Staying Active as You Get Older: How Much Exercise Do You Really Need?

A practical guide to strength, balance, mobility, confidence and staying independent

This article has been written using the NHS guidance on physical activity for older adults as a starting point, with additional information from current physiotherapy evidence and local Cornwall resources. We wanted to take the NHS recommendations and explain what they actually mean in everyday life, particularly if you are older, less active than you used to be, recovering from illness or surgery, or beginning to worry about your strength or balance.

You can read the full NHS guidance here: NHS – Physical activity guidelines for older adults

There is a common misconception that getting older automatically means becoming weaker, slower and less active. Perhaps you have noticed that you do not walk quite as far as you used to, you get tired more easily, or activities that once felt effortless now take a little more thought. It can be tempting to put this down to "just getting older" and accept that becoming less active is simply part of the process.

Ageing does bring some natural changes to our muscles, joints, cardiovascular fitness and balance, but becoming increasingly inactive is not an inevitable part of getting older. In fact, physical activity becomes particularly important as we age because it helps maintain the things that allow us to remain independent: strength, balance, mobility, stamina and confidence.

The NHS recommends that adults aged 65 and over should be physically active every day, even if some of that activity is light. Alongside this, the guidance recommends at least 150 minutes of moderate-intensity activity each week, or 75 minutes of vigorous activity for those who are already active, together with activities that improve strength, balance and flexibility on at least two days each week. The NHS also recommends reducing the amount of time spent sitting or lying down and breaking up long periods of inactivity with movement. NHS – Physical activity guidelines for older adults

At first, those recommendations can sound like a lot. But when you understand what counts as activity and why each type of movement matters, they become much more achievable.

You don't need to become a gym-goer

When people hear the word "exercise", they often imagine a gym, running on a treadmill or lifting heavy weights. None of these are necessary. Physical activity is simply movement that uses your body, and it can be incorporated into ordinary life.

Walking to the shops, gardening, cycling, dancing, swimming, carrying shopping, doing some housework or taking the stairs can all contribute to your overall activity. The NHS describes moderate activity as something that makes you breathe a little faster and feel warmer but still allows you to talk, although you would probably struggle to sing a song comfortably. NHS – Physical activity guidelines for older adults

This is important because the best activity is often the activity you are actually going to do. If you hate gyms, you do not need to join one. If you enjoy walking with a friend, gardening, dancing or going swimming, those activities may be much more sustainable. The aim is not to turn your life into an exercise programme; it is to keep your body moving regularly and maintain the physical capacity you need for everyday life.

Why strength becomes so important as we age

Strength is one of the areas we often focus on in physiotherapy because it has such a direct relationship with independence. Strong legs help you get out of a chair, climb stairs, walk further and recover your balance if you stumble. Strength in your arms and upper body helps with carrying shopping, using walking aids, getting up from the floor and managing everyday tasks

around the home.

Muscle mass and strength naturally change with age, but inactivity can accelerate this process.

This becomes particularly noticeable after a period of illness, hospitalisation or reduced mobility. Someone who has previously been independent can sometimes find that a relatively short period of inactivity makes everyday tasks considerably harder.

The good news is that older muscles can still respond to exercise. Research consistently shows that resistance exercise can improve muscle strength and physical function in older adults, including people who are already experiencing age-related loss of muscle and strength. That does not necessarily mean lifting heavy weights in a gym. Resistance bands, bodyweight exercises, repeated sit-to-stands, step exercises and appropriately selected weights can all provide a useful stimulus.

This is why the NHS specifically recommends activities that strengthen the major muscle groups on at least two days each week. NHS – Physical activity guidelines for older adults

Strength is about what you can do, not how much you can lift

For an older person, strength training does not have to be about achieving a particular number on a dumbbell. From a physiotherapy perspective, a much more useful question is: what do you need your body to be strong enough to do?

If getting out of your favourite armchair has become difficult, practising repeated sit-to-stands may

be more relevant than using a piece of gym equipment. If stairs are becoming harder, strengthening your legs and practising stepping may be more useful. If carrying shopping is difficult, exercises involving the arms, shoulders and trunk may have a practical purpose.

This is one reason home-based physiotherapy can be particularly useful. We can look at the activities that someone actually needs to manage in their own environment and work backwards from those goals.

Don't forget about balance

Strength is only part of the picture. Good balance is what allows you to move safely through your environment, whether that means walking across the kitchen, turning around, stepping over a doorstep or getting up during the night.

Balance can become more challenging with age for several reasons. Changes in muscle strength, vision, sensation in the feet, joint movement, reaction speed and the way the brain processes information can all contribute. Previous falls can also have an important effect. Someone who has fallen may become understandably cautious, walk less and avoid situations where they feel

unsteady.

That can create a difficult cycle. Less movement can lead to less strength and confidence, which can make movement feel harder, leading to even less activity.

This is why balance exercises are not simply about standing on one leg. Good balance rehabilitation should reflect the situations in which someone actually needs to remain stable. This might include turning, changing direction, stepping, reaching, getting up from a chair or negotiating different surfaces.

For people who have fallen or are worried about falling, a properly assessed strength and balance programme can be particularly valuable. The NHS specifically recommends strength, balance and flexibility activities for older adults, while Cornwall Council also provides information about local falls-prevention support. Cornwall Council – Falls Prevention

What about the 150-minute recommendation?

The NHS recommendation of 150 minutes of moderate activity each week can sound intimidating if you are currently inactive. But it does not mean that you need to exercise for two and a half hours in one go.

You can break activity into smaller amounts throughout the week. A 20-minute walk here, some gardening there, walking to the shops, attending a class and being generally more active around the house can all contribute. If you currently do very little activity, starting with shorter periods and gradually building up is often a much more realistic approach.

It is also worth remembering that some activity is better than none. If 150 minutes is currently unrealistic, that does not mean there is no benefit in moving for 10 or 20 minutes. Your starting point matters.

For someone who has recently been unwell, had an operation or spent time in hospital, the appropriate starting point may be considerably lower. In these situations, the priority may initially be sitting out of bed, standing safely, walking to the bathroom or completing a few simple strengthening exercises. Progress can then be built gradually.

What if walking hurts because of arthritis?

One of the most common reasons people become less active is pain. Knee, hip, back and shoulder problems can make movement uncomfortable, and it is completely understandable to become cautious when something hurts.

However, pain does not automatically mean that movement is damaging the joint. For many common musculoskeletal conditions, appropriately dosed exercise forms an important part of management. The challenge is finding the right level and type of activity.

Someone with knee arthritis, for example, may not be able to walk for an hour, but they may manage several shorter walks combined with strengthening exercises. Someone with shoulder pain may need to modify the way they exercise rather than stop using the shoulder altogether.

This is where individual assessment becomes useful. There is a big difference between saying "keep exercising" and working out which movements are appropriate, how much is enough, what symptoms to expect and how quickly to progress.

What if you've recently been in hospital?

This is another situation where physical activity becomes particularly important.

After an illness or hospital admission, someone can come home medically well enough to leave hospital but still feel surprisingly weak. Walking may be slower, getting out of a chair may be harder and activities that previously seemed straightforward may suddenly feel exhausting.

A period of reduced activity can affect strength, endurance and confidence, particularly in older adults. This is one reason rehabilitation after hospitalisation is so important. Current research supports exercise-based rehabilitation after acute hospitalisation, with recent systematic review evidence showing improvements in physical function among older adults following discharge.

Recovery is not simply about waiting until you feel stronger. The body generally needs an appropriate reason to become stronger again. Gradually increasing walking, practising functional movements and introducing suitable strengthening exercises can all help rebuild physical capacity.

For some people, that rehabilitation can be carried out safely at home, where we can also see the practical challenges they are facing. A person may technically be able to walk 50 metres, for example, but still struggle with the three steps into their garden or getting upstairs to the bedroom.

Those details matter.

Your home can tell us a lot about your mobility

One of the advantages of physiotherapy at home is that we are not assessing movement in an artificial environment.

We can see how you get out of your actual chair, how you walk through your hallway, whether you manage the stairs, how you get in and out of the shower and whether you are relying on furniture for support. We can also look at whether a walking aid is being used appropriately and whether there are simple changes that could make everyday activities safer.

Sometimes the problem is not simply that someone's legs are weak. They may have difficulty turning, poor confidence on stairs, reduced foot sensation, difficulty judging obstacles or a fear of falling. The home environment can reveal these issues very quickly.

For Physio at Home, this is a particularly important part of what we do. Rehabilitation is not just about completing exercises; it is about helping people become more capable of doing the things that matter to them in their own lives.

Exercise can be social too

There is another side to physical activity that is sometimes overlooked: you don't have to do it alone.

For some older people, one of the biggest barriers to becoming more active is not physical ability but confidence, motivation or simply not having anyone to do things with. A regular walking group, exercise class, gardening group, dance class or community activity can provide both movement and social contact.

This can become particularly important if someone has retired, lost a partner, stopped driving or gradually become less involved in activities they previously enjoyed.

Being active can therefore be about much more than improving muscle strength. It can provide a reason to leave the house, meet people, develop a routine and regain confidence after a period of illness or reduced mobility.

What is social prescribing?

This is where social prescribing can be incredibly useful.

Social prescribing is an NHS-supported approach that connects people with community groups, activities and services that can support their practical, social and emotional wellbeing. A social prescribing link worker takes time to understand what matters to the individual and can help connect them with appropriate local opportunities. (NHS England)

That could mean finding a walking group, exercise class, gardening project, volunteering opportunity, community café, arts group or another activity that gives someone a reason to get out and about. It is particularly relevant for people who are experiencing loneliness or isolation, living with long-term conditions or dealing with wider social circumstances that are affecting their wellbeing. (NHS England)

Importantly, social prescribing does not mean being told to "go and join a gym". The emphasis is on finding something that is meaningful to you.

If you enjoy gardening, that may be the starting point. If you used to sing, perhaps a singing group would be more motivating. If you have always enjoyed walking but have lost confidence after a fall, a suitable supported walking group could provide a gradual way back into activity.

There are lots of opportunities across Cornwall

Cornwall has a growing network of community-based activities and support, although what is available varies between areas.

For people concerned about falls or who have become less confident on their feet, Cornwall Council's Move More programme provides a 25-week exercise programme through iCareiMove, with face-to-face and online sessions operating across different areas of Cornwall. The programme is specifically aimed at older people who are at risk of falls or have a fear of falling, and self-referral is possible. Current areas include Truro, Camborne and Falmouth in Mid Cornwall, as well as locations across North, East and West Cornwall. (Cornwall Council)

Age UK Cornwall and the Isles of Scilly is another useful starting point. Its Community Gateway is a free service providing information and connections to local support, with the service currently available from 8am to 8pm, seven days a week. The service can help people access community activities, practical support, transport and other services that can help them remain independent at home. (Age UK)

Age UK Cornwall also provides community transport, which can be particularly valuable for people who would like to attend activities but find getting there difficult. Their service supports journeys to community hubs, health appointments, social activities and other destinations across Cornwall and the Isles of Scilly. (Age UK)

Cornwall also has a network of community hubs and other local organisations offering activities and support. What is available changes regularly, so if you are looking for something locally, it is worth asking your GP surgery, social prescribing link worker, Age UK Cornwall or Cornwall Council what is currently available in your area.

But what if you're not fit enough to join a class?

This is a question we hear regularly.

Someone might think, "I'm too weak to go to an exercise class," or "I'd be embarrassed because everyone else will be fitter than me." Those concerns are understandable, particularly after illness, a fall or a long period of inactivity.

You do not necessarily need to reach a particular level of fitness before starting. In many cases, the important thing is finding an appropriate starting point and progressing from there.

For one person, the first step might be walking around the garden. For another, it might be standing from a chair several times. Someone else may need to start with exercises performed sitting down before progressing to standing activities and eventually walking outside.

The important thing is that the activity is appropriate for the individual and progresses as their ability improves.

You don't have to exercise every day in the same way

A useful way of thinking about activity is to have a mixture of different things across the week.

You might walk on several days, complete some strengthening exercises twice a week, do some balance exercises, spend time gardening and perhaps attend a social activity that involves movement. You could also make small changes to your everyday routine, such as standing up regularly if you have been sitting for a long period or walking to a nearby shop rather than driving.

The NHS guidance is not asking everyone to follow exactly the same exercise programme. It provides a framework, but what that looks like in practice depends on your health, mobility, interests and starting point. NHS – Physical activity guidelines for older adults

For someone who is already active, the focus might be on maintaining strength and challenging balance appropriately. For someone who has become very inactive, the first goal may simply be to start moving more regularly.

When should you consider seeing a physiotherapist?

If you have noticed that everyday activities are becoming harder, it is worth paying attention to the change rather than simply assuming that it is ageing.

Perhaps you have started using your arms to push yourself out of a chair, holding onto furniture when walking around the house, avoiding the stairs, taking much longer to get dressed, stopping going out because you are worried about falling, or becoming less active because your joints hurt.

None of these things necessarily mean that there is a serious problem, but they can be useful early warning signs that your physical capacity has changed.

A physiotherapy assessment can help identify why something has become difficult and what can be done about it. Sometimes the answer is strengthening. Sometimes it is balance work, improving joint movement, changing the way an activity is performed or addressing confidence after a fall.

Sometimes the most appropriate advice is to speak to another healthcare professional because physiotherapy is not the main issue.

The earlier these changes are recognised, the more opportunity there may be to address them before they significantly affect independence.

Staying active is really about staying independent

The ultimate goal of physical activity as we get older is not necessarily to become fitter than everyone else or to achieve a particular exercise target.

It is about maintaining the ability to do the things that make up your life.

Getting out of your chair without help. Walking to the shops. Climbing the stairs. Looking after the garden. Taking the dog for a walk. Going on holiday. Meeting friends for coffee. Getting up from the floor if you have fallen. Carrying your shopping. Getting in and out of the car. Continuing to live safely in your own home. These are the things that matter.

At Physio at Home, we see the difference that maintaining strength, mobility and confidence can make to people's everyday lives. Our physiotherapists provide individual assessments and rehabilitation in people's own homes and care settings across Mid Cornwall, helping people work towards the activities and goals that are important to them.

If you or a family member has become less mobile, is struggling with strength or balance, is recovering from an illness or hospital stay, or simply isn't as confident on their feet as they used to be, a physiotherapy assessment may be a useful starting point.

You don't have to wait until you have fallen, had an operation or lost a significant amount of mobility before asking for help. Sometimes recognising a small change early can make a big difference to what you are able to do later.

Useful information and local support

NHS – Physical activity guidelines for older adultsThe full NHS recommendations for physical activity, strength, balance and reducing prolonged periods of inactivity. NHS physical activity guidelines for older adults

Cornwall Council – Falls PreventionInformation about falls prevention and the Move More programme, including current areas and referral information. Cornwall Council Falls Prevention

Age UK Cornwall and the Isles of ScillyInformation about local services, community activities, transport, support at home and the Community Gateway. Age UK Cornwall

Age UK Cornwall – Community GatewayA free service providing information and connections to local support, available 8am–8pm, seven days a week. Age UK Cornwall Community Gateway

NHS England – Social PrescribingAn explanation of social prescribing and the role of social prescribing link workers. NHS England – Social prescribing

A final thought

Being active as you get older isn't about trying to turn back the clock. It's about giving your body the best chance of continuing to do the things that matter to you.

Even small changes can be worthwhile. A little more walking, a few strengthening exercises, getting involved in a local group or simply spending less of the day sitting can all be steps towards maintaining mobility, confidence and independence.

And if you are not sure where to start, that is exactly where a conversation with a physiotherapist can help.

Physio at Home – Physiotherapy & Rehabilitation across Mid Cornwall. Home visits across Falmouth, Penryn, Truro, Helston and surrounding areas.www.physioathome.uk