Aging Strong: How Exercise Protects Your Body From Injury Over Time

Why injury risk increases as we age

Starting in our 30s and 40s, our bodies naturally begin to lose:

• Muscle mass and strength (sarcopenia)

• Bone density, especially in women after menopause

• Balance and coordination

• Tendon and joint resilience

Research shows that aging is associated with progressive loss of both bone and muscle mass, and when those losses pass a certain threshold, the risk of falls, fractures, and disability rises sharply. PMC Tendons also undergo age-related changes that make them less tolerant to sudden, unaccustomed loads. Physiology Journals

Put simply: we become easier to knock over and easier to break—unless we actively do something about it.

How exercise lowers your risk of injury

1. Strength training preserves muscle and protects joints

Strength (resistance) training helps you maintain and rebuild muscle as you age, combatting sarcopenia and improving your ability to control your body in real-world situations—lifting groceries, catching yourself from a trip, or getting up from the floor.

Studies show that resistance training improves muscle strength and functional capacity and indirectly benefits bone by increasing the loads placed on the skeleton. E-ENM+1 Strong muscles act as shock absorbers around your joints, reducing strain on ligaments and cartilage and lowering the chance of sprains and overuse injuries.

2. Exercise improves balance and cuts fall risk

Falls are one of the leading causes of serious injury in older adults, including hip fractures and head injuries. The good news: exercise has some of the strongest evidence we have for fall prevention.

• A large Cochrane review found that programs focusing on balance, gait, and muscle strength significantly reduce falls in community-dwelling older adults. health.gov

• Other systematic reviews and meta-analyses report fall reductions of up to 20–50% with appropriately designed exercise programs. PMC+1

• Balance and functional exercises alone have been shown to cut fall rates by about 24%. medicine.tufts.edu

Balance-focused movement like single-leg stands, heel-to-toe walking, tai chi, and specific strength and balance routines help your brain and body stay coordinated, improving proprioception (your sense of where your body is in space). Mayo Clinic+1

3. Weight-bearing and impact exercise strengthens bones

As we age, bones can become thinner and more fragile, increasing the risk of fractures from even minor falls. Weight-bearing and impact activities—walking, stair climbing, resistance training, and appropriately progressed jumps or hops—stimulate bone to stay strong.

Research shows that mechanical loading from physical activity and resistance training stimulates bone formation in key areas like the hip and spine and helps maintain bone mineral density over time. PMC+2journalmsr.com+2 These “osteogenic” exercises encourage the body to build and remodel bone, making it more resistant to fracture if you do fall. Physiopedia

4. Exercise keeps tendons, ligaments, and connective tissue resilient

Tendons and other connective tissues also respond to loading. While aging tends to make tendons stiffer and more prone to injury, regular, progressive exercise can help maintain their structure and function.

Reviews of aging and tendons show that properly dosed exercise leads to positive adaptations in tendon stiffness and strength, which supports force transfer from muscle to bone and reduces the risk of tendon tears or chronic overuse pain. Physiology Journals+1

5. Better movement patterns = fewer “everyday” injuries

Beyond raw strength and balance, exercise trains your nervous system. Multicomponent programs that include:

• Strength

• Balance

• Functional movements (sit-to-stand, step-ups, carrying)

• Flexibility and mobility

help you move more efficiently and safely in daily life. The U.S. Physical Activity Guidelines specifically recommend this kind of multicomponent training for older adults to reduce fall and injury risk. Health.gov+1

When your body is used to squatting, hinging, pushing, pulling, and rotating under control, you’re less likely to strain your back lifting a box or twist your knee stepping off a curb.

What types of exercise offer the most protection?

The strongest evidence for injury and fall prevention points to combining several types of training:

1. Strength training (2+ days per week)

Focus on:

• Legs: squats, lunges, step-ups, leg presses

• Hips and glutes: hip thrusts, bridges, hip abduction

• Core: anti-rotation, carries, planks

• Upper body: rows, presses, pulldowns, push-ups

Research and guidelines emphasize muscle-strengthening activities for all major muscle groups at least twice per week in older adults. CDC+1

2. Balance and functional training

Include exercises that challenge your base of support and coordination, such as:

• Single-leg balance (with support as needed)

• Heel-to-toe walking

• Sit-to-stands from a chair without using your hands

• Step-ups and lateral steps

• Tai chi or similar gentle movement practices

These activities are consistently highlighted in fall-prevention guidelines and systematic reviews as key components in reducing fall risk. USPSTF+2PMC+2

3. Aerobic activity

Aerobic exercise like walking, cycling, or swimming supports:

• Heart and lung health

• Endurance for daily activities

• Weight management

The CDC recommends at least 150 minutes per week of moderate-intensity aerobic activity for older adults (for example, 30 minutes on 5 days per week). CDC+1 Aerobic fitness reduces fatigue, which indirectly lowers injury risk by helping you move with better control throughout the day.

4. Flexibility and mobility work

Gentle stretching, yoga, and mobility drills help maintain joint range of motion so you can move freely and safely. While flexibility alone doesn’t prevent falls, combining it with strength and balance work helps keep movement smooth and reduces the chance of muscle strains during daily activities. Woman & Home

How much is enough to make a difference?

You don’t need to train like an athlete to see meaningful changes. Research shows that even moderate, consistent exercise leads to:

• Lower fall rates

• Better balance and walking speed

• Higher bone density and muscle strength

• Less disability and better quality of life PMC+2British Journal of Sports Medicine+2

A realistic weekly goal for most adults 50+ might look like:

• 2–3 days of strength training (20–45 minutes)

• Most days of the week: light-to-moderate walking or other aerobic activity

• 2–3 days of balance/functional drills for 10–20 minutes

• Brief flexibility/mobility work at the end of sessions

Always adjust intensity based on your current fitness level and medical history, and talk with a healthcare provider if you have conditions like severe osteoporosis, heart disease, or significant joint problems.

Bottom line: Exercise is active injury insurance

Aging by itself does not guarantee that you’ll be fragile or constantly hurt. The combination of strength training, balance work, weight-bearing cardio, and basic mobility is like insurance for your future body:

• Stronger muscles protect your joints

• Denser bones resist fracture

• Sharpened balance and coordination prevent falls

• Healthier tendons and connective tissue tolerate daily stress

• Better movement patterns reduce those “random” tweaks and pulls

You can’t stop time—but you can train your body to stay more stable, powerful, and injury-resistant at every age.

References:

Caristia, S., De Leo, D., Guarino, M., Marozzi, E., Salerno, M. C., & Alunno, A. (2021). Physical exercise and fall prevention: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 95, 104383. ScienceDirect

Carter, M. I., & Hinton, P. S. (2014). Physical activity and bone health. Orthopedic Clinics of North America, 45(4), 465–475. PMC

Ferrucci, L., Baroni, M., Ranchelli, A., Lauretani, F., Maggio, M., Mecocci, P., Ruggiero, C., & Cherubini, A. (2014). Interaction between bone and muscle in older persons with mobility limitations. Current Pharmaceutical Design, 20(19), 3178–3197. PMC

Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2024). Interventions to prevent falls in older adults: Updated evidence report and systematic review for the US Preventive Services Task Force. Journal of the American Medical Association, 331(1), 65–79. JAMA Network+1

Hong, A. R., & Kim, S. W. (2018). Effects of resistance exercise on bone health. Endocrinology and Metabolism, 33(4), 435–444. E-ENM

Montero-Odasso, M., van der Velde, N., Alexander, N. B., Becker, C., Blain, H., Camicioli, R., Close, J., et al. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9), afac205. PMC

Sadaqa, M., Silva, P. A., Pimentel, R. M., Oliveira, D. V., & Pereira, D. S. (2023). Effectiveness of exercise interventions on fall prevention in community-dwelling older adults: A systematic review and meta-analysis. BMC Geriatrics, 23, 567. PMC

Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2020). Exercise for preventing falls in older people living in the community. British Journal of Sports Medicine, 54(15), 885–891. British Journal of Sports Medicine

Svensson, R. B., Heinemeier, K. M., Couppé, C., Kjaer, M., & Magnusson, S. P. (2016). Effect of aging and exercise on the tendon. Journal of Applied Physiology, 121(6), 1237–1246. Physiology Journals

U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans (2nd ed.).