause in women)
• Old age

Kyphosis

Kyphosis is a curve of the spine that resembles the shape of the letter “C”. This condition causes the angle of the spine to increase, which may lead to the decline of physical performance and the quality of life. Osteoporosis is considered a contributing factor to this spinal abnormality. Consequences associated with age-related kyphosis includes the impairment of mobility, and higher risk of falls and fractures.

After the age of 40, kyphosis is more likely to effect women than men at a quicker pace. Research shows the prevalence of kyphosis is 20-40% in older adults among both men and women.

Image source: https://www.physio-pedia.com/Age-related_Hyperkyphosis

Free Back Strengthening Exercise Plan for Seniors

Below is an exercise plan with 7 exercises that do not require any equipment. This can be done at home and targets the upper, middle, and lower back. Some exercises may be performed on the bed , floor, or chair. Hyperlinks are attached to each listed exercise for demonstrations. This back-strengthening plan with additional exercises is available for download here.

Terminology:

•  Repetition (Reps): the number of times a specific exercise is performed
• Duration: the amount of time a specific exercise will be performed
• Sets: the number of cycles of reps that are to be completed

DISCLAIMER: Keep in mind that this exercise plan is NOT for everyone. Please consult with your Physician prior to following an exercise plan.

In addition, the CDC, states that physical activity can prevent or postpone conditions that come with age. Older adults are recommended to participate in muscle-strengthening activities for at least 2 days per week. The CDC provides several different examples of muscle-strengthening activities such as carrying groceries and gardening.

No specific amount of time is recommended for older adults to perform muscle-strengthening exercises. However, the activity should be performed to the point at which it would be difficult to complete another repetition (Physical Activity Guidelines for Americans 2019). Some exercises can be used while completing house chores. This may include carrying a full laundry basket or moving furniture around.

Be as physically active as your abilities and conditions allow you to be.

Back Strength and Balance

In addition to back-focused exercises, consider including balance exercises. The combination of movements that benefit back mobility and strength. Then progression to exercises that promote balance can increase the quality of life, reduce risks of injury, and back pain relief in older adults.

Displayed below are balance exercises that can be practiced at home.  Remember, it’s important for older adults to listen to their body and be familiar with their limitations. Therefore, pay attention to pain when performing exercises. There’s a difference between an ache and a sharp pain. An ache can sometimes be an indication of “Oh, I haven’t used this muscle in a long time…” A sharp pain on the other hand, can be associated with injury. It’s important to be patient and to understand that these movements take time to master.

Seeking professional assistance such as a Physical Therapist or a Certified Personal Trainer can teach proper form and prevent injury. Furthermore, a stronger back is essential to improve balance.

Here are two examples of balance exercises:

One-leg balance

All you need is a chair. Stand behind the chair, lift one foot off of the floor, and use the backrest for assistance to maintain balance if needed.

Heel-to-toe

This is a walking movement with an emphasis on foot placement. While walking, alternate with each foot and lift the toes and ball of the foot off the floor, then shift weight back onto toes.

To learn even more balance exercises, check out our article 13 Balance Exercises for Seniors!

5 Benefits of Back Strengthening Exercises for Seniors

1. Balance: Back strength supports balance, and reduces the risk of falls and fractures.

2. Pain Relief: Weak back muscles tend to be associated with low back pain. However, pain may be relieved by strengthening the back muscles.

3. Prevention: Back strengthening can prevent or postpone adverse effects of diseases that reduce muscle and bone mass, and further injury.

4. Posture Improvement: Back-focused exercises can strengthen the spine and muscles. This can prevent the spine from curving.

5. Quality of life: Older adults can continue performing everyday tasks independently. A strong back will reduce the demand for long-term care.

Back Strengthening Exercises for the Elderly (With Equipment)

Equipment is not required to improve back strength; however, it may provide greater resistance. Exercise items such as resistance bands, exercise balls, a PVC pipes (can be substituted), or yoga mats can be used indoors and outdoors. Also, these items can easily be stored at home with minimal space required. Here are a few pieces of exercise equipment to consider:

Resistance Bands

Resistance bands are often used in physical rehabilitation, and provide tension that can help older adults gain coordination and balance. In addition, resistance bands come in different levels of tension based on the thickness of the band, which allows seniors to gradually work their way up to more challenging exercises. Also, resistance bands can be used for muscles in the back, legs, and arms.

PVC Pipe

A PVC pipe can be substituted with house hold items such as a broom stick. The purpose of a PVC pipe is to help stretch and increase mobility of the shoulders, which can help relieve tension located in the upper back, shoulders, and chest.

Swiss Exercise Ball

An exercise ball or “swiss exercise ball” can help seniors increase balance, strength, and stability.

Yoga Mat

A yoga mats can help prevent slips and falls because it provides greater grip on the floor, feet, and hands.

Conclusion

Lack of back strength is associated with back pain. Therefore, participation in back strengthening exercises that can lead to improved functional outcomes. With strengthening exercises, bone and muscle diseases such as osteoporosis and sarcopenia can be prevented or postponed. There are several exercises that can be performed with or without equipment.

This article only provides a fraction of information on back strengthening exercises for seniors. However, if seniors are interested in learning more back strengthening exercises, additional resources are provided below.

One strength exercise plan does not fit all. Therefore, it’s important that you consult your Physician about participating in an exercise plan. Also consider the assistance of other professionals such as Physical Therapists or Certified Personal Trainers.

Additional Resources:

• Exercises for Low Back Pain
• 14 Exercises to Help Improve Balance

References

Back Muscles. (n.d.). Retrieved September 10, 2020, from https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-muscles.html

Ferrucci, L., Baroni, M., Ranchelli, A., Lauretani, F., Maggio, M., Mecocci, P., & Ruggiero, C. (2014). Interaction between bone and muscle in older persons with mobility limitations. Current pharmaceutical design, 20(19), 3178–3197. https://doi.org/10.2174/13816128113196660690

How much physical activity do older adults need? (2020, April 10). Retrieved September 10, 2020, from https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

Hsu, W., Chen, C., Tsauo, J., & Yang, R. (2014). Balance control in elderly people with osteoporosis. Journal of the Formosan Medical Association, 113(6), 334-339. doi:10.1016/j.jfma.2014.02.006

Katzman, W. B., Wanek, L., Shepherd, J. A., & Sellmeyer, D. E. (2010). Age-related hyperkyphosis: its causes, consequences, and management. The Journal of orthopaedic and sports physical therapy, 40(6), 352–360. https://doi.org/10.2519/jospt.2010.3099

Ishak, N. A., Zahari, Z., & Justine, M. (2016). Effectiveness of Strengthening Exercises for the Elderly with Low Back Pain to Improve Symptoms and Functions: A Systematic Review. Scientifica, 2016, 3230427. https://doi.org/10.1155/2016/3230427

Managing Low Back Pain. (1999). Retrieved September 10, 2020, from https://uhs.berkeley.edu/health-topics/ergonomics-and-back-health/managing-low-back-pain

Products – Data Briefs – Number 179 – January 2015. (2015, November 06). Retrieved September 10, 2020, from https://www.cdc.gov/nchs/products/databriefs/db179.htm

Santilli, V., Bernetti, A., Mangone, M., & Paoloni, M. (2014). Clinical definition of sarcopenia. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 11(3), 177–180.

The Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You. (n.d.). Retrieved September 10, 2020, from https://bones.nih.gov/health-info/bone/SGR/surgeon-generals-report

Walston J. D. (2012). Sarcopenia in older adults. Current opinion in rheumatology, 24(6), 623–627. https://doi.org/10.1097/BOR.0b013e328358d59b

Waxenbaum JA, Reddy V, Williams C, et al. Anatomy, Back, Lumbar Vertebrae. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459278/