Harvard Health Letter

The 4 most important types of exercise

Strengthening, stretching, balance, and aerobic exercises will keep you active, mobile, and feeling great.

Exercise is key to good health. But we tend to limit ourselves to one or two types of activity. "People do what they enjoy, or what feels the most effective, so some aspects of exercise and fitness are ignored," says Rachel Wilson, a physical therapist at Harvard-affiliated Brigham and Women's Hospital. In reality, we should all be doing aerobics, stretching, strengthening, and balance exercises. Here, we list what you need to know about each exercise type and offer examples to try, with a doctor's okay.

1. Aerobic exercise

Aerobic exercise, which speeds up your heart rate and breathing, is important for many body functions. It gives your heart and lungs a workout and increases endurance. "If you're too winded to walk up a flight of stairs, that's a good indicator that you need more aerobic exercise to help condition your heart and lungs, and get enough blood to your muscles to help them work efficiently," says Wilson.

Aerobic exercise also helps relax blood vessel walls, lower blood pressure, burn body fat, lower blood sugar levels, reduce inflammation, boost mood, and raise "good" HDL cholesterol. Combined with weight loss, it can lower "bad" LDL cholesterol levels, too. Over the long term, aerobic exercise reduces your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls.

Aim for 150 minutes per week of moderate-intensity activity. Try brisk walking, swimming, jogging, cycling, dancing, or classes like step aerobics.

Marching in place

Starting position: Stand tall with your feet together and arms at your sides.
Movement: Bend your elbows and swing your arms as you lift your knees.
March in a variety of styles:

  • March in place.
  • March four steps forward, and then four steps back.
  • March in place with feet wide apart.
  • Alternate marching feet wide and together (out, out, in, in).

Tips and techniques:

  • Look straight ahead, and keep your abs tight.
  • Breathe comfortably, and don't clench your fists.

Make it easier: March slower and don't lift your knees as high.
Make it harder: Lift your knees higher, march faster, and really pump your arms.

2. Strength training

As we age, we lose muscle mass. Strength training builds it back. "Regular strength training will help you feel more confident and capable of daily tasks like carrying groceries, gardening, and lifting heavier objects around the house. Strength training will also help you stand up from a chair, get up off the floor, and go up stairs," says Wilson.

Strengthening your muscles not only makes you stronger, but also stimulates bone growth, lowers blood sugar, assists with weight control, improves balance and posture, and reduces stress and pain in the lower back and joints.

A physical therapist can design a strength training program that you can do two to three times a week at a gym, at home, or at work. It will likely include body weight exercises like squats, push-ups, and lunges, and exercises involving resistance from a weight, a band, or a weight machine.

"Remember, it's important to feel some muscle fatigue at the end of the exercise to make sure you are working or training the muscle group effectively," Wilson says.

Squat

Starting position: Stand with your feet shoulder-width apart, arms at your sides.
Movement: Slowly bend your hips and knees, lowering your buttocks about eight inches, as if you're sitting back into a chair. Let your arms swing forward to help you balance. Keep your back straight. Slowly return to the starting position. Repeat 8-12 times.

Tips and techniques:

  • Shift your weight into your heels.

  • Squeeze your buttocks as you stand to help you balance.

Make it easier: Sit on the edge of a chair with your feet hip-width apart and arms crossed over your chest. Tighten your abdominal muscles and stand up. Slowly sit down with control.
Make it harder: Lower farther, but not past your thighs being parallel to the floor.

3. Stretching

Stretching helps maintain flexibility. We often overlook that in youth, when our muscles are healthier. But aging leads to a loss of flexibility in the muscles and tendons. Muscles shorten and don't function properly. That increases the risk for muscle cramps and pain, muscle damage, strains, joint pain, and falling, and it also makes it tough to get through daily activities, such as bending down to tie your shoes.

Likewise, stretching the muscles routinely makes them longer and more flexible, which increases your range of motion and reduces pain and the risk for injury.

Aim for a program of stretching every day or at least three or four times per week.

Warm up your muscles first, with a few minutes of dynamic stretches—repetitive motion such as marching in place or arm circles. That gets blood and oxygen to muscles, and makes them amenable to change.

Then perform static stretches (holding a stretch position for up to 60 seconds) for the calves, the hamstrings, hip flexors, quadriceps, and the muscles of the shoulders, neck, and lower back.

"However, don't push a stretch into the painful range. That tightens the muscle and is counterproductive," says Wilson.

Single knee rotation

Starting position: Lie on your back with your legs extended on the floor.
Movement: Relax your shoulders against the floor. Bend your left knee and place your left foot on your right thigh just above the knee. Tighten your abdominal muscles, then grasp your left knee with your right hand and gently pull it across your body toward your right side.
Hold 10 to 30 seconds.
Return to the starting position and repeat on the other side.

Tips and techniques:

  • Stretch to the point of mild tension, not pain.

  • Try to keep both shoulders flat on the floor.

  • To increase the stretch, look in the direction opposite to your knee.

4. Balance exercises

Improving your balance makes you feel steadier on your feet and helps prevent falls. It's especially important as we get older, when the systems that help us maintain balance—our vision, our inner ear, and our leg muscles and joints—tend to break down. "The good news is that training your balance can help prevent and reverse these losses," says Wilson.

Many senior centers and gyms offer balance-focused exercise classes, such as tai chi or yoga. It's never too early to start this type of exercise, even if you feel you don't have balance problems.

You can also go to a physical therapist, who can determine your current balance abilities and prescribe specific exercises to target your areas of weakness. "That's especially important if you've had a fall or a near-fall, or if you have a fear of falling," explains Wilson.

Typical balance exercises include standing on one foot or walking heel to toe, with your eyes open or closed. The physical therapist may also have you focus on joint flexibility, walking on uneven surfaces, and strengthening leg muscles with exercises such as squats and leg lifts. Get the proper training before attempting any of these exercises at home.

Standing knee lift

Starting position: Stand up straight with your feet together and your hands on your hips.

Movement: Lift your left knee toward the ceiling as high as is comfortable or until your thigh is parallel to the floor. Hold, then slowly lower your knee to the starting position.

Repeat the exercise 3-5 times.

Then perform the exercise 3-5 times with your right leg.

Tips and techniques:

  • Keep your chest lifted and your shoulders down and back.

  • Lift your arms out to your sides to help you balance, if needed.

  • Tighten your abdominal muscles throughout.

  • Tighten the buttock of your standing leg for stability.

  • Breathe comfortably.

Make it easier: Hold on to the back of a chair or counter with one hand.

Make it harder: Lower your leg all the way to the floor without touching it. Just as it is about to touch, lift your leg up again.