The creeping fear of losing your independence during what are supposed to be your golden years is a common one. According to one survey, 78 percent of Americans 65 and older said they’d prefer a shorter life with the capacity to care for themselves than a longer life while depending on others.
Old injuries, creaky joints, arthritis, and muscle loss can all make the tasks you took for granted in your twenties — like getting up from the couch or stepping down from your front porch — much more daunting. But there are plenty of things you can do now to ensure that you’ll be able to manage on your own for years to come.
That’s where Will Harlow comes in: He’s a U.K.-based physiotherapist who specializes in helping people 50 and over build their strength, mobility, balance, and skeletal health. His YouTube channel (which boasts 1.7 million subscribers) features simple exercises and routines you can do at home, and his new book, Independence for Life, is packed with great guidance to help you stay active.
"What I've found is you can make a huge difference to your life with as little as 10 to 20 minutes of effort each day, if you're considered with what you're doing," he tells us.
We spoke to Harlow about the four things you should train in order to stay independent, how to measure your own capacity at home, and the red flags to be aware of.
When it comes to maintaining your independence later in life, you point to four things that people need to consider.
Will Harlow: I structured the book around four pillars: mobility, strength, balance, and skeletal health. If you lose any one of these, then your independence is at risk. I think of it as a four-legged table: If you knock out any one of those legs, the whole thing becomes wobbly.
When I refer to mobility, I’m talking about how well you can move your joints. If you've got stiffness in your joints or if you've lost the ability to get up and down from the floor, that's poor mobility.
The second thing is strength. We're all familiar with the concept of muscle loss with age, but there's a lot we can do to regain muscle and strength as we get older.
The third pillar is balance. Obviously, if you don’t have a good sense of balance, you're at risk of falls, but you're also not going to feel confident moving around. One of the biggest problems I see for the people I treat isn’t necessarily that they keep falling — it's that they're so scared they might fall. Their world starts to shrink, and they do less and less.
The final thing is skeletal health, by which I mean the health of both your bones and joints. If you can maintain these four pillars, that gives you the best possible chance of staying independent for life.
What are the most common joint pain issues you see among your clients?
We did a survey in the clinic and found that backs and knees were the two most common issues. The obvious thing to blame it on is arthritis, but that's not always the case. Often, the issue is mechanical, meaning the pain is linked to a defect in how you’re moving and not necessarily linked to wear and tear or an injury. It might be that they have some arthritis in their knee, but they've got weak quads, weak glutes, their calves are tight, and those are the things that are causing the knee pain — not the arthritis itself.
The good news about that is when we fix those mechanical problems, which can be done through exercise, people's pain often goes away. And that's the case with their backs, knees, hips, everything.
One of the biggest messages I want to get across to people is that just because you're in pain, it doesn't mean that your joints are wearing out. It doesn't necessarily mean there's an injury there that will never heal and that you're stuck with it for life. It could just be one of these mechanical problems that hasn't been addressed.
What are some of the early red flags that someone may be starting to lose their independence?
They’re often things that we don't pay much attention to. They're subtle, and they sneak up on us. One of the big ones that I find with my patients is they start to use their hands to lever themselves out of a chair when they're getting up and down from sitting. Most of them don't actually realize it's happening until one day you ask them to rise without using their hands and they can't do it.
Another thing is being able to get up and down from the floor. I had a client who came to see me even though she didn’t have any pain, but she was so scared of the fact that she’d been out in the garden pulling some weeds and wasn’t able to get back up. There was no one around, and she had nothing to grab hold of. She had to crawl back to the house to call for help.
There are other things that can jeopardize your independence, like pain, but I think the far more pernicious problems are the ones that we don’t see sneaking up on us.
How can people test their level of physical independence at home?
One test is the 30-second chair stand test. All you just need is a dining room chair and a timer, and you want to see how many times you can get up and down from a chair without using your hands. There are different ideal ranges based on age, but I’d like just about everyone to be able to do at least 12 times in 30 seconds. If you can get up to 15, brilliant — but as a minimum, everyone should be hitting 12. If you’re not, it means you’re probably lacking strength in your quads and glutes.
The other test is to see whether you can get up and down from the floor — without using someone’s help or grabbing hold of anything — within 10 seconds. So, you start by standing, get down on the floor, and try to get back up. You can use your hands, but don't use any furniture to help you.
