“Take it easy. Protect your joints. Don’t lift anything heavy.” After 50, that advice comes from everywhere, and some of it is sensible. A recent Prevention article collected the myths that trainers who work with older adults hear most. Plenty of what they said is coaching experience. Three of the claims, though, trace back to published studies, so I read those studies directly. Here is what they found, and what they leave open.
Myth 1: If a joint hurts, work around it by not training it
A 2024 systematic review and meta-analysis pooled 27 studies with 1,712 people who had osteoarthritis of the knee or hip. Each study compared a resistance training program with no resistance training. Resistance training improved pain (standardized mean difference, or SMD, −0.48; 95% confidence interval −0.58 to −0.37), strength (SMD 0.40; 0.32 to 0.47) and physical function (SMD −0.56; −0.65 to −0.47). The minus signs on pain and function are how the authors report improvement on those scales.[1]
Program length mattered a little. In studies lasting four weeks or less, pain and strength improved but function did not. Knee and hip results were both positive.[1]
What this does not tell you: the analysis covers people with diagnosed knee or hip osteoarthritis, not every kind of joint or back pain. The pooled studies differed from each other (the statistic for pain, I², was 45%, which signals moderate differences between studies), and the comparison was against no resistance training rather than against other forms of exercise. It also says nothing about which exercises suit a particular painful joint. That is a question for a physical therapist or clinician who has examined you.
Myth 2: With low bone density, you are too fragile to lift heavy
The LIFTMOR trial put this one to a direct test. Researchers in Australia randomized 101 postmenopausal women (average age 65) with low bone mass to one of two groups. One group did eight months of supervised, twice-weekly, 30-minute sessions of high-intensity resistance and impact training: five sets of five repetitions at more than 85% of the heaviest weight they could lift once. The comparison group followed a low-intensity program at home.[2]
At the end, lumbar spine bone mineral density rose 2.9% in the lifting group and fell 1.2% in the comparison group. At the femoral neck (the top of the thigh bone), the change was +0.3% versus −1.9%. Every functional test the team measured, including timed up-and-go and sit-to-stand, favored the lifting group. One adverse event was reported: a minor lower back spasm.[2] A related earlier post, Astronaut Training Lessons for Muscle and Bone After 40, looks at how mechanical load and bone connect.
The limits are important here. The sessions were closely supervised, the women were screened for conditions and medications that affect bone, and the authors describe the sample as otherwise healthy. The trial measured bone density and physical performance, not fractures, so it can show that these markers improved but not that fewer women broke bones. Eight months is also a short window. A 2019 erratum was published for the paper, and I could not retrieve its text, so I have kept to the design and the headline results reported in the abstract. If you have osteoporosis, this is not a reason to start heavy lifting on your own. It is a reason to ask about supervised, progressive loading.
Myth 3: Hard exercise spikes cortisol, so avoid it
Cortisol is the hormone people usually mean when they talk about “stress hormones,” and the worry is that intense workouts push it up. They do, briefly. A 2021 meta-analysis looked at what happens to cortisol after a single session of high-intensity interval training (HIIT) in healthy people. It combined 10 controlled studies (213 participants) and 50 before-and-after groups (677 participants).[3]
Cortisol was significantly higher immediately after the session, and still higher at 30 and 60 minutes. In the before-and-after groups it then fell below baseline at 120 and 180 minutes, and was back to baseline at 24 hours.[3] So a single hard session produced a temporary rise that had settled within a day in these analyses. Related reading: Once-Weekly HIIT and Fat Loss: What a 315-Adult Trial Found.
Again, the boundaries. The participants were healthy individuals, not specifically older adults or menopausal women, and the review measured one session at a time. It does not show what repeated high-intensity training does to cortisol over months, how it affects symptoms, or whether any particular person should do HIIT. It only addresses the idea that a workout’s cortisol spike is a reason to avoid it.
What this adds up to
- Pain and bone density are reasons to ask better questions, not to stop moving. In these studies, people with knee or hip osteoarthritis, and women with low bone mass, did resistance work and the markers moved in the right direction.
- Supervision and screening were part of the evidence. The bone trial was run by trained staff on screened participants. Results from that setting do not automatically carry over to training alone.
- One study is not a plan. None of these three papers tests a full routine for people over 50, and the trainers’ other points (progressive overload, balance work alone not preventing falls, never being too old to start) are experience-based claims I did not trace to a study here.
If you live with osteoarthritis, osteoporosis, heart disease or another condition, talk with your clinician or a physical therapist before changing how you train.
References
[1] Lim J, Choi A, Kim B. The Effects of Resistance Training on Pain, Strength, and Function in Osteoarthritis: Systematic Review and Meta-Analysis. Journal of Personalized Medicine, 2024;14(12):1130. Population: 27 studies, 1,712 people with knee or hip osteoarthritis (databases searched to 14 September 2024). DOI: https://doi.org/10.3390/jpm14121130. Finding as used: resistance training versus no resistance training improved pain (SMD −0.48, 95% CI −0.58 to −0.37; I² 45%), strength (SMD 0.4, 0.32 to 0.47; I² 0%) and function (SMD −0.56, −0.65 to −0.47; I² 30%); by duration, pain and strength improved in all duration subgroups but function did not improve in programs of four weeks or less; knee and hip both improved. ↑︎
[2] Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 2018;33(2):211-220. A 2019 erratum is listed for this paper (DOI 10.1002/jbmr.3659 ; text not retrieved). Population: 101 postmenopausal women (age 65 ± 5) with low bone mass (T-score below −1.0), randomized to 8 months of supervised twice-weekly 30-minute high-intensity resistance and impact training (n = 49; 5 sets of 5 repetitions at over 85% of one-repetition maximum) or home-based low-intensity exercise (n = 52). DOI: https://doi.org/10.1002/jbmr.3284. Finding as used: lumbar spine bone mineral density +2.9% versus −1.2% (p < 0.001); femoral neck +0.3% versus −1.9% (p = 0.004); all functional performance measures favored the training group (p < 0.001); one adverse event reported (minor lower back spasm); the authors conclude the program was efficacious with no adverse events under highly supervised conditions in an otherwise healthy sample. ↑︎
[3] Dote-Montero M, Carneiro-Barrera A, Martinez-Vizcaino V, Ruiz JR, Amaro-Gahete FJ. Acute effect of HIIT on testosterone and cortisol levels in healthy individuals: A systematic review and meta-analysis. Scandinavian Journal of Medicine & Science in Sports, 2021;31(9):1722-1744. Population: healthy individuals; 10 controlled studies (213 participants) and 50 pre-post intervention groups (677 participants). DOI: https://doi.org/10.1111/sms.13999. Finding as used: cortisol increased significantly immediately after a single HIIT session and at 30 and 60 minutes, decreased significantly below baseline at 120 and 180 minutes (pre-post groups only), and returned to baseline by 24 hours. ↑︎
Kurt Greiner
Kurt is a digital strategist and IT professional blending emerging technology with practical application to help businesses and individuals streamline their digital presence. His current work focuses on the intersection of intentional living and technological resilience, exploring how individuals can leverage modern tools to navigate the second half of life with purpose.
Leave a Reply