Preventing Gym Injuries in Older Adults
Starting a new exercise routine can be exhilarating, but for older adults — especially former athletes — it’s crucial to approach it with caution. Small muscles, like those in the forearms and shoulders, are particularly vulnerable to overuse injuries such as tennis elbow, which can take months or even years to heal. The key to avoiding such injuries is not just caution but a deep understanding of one’s limits and a commitment to gradual progression far below your capabilities. Your body will take time to get used to the new regime. Give it a year, not a few weeks. A five percent gain in one year is far better than a 20-percent gain and a nagging injury.
The Vulnerability of Small Muscles
Small muscles, though less conspicuous than their larger counterparts like biceps or quads, play a critical role in joint stability and movement. Their smaller size, rare use, and higher tendon-to-muscle ratio make them susceptible to strain. For instance, the forearm extensors, involved in gripping exercises, can develop tennis elbow if overworked without adequate preparation. Do not attempt to build grip strength without an experienced instructor. Similarly, the rotator cuff muscles, essential for shoulder stability, risk strain during compound movements that aren’t carefully designed. According to an article in WebMD, overuse injuries such as tendonitis often affect these areas due to repetitive stress, with recovery potentially extending months or years. Older adults, with age-related declines in muscle mass, bone density, and flexibility, are particularly at risk, as studies from the National Center for Biotechnology Information (NCBI) show delayed and less efficient recovery from muscle damage.
One of the challenges with overuse injuries is that they often develop insidiously—you might not feel pain immediately after a workout, but over a few weeks, the cumulative effect of too much stress on your muscles and tendons can lead to an injury you immediately regret by the time you feel it. That’s why it’s crucial to follow a structured plan and not rely solely on how you feel in the moment. Just because you “haven’t been hurt yet” doesn’t mean you’re okay to keep going. By limiting the total number of reps per week for each muscle group and ensuring adequate rest, you can stay well under your injury threshold.
Grip strength
Most people hear how important grip strength is, so they buy several grip trainers on Amazon and start pumping them several times a day. That’s how you get tennis elbow that doesn’t heal for months and months.
For grip strength, grab a pair of light dumbbells, like 10 or 15 pounds, hold them down at your sides, and relax your grip, so the dumbbell is held very loosely toward the end of your fingers. Hold this for 30 seconds. It should be trivially easy. Do that 3 times in one day. Do that every three days to start, skipping two days in between. Then go up 5 pounds in each hand. Don’t even think of going to every other day during the first year. If you get to 15-20 pounds per hand three times in one day, three days a week — gradually — in the first year, you’re doing it about right. With that base after the first year, you can start moving into new territory.
If you want to do farmer carries, grab two 25-pound barbell plates and carry those with a full grip. If that’s too heavy, start with kettlebells or dumbbells and a full grip. Always do farmer carries with a straight spine and head held high. The biggest danger in farmer carries is loading and unloading, so start with less weight and build good form before moving up.
For a former athlete, this will be frustratingly slow. Be patient. Build your platform first.
Principles of Injury Prevention
For most people, warming up is critical: a 5–10-minute dynamic warm-up, such as arm circles or leg swings, increases blood flow and prepares muscles for exertion. Don’t just jump into it. Cooling down with static stretches, held for 20–30 seconds, aids recovery and reduces stiffness. Use gravity for stretches when possible. Gradual progression is equally vital; the “10% rule,” supported by EōS Fitness, suggests increasing workout intensity by no more than 10 percent weekly to allow tendons and ligaments to adapt. However, for older adults, especially those new to exercise, change that to ten percent monthly, max. Start light. Instead of lifting to failure or doing too many reps, begin with weights that allow you to perform 6-8 reps with perfect form but without straining. Stop well before your maximum — leave the hard work for later. Go until you feel a bit of discomfort, then stop. The goal is to build a routine and let your body adapt to the mild stress without causing pain or excessive soreness.
Pain should never be your guide. If you feel any pain at all during or after a workout, it’s a sign you’ve done too much. Take a week off. Adjust your routine immediately by reducing weight, reps, or frequency. The aim is zero pain and only minimal muscle soreness. Proper form is paramount, especially for exercises targeting small muscles. Learning from certified trainers or reliable resources ensures movements are executed safely. Variety in training prevents overuse by alternating movements—switching from pronated to supinated grips, for instance, distributes load across forearm muscles. Rest and recovery, with at least 48 hours between sessions for the same muscle group, are essential, particularly for small muscles that heal slower.
I’ve been doing arm curls for years, working on my biceps. Then I learned about brachialis curls. The brachialis is a small muscle that has the potential to become quite a bit bigger and enlarge your forearms. I was so excited about building this muscle that I overdid it, and now six months later I still have nagging pain in both elbows. It’s easy to overdo something if you want quick results. Resist the temptation! Ultimately, results are the only thing that matter, but an injury is a result you don’t want.
Especially for former athletes: give yourself a year to build a platform, then gradually start working out hard enough to feel sore afterward.
Optimizing Recovery and Gains
Beyond the physical aspects of training, optimizing recovery is key to achieving fitness goals without injury. Adequate sleep is crucial for muscle recovery and growth. During sleep, the body releases growth hormone, which aids in tissue repair. According to an article in the Journal of Strength and Conditioning Research, sleep deprivation can negatively impact muscle recovery and performance.
Getting enough protein every day helps in rebuilding muscle fibers. You don’t need to get a huge dose of protein right after a workout — just keep up your protein intake throughout the day. Most people should aim for one gram of protein for every pound of lean bodyweight every day. That’s a lot. Break it into four times per day when you’re getting 30-50 grams. The best protein comes from animal sources, though vegetarians can compensate by getting even more. There is almost no upper bound on the amount of protein that supports muscle growth!
On the other hand, stress and fatigue can hinder recovery. Chronic stress elevates cortisol levels, which can break down muscle tissue and impair recovery. Managing stress through techniques like meditation or yoga can help maintain hormonal balance. Fatigue, whether from lack of sleep or overtraining, increases the risk of injury due to poor form and reduced coordination.
Body weight vs weighted exercise
There are so many good body-weight exercises that you can leave the weights out of your routine most of the time. Check YouTube for body-weight, floor, and movement exercises that are very challenging. Don’t think of yourself as a bodybuilder doing traditional movements. Lifts like deadlifts and overhead press are unnatural movements you’ll never use in real life. Work on doing compound movements that give you overall stability. Strengthen your back muscles without torturing them.
Instead of weighted squats, begin with bodyweight squats. Use a 30-degree wedge at the beginning to build good form. Get on a low platform and do toe and heel touches. Situps, pullups, and pushups are great starter exercises, and you can cheat them to get started — use bands, inclines, and isometrics like wall sits to build your foundation. Better yet, watch Lee Weiland take you on a smooth-movement journey and mix all your moves into fluid flow. Take small steps, ensuring that each step is taken with care.
Don’t be a specialist
As Peter Attia says in his book Outlive, you should choose about 20 different activities and become strong in all of them. It does not pay to be a pickleball or bench-press specialist. You want to work on big muscles, small muscles, balance, agility, stability, hand-eye coordination, carrying loads, off-center moves, lateral moves, floor moves, grip strength, rebound, jumping, core, even neck muscles. The body has a lot of muscles, so you can always be working something. Even when sitting or watching TV, you can do tibialis (toe) raises and push your hands together firmly, to flex your hand tendons. In the gym, you can do a lot of light activities from neck exercises to shoulder to core, movement, mobility, balance, hopping, step-ups, etc. So even if it’s just body weight at first, you can actually spend 90 minutes in the gym doing many different things and keep mixing it up all week with new movements. Do a lot of small things in the gym, but stop when your form starts to deteriorate because you’re too tired overall.
Mix cardio and resistance. You need both. Don’t do cardio on one day and weights the next. When you mix them, you can do more in a week than you can by separating them by day. An ideal routine would be a cardio exercise in the morning and a light workout in the gym in the afternoon. Every day.
Starting Slow and Building a Routine
Getting into a routine is crucial for long-term success. Start with 2-3 workouts per week. Focus on consistency rather than intensity. This approach helps your body adapt to the mild stress of exercise, reducing the risk of injury. Former athletes, in particular, need to be cautious. Their past experience might tempt them to push too hard, but age-related changes mean they can’t perform as they did in their youth. It’s essential for them to limit their weight and volume to about half of what their ego might suggest. For instance, if they feel they can lift 20 pounds for 10 reps, they should start with 10 pounds for 6 reps, then go do something else before getting fatigued. It may seem like too little, but you live to lift another day.
A 24-Month Progression Framework
The journey from beginner to intermediate should span 24 months, not weeks, to build resilience without risk. Think in terms of a 0-100 scale, where 100 represents maximum potential — competitive bodybuilder or powerlifter in your age category. Older adults should aim to reach approximately ten percent of their potential after one year, then 20-30 percent after two years. If you keep it up, after four years you’ll be close to 50 percent of your potential, which would be a transformation everyone will notice and will keep you strong and healthy for many more years. For those in their 70s and 80s, adjust that target downward to account for age-related declines in muscle mass, bone density, and flexibility. Imperceptible gains are better than quick wins. You should be frustrated with your lack of progress after three months and pleasantly pleased after nine months.
Some women worry they will become too big and look strange with all that muscle. This is a cartoon that won’t happen. To add five pounds of muscle would take two years of work for most women, and it would look natural and strong, not freakish. For most people, 10-15 pounds of muscle would be a good four-year goal, and it will make you look and feel fantastic.
The Long View
Slow and steady wins this race. Don’t be the person who says “I did something stupid and paid the price.” Preventing gym injuries requires patience and discipline. By warming up, progressing gradually, maintaining form, varying exercises, listening to the body, ensuring rest, and seeking professional advice, clients can safely navigate their fitness journey. Slow and steady wins the race, especially when the stakes are as high as maintaining mobility and independence in later life, ensuring a lifetime of active, injury-free living. Just wait until you get to year three!
Listen to Peter Attia talk with Kyler Brown, a sports-rehab specialist, about preventing injuries.