In this blog, we are going to look at how we can include mobility and flexibility when programming for older adults, why this is important and the benefits for our clients.

Considerations for mobility exercises

The changes that take place in the joints as we age, such as the reduction in the synovial fluid and thinning of the cartilage, mean that we should mobilise all joints thoroughly in the warm-up. However, common conditions such as osteoarthritis and obesity may need to be taken into consideration.

Mobility is an important and sometimes overlooked component of the warm-up.

There are circumstances where mobility can be combined within the pulse raiser activity itself such as using a rower or cross trainer.
However, with older clients, you may need to include some or all mobility at the beginning of the warm-up to prepare the body for the pulse raiser. For example, mobilise the knees and ankles before using a cross-trainer or shoulders before using a rower.

In a class or studio setting where cardio equipment is not being used, the mobility can be combined with a pulse raiser. This could include knee lifts, marching with shoulder rolls, leg curls and similar. Consideration needs to be given to mobilising joints such as knees, hips, and ankles, before loading. For example, if bodyweight squats are going to be part of the warm-up, then exercises such as knee lifts should be included to take the joint through the range of movement before body weight is added.

After discussing any areas of stiffness as part of the screening process, you may need to include specific mobility exercises that the client requires such as neck, shoulder girdle, wrists, and ankles. It always good practice to mobilise all main areas too such as the shoulders, spine, elbows, hips, and knees.

Joints need to be mobilised to cover all joint actions available at the specific joint. For example, circumduction at the shoulder joint (shoulder rolls) will cover all actions available at the shoulders but hips may need to mobilise using adduction and abduction, flexion and extension and rotation.

The spine mobility should include flexion and extension which could be done with small roll-downs, back rounding with the hands on the knees or back hollowing in a seated position. Pelvic tilting may be beneficial to clients with poor lower back mobility and is best performed in a standing position.

Consider stability and posture as some clients will find it difficult to rotate the thoracic spine with a waist twist and not move the hips and knees which could cause problems for older people. In this case, use a seated position on a chair or bench.

It is a good idea to look at practising patterns of movement you are going to use in the main session, such as chest press, side and frontal raises, upright row and build these planes of movement into your warm up.

As mobility will be done at the start of the programme this could be combined with balance and co-ordination exercises, for example standing on one leg and circling the ankles.

Considerations for flexibility

As we age, our ligaments shorten and tighten and connective tissue around and within muscles becomes less flexible. Flexibility is very important to maintain function as we age, for example being able to reach up to high shelves and bend down to put on shoes.

Dynamic or static stretches can be used in the warmup and maintenance and developmental stretching should be used at the end of a workout.

Warm-up stretches

All muscle groups that are going to be used in the main session should be stretched in the warm-up to take the muscle to a pre-exercise length and the joint through a full range of motion. Use 10-15 repetitions or hold for 8-10 seconds.

Warm-up stretches are a good tool to analyse a client’s range of movement and posture and may help to identify areas to focus on in the session and the cool down stretch component.
They should be done standing, or if needed seated, but floor-based positions should be avoided in this part of the programme. Balance issues need to be considered when holding stretches, such as a standing quadricep or calf stretch or dynamic leg swings. If possible, the environment should have a wall and hard floor rather than mats.

Mobility and dynamic stretches will often be covered in one exercise, such as arm circles, which will mobilise the shoulder and stretch the chest, however, this needs to be considered for each client and may be a progression.

Cool down stretches

At the end of the programme all major muscle groups should be stretched, paying particular attention to any areas of stiffness and tightness that have been identified at screening and during the session. Hold maintenance stretches for 15-20 seconds, focusing on feeling mild tension and avoiding any movement. Hold developmental stretches for 30-40 seconds taking the stretch a bit further after 10-15 seconds to increase the range of movement in areas that need it.

It is important to consider the individual needs of the client, rather than use a set stretch routine. Look at postural problems and focus on specific stretches to benefit the client. This could include chest stretches for clients with kyphosis, back stretches for clients with lordosis and retraction for clients with ‘forward head’. Include hip flexors, lower back, and gluteal stretches for this age group, especially if there is a lack of mobility in the lower back.

Stretches may need to be done standing or seated on a bench or chair if the client cannot get down to or up from the floor, and props may be needed to assist the client, such as bands.
Consider the order and flow of stretches so the client does not have to get down or up from the floor, bench, or chair more than once.

In conclusion, with our older adult clients, mobility and flexibility should be a priority and an important part of the overall programme as improving daily function and maintaining independence it is often one of their major goals.

If you would like to refresh your knowledge on some mobility and flexibility exercises for warm ups, then we have a short CPD training here.