Updated: May 29, 2020
We asked physical therapists for their pain-busting stretching and strengthening moves.
While it might be the last thing you feel like doing when your back or knees are bothering you, staying active is one of the top ways experts recommend to beat back age-related aches and pains, particularly around major joints such as your back, knees, hips and shoulders. But which strengthening and stretching exercises work best for what? We asked physical therapists and experts from the American Academy of Orthopaedic Surgeons to lay out options for the most commonly reported trouble spots. Some work to provide relief in the moment, while others build up strength that fends off pain down the road.
For your back
“The most important thing with back pain is to keep moving, especially with activities that keep your core strong, such as walking, yoga or tai chi,” says physical therapist Meredith Harris, a spokesperson for the American Physical Therapy Association. In fact, yoga is just as effective as physical therapy for treating folks with chronic low back pain, according to a 2017 study published in the Annals of Internal Medicine. But if you just can’t get into a Downward Dog, try these moves instead.
“It strengthens the transversus abdominis, one of our major core muscles that supports our low back,” explains Christi Reinhardt, a physical therapist at the Hospital for Special Surgery in New York City.
Try it: The trickiest part of the kegel is identifying the right muscles: You can do this by stopping your flow of urine midstream. Once you’ve done that, start with tightening these muscles for five seconds, then relaxing them for five seconds, five times a day. As you get comfortable, build up to 10 seconds at a time. Eventually, you want to do three sets of 10 reps each day.
This exercise strengthens your entire upper and lower back, Harris says.
Try it: Lie on your stomach on a flat surface and raise both your arms and your legs at the same time, as though you are flying. Hold for five seconds, then return to starting position. Repeat 10 times.
“People often assume a plank is best for core and back strength, but if you do it wrong, it can irritate the back,” Reinhardt says. A hip bridge works all the same muscles, but is more forgiving.
Try it: Lie on your back either on the floor or on a bed, your arms at your sides, knees bent, and your feet flat. Tighten your tummy and butt muscles, then lift your pelvis so your body is in a straight line from your shoulders to your knees. Hold for 15 seconds, then slowly return to your start position. Repeat five times.
Knee to chest stretch
This stretches out your lower back as well as the front of your hip and inner thigh, Reinhardt says.
Try it: Lie on your back on the floor, then lift one leg and bring your knee toward your chest. Hold for five seconds, with your abdominals tight and your spine pressed to the floor. Release and repeat on the other side. Repeat the sequence 10 times.
One reason for back pain among older adults is poor posture. “People don’t even realize the slow subtle changes that can occur as back muscles age,” says physical therapist James Nussbaum, clinical and research director of ProHealth & Fitness PT OT in New York City. But as you slide into slouching, more and more pressure is put on your spine, causing pain.
What to do: Stand with your back, buttocks and heels against the wall. If you can’t get into this position, or can only do it with your chin lifted up, you need to practice perfecting your posture, Nussbaum says. Place a couple of towels behind your head, then press your head and back against the wall. Imagine you’re trying to bring your belly button toward your spine. Hold for a minute, and repeat four to six times each day.
For your knees
Any activity that strengthens muscles around the knee will help relieve knee pain, since it takes pressure off of the joint, Harris says. Simply walking every day can yield dramatic results: People with knee osteoarthritis who walked 6,000 steps daily reported less difficulty and pain doing everyday activities such as walking up the stairs, according to a study published in Arthritis Care & Research. If that’s too painful, consider walking in a pool, which offers the same benefits with much less pressure on your joints, adds registered nurse Barbara Resnick, the Sonya Ziporkin Gershowitz Chair in Gerontology at the University of Maryland School of Nursing.
Other exercises that can help include:
Straight leg raises
This move strengthens your quadriceps, the group of muscles located in front of your thighs, Reinhardt says. These types of exercises helped relieve pain among patients with knee osteoarthritis, according to a Journal of Physical Therapy Science study.
Try it: Lie on the floor, your elbows directly under your shoulders, one leg straight while the other is bent so your foot is flat on the floor. Tighten the thigh muscle of your straight leg and raise it six to 10 inches off of the floor. Hold for five seconds, then return to starting position. Repeat 10 times, then switch sides. Aim for three sets of 10, four to five times a week.
Contrary to popular belief, squats are actually great for strengthening sore, arthritic knees, Harris says. The key is doing them correctly — go too deep and you’ll cause pain.
Try it: Stand with your feet shoulder distance apart, hands in front of you. Lower your hips about 10 inches, as if you’re sitting down in a chair, with your weight in your heels. Hold for five seconds, then stand back up. Do three sets of 10, four to five times a week. As the exercise becomes easier, gradually add in hand weights, beginning with 3 pounds or 5 pounds and working your way up to 10 pounds.
Try it: Sit at the edge of a chair, chest high, abdominals engaged so that your belly button is toward your spine. Slowly straighten one knee, raising that leg as high as possible, your toes pointed upward. Hold for two seconds, then slowly return to the starting position. Do two sets of eight with each leg, four to five times a week.
For your hips
Chronic hip pain is often due to osteoarthritis, which can be exacerbated by tight glute (butt) muscles, Reinhardt says.
This exercise helps stretch out tight hip muscles that can trigger pain.
Try it: Lie on your side, legs stacked and knees bent at a 45-degree angle. Keeping your heels touching, raise your upper knee as high as you can (like an opening clamshell) without shifting your hips. Hold for two seconds, then return to starting position. Repeat 10 to 15 times, then repeat on the other side.
If this is too hard to do on the floor, you can do this exercise on your bed instead, Harris says.
Try it: Lie on your stomach with a pillow under your hips. Bend one knee at a 90-degree angle and lift it straight up, then slowly lower, counting to five. Do eight to 12 repetitions on each side. As the exercise becomes easier, add ankle weights in 1-pound increments.
Standing hip abduction
This exercise helps promote strength and stability in your hip muscles, and is simple enough that you can do it twice a day when you’re standing in front of your bathroom sink, Resnick says.
Try it: While standing, tighten your abdominal muscles and slowly move one of your legs out to the side, maintaining balance with the opposite leg. (If that’s too hard, you can hold onto the edge of the sink to steady yourself.) Hold for a few seconds, then return to the starting position. Do three sets of 10 on each leg.
For your shoulders
Gradual wear and tear as you age can lead to arthritis in your shoulders, and pain can develop for seemingly no reason at all. “It can be something as innocuous as turning to see something in the back seat of your car, triggering strain and pain,” Harris says. Exercises to keep shoulders in shape include:
Shoulder blade squeeze
This exercise improves posture, which is crucial for shoulders to work correctly, Reinhardt says.
Try it: Stand straight and tall. Pull your shoulder blades down and back to bring your elbows back and inward. Return to the starting position. Do three sets of 10.
This is an easy shoulder stretch you can do anywhere, Harris says.
Try it: Stand with your feet shoulder-width apart and your arms at your sides. Keeping your arms straight, move them around in big circles going forward. After you have done 15 to 20 reps, switch directions.
This move is a great full body exercise that strengthens your back and core as well as your shoulders, Harris says. Do them on your elbows instead of your hands in order to reduce shoulder strain.
Try it: Lie on your stomach with your elbows bent on the floor. Tighten your abdominal muscles and lift your hips and knees up off the floor. Hold for 30 seconds, then return to starting position. Rest 30 seconds, then repeat. Gradually work your way up to five a day.
Article by Hallie Levine, AARP, February 1, 2019