The first article in this series [January 2026 issue] discussed the chiropractic approach to squaring off the geriatric aging curve: the steps to reduce the steady decline in vitality that occurs with aging. The research is clear that strength, agility, flexibility, and cardiovascular fitness are all synonymous with longevity. Now let’s discuss seven low-tech exercises to promote lifegevity – squaring off the geriatric curve.
#1: Sit to Stand
The five times sit-to-stand test is a recognized biomarker of strength and fitness. In addition, the movement pattern of sitting to standing, when performed correctly, is the same as the ascent phase of a back squat, a foundational exercise for athletics and fitness. This makes the sit-to-stand a foundational exercise for life.
Technique is paramount here, as in a back squat. Feet are hip-shoulder width apart and the drive for the ascent comes from the hips, while maintaining the torso erect. Technically, the tibia and torso sagittal plane lines must be parallel. Torso flexion is to be avoided at all costs, as this loads the lumbar discs significantly.
In the descent phase the hips lead the motion, eccentrically loading the posterior chain with the buttocks just barely touching the chair behind the patient at the bottom. Do not allow the patient to flop back into the chair. In addition, the eyes should look forward (maybe slightly up), chest up, weight balanced, and knees tracking directly over the feet, which are also facing directly forward. It is a traditional back squat but without the bar and external load.
Relevant Tip: Deconditioned patients often lean forward to stand in lieu of driving from their hips. This abnormal movement pattern leads to and perpetuates back pain. To regroove this movement pattern, have the patient perform this exercise at chair height, where they will be successful in ascending and descending with optimal mechanics and control.
#2: Single-Leg Stance
Fall prevention is paramount for everyone, especially as our patients age. The starting point to train better balance is the single-leg-stance exercise. The goal is to be able to stand on one leg, eyes open, for 20 seconds without holding on. It is that simple.
However, balance also includes sagittal-plane alignment; therefore, standing on one foot while maintaining the sagittal plane plumb line from the ears though the shoulders into the hips would be ideal.
The patient should do it somewhere safe, such as close to a wall, alongside a high counter, next to a railing; somewhere the patient can stabilize immediately if needed. As in the sit-to-stand, successful performance is essential, so in the beginning a finger touch is allowed for stability.
Relevant Tip: The single-leg stance is best performed without shoes. If in the beginning wearing shoes is required to be successful, start there, with the goal to move to stocking feet. Patients who wear corrective pedal orthotics will have more difficulty without their orthotics and shoes.
#3: Single-Leg Quarter Squat
The sit-to-stand exercise is a full-bodyweight foundational exercise. Once the patient can control the ascent and descent from the height of a normal chair (approx. 23”), you can add load. Holding dumbbells in each hand is a good choice since grip strength is directly related to longevity. However, standing on one leg and doing a ¼ squat is the same as walking upstairs or a curb.
Therefore, as soon as the patient can, progress them to single-leg ¼ squats. Not only is this functional; it also is an excellent way to increase load.
Relevant Tip: The load in a single-leg squat is about 84% of bodyweight versus the load in a double-leg squat, which is closer to 68% bodyweight on each leg. Therefore, for a 150-lb person, a single-leg squat equals 126 lbs on the stance leg without adding external weights. If 10 lb dumbbells were to be added in each hand (20 lbs total), the load increases to 142.8 lbs in a single-leg squat. All with no spinal compression and enhanced grip strength.
#4: Single-Leg Stance, Eyes Closed
Eyesight is a component of balance, and removing visual input increases the risk of falls. To offset this risk of falling in low-light conditions or when the patient may not be looking directly ahead, the single-leg stance is performed with the eyes closed. The goal here is 10 seconds, eyes closed, stocking feet and no holding on. This is an exercise progression from the single-leg, eyes-open stance and is introduced once the patient can perform 20 seconds of the eyes-open version.
Relevant Tip: Slow high-knees walking is a good transition exercise from single-leg stance eyes open to eyes closed. Another transitional exercise option is to reduce the amount of light in the room when doing the single-leg stance with eyes open.
#5: Floor Get-Ups
Every exercise discussed so far has a component of fall prevention. However, it happens, and once on the floor, trying to figure out how to get up can be a real problem for the deconditioned patient.
As an exercise, it is simply getting up off the floor. Using a chair, couch or bed for assistance is acceptable to start, and maybe the patient only arises from a kneeling position. However, the goal is to lie both supine and prone and arise from the floor without using hands or an aid. Athletes use Bulgarian get-ups for total-body strength and agility; aging patients simply get up.
#6: Cat Camel Pose
The traditional yoga exercise, cat-camel posture, is excellent for spinal mobility. It also helps with floor get-ups, too. However, train the patient to observe good spinal hygiene and alignment while performing the cat camel. The starting position has the hips and knees at 90 degrees and the arms directly under the shoulders.
In the cat position, be sure the patient tucks the chin and sacrum, flexing the entire spine and slowly reversing the entire spine in the camel position to extend each spinal segment, with an emphasis on extending the thoracic spine. Have them hold each position for 20 seconds or more and breathe into the posture.
Relevant Tip: Patients who cannot maintain a quadruped position should not do the cat camel. For spinal mobility, in addition to CMT, a similar motion can be performed seated and/or standing. Seated spinal twists with breathing as a muscle energy technique are another option.
#7: Wall Angels
Forward-head posture, rounding of the shoulders and increased thoracic kyphosis are epidemic postural distortions of our day. In addition, gravity is not our friend as we age. Over time we all collapse on ourselves from the combined effects of disc desiccation, sarcopenia, previous injuries, and lifestyle. The wall angel exercise is excellent to ward off these progressive changes.
The patient stands against the wall with their heels, hips, back, shoulders, and head all touching the wall. If this is not possible, then a rolled-up towel or pillow can be placed in the area that has a gap from the wall.
The patient then brings their arms into 90 degrees of both shoulder and elbow flexion with the triceps against the wall. At that point instruct the patient to externally rotate their arms to hopefully touch the wall with their forearms and wrists (hostage position). While maintaining contact with the wall at all of the above checkpoints the patient reaches to the ceiling as far as possible and then depresses the elbows into a “w” position. Hence the name: wall angels.
Relevant Tip: The regression of wall angels is to have the patient lie supine, knees bent and a pillow under the head if needed. Follow the same movement progression as when standing. Start in hostage position, sliding the hands along the floor overhead and then downward, bringing the elbows into a “w” position.
Clinical Pearls
The importance of lifegevity hits a patient when they have the revelation that they will not be able to increase performance in sport, recreational activities or work. Often shrugged off as “aging,” it is left unchecked until they cannot do ADLs like stair climbing, arising from a low couch, balancing themselves, or carrying groceries from the car. Often lack of strength and mobility is stacked with chronic postural aches and pains and postural distortions, leading to a declining aging curve.
Talk to your patients about lifegevity and teach your aging patients these simple exercises. Progress them in these exercises just as you would with any exercise prescription, and encourage them to be consistent.
Squaring off the geriatric curve takes consistent effort, it is not a one-and-done process by any means. Encourage them to stay ahead of the geriatric curve with simple activities related to movement, function, strength, stability, and balance. Stack movement and motion with the lifestyle factors discussed in the first article in this series and enjoy a practice full of patients training for lifegevity.
Resources
- Bohannon RW. Grip strength: an indispensable biomarker for older adults. Clin Interv Aging, 2019 Oct 1;14:1681-1691.
- Izquierdo M, et al, Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR). J Nutr Hlth Aging, 2025 Jan;29(1):100401.
- Thornton JS, Morley WM, Sinha SK, Move more, age well: prescribing physical activity for older adults, CMAJ, 2025 Jan 27;197:E59-67.
