ACERCA DE ESTE EPISODIO
In a dusty square in Kathmandu, men waited for minibuses in a deep squat. I took those minibuses to the hospital, where I worked in traumatology, and began wondering why I rarely used that position myself.
Years later, during an hour's wait outside an embassy with my family, I was the only person in the queue squatting.
This episode of Under Load looks at mobility as we age, with a practical question for anyone whose working week involves a lot of sitting: which everyday movement do you want to keep being able to do?
I discuss how flexibility, strength and balance contribute to getting into and out of a position. The LIFE trial gives us evidence about preserving walking ability in older adults with physical limitations. Stretching studies help estimate how much practice may be useful, although much of that evidence comes from younger adults.
The episode covers the estimated ten minutes of stretching per muscle group each week, why that estimate needs care, and what researchers mean by tissue stiffness and stretch tolerance. I also look at resistance training's effects on flexibility and the limits of the comparisons between different training intensities.
The practical section contains a supported squat, a hip-flexor stretch, a calf stretch and a supported one-leg stand. The sequence and starting amounts are my recommendation; the exact routine hasn't been tested as a package. I explain how to begin with support and observe progress without making every session harder.
The closing question is about the movement you've started avoiding. That gives the practice a purpose you can recognize outside an exercise session.
[Visit The Upward ARC and subscribe](https://www.andreheeg.com).
Under Load is the Sunday edition of The Upward ARC, by Andre Heeg, MD, DDS, physician and reconstructive facial surgeon. This edition sits within Activate, with Capacity as the reason to continue.
Key sources:
- [Pahor et al., 2014, JAMA](https://doi.org/10.1001/jama.2014.5616): the LIFE randomized trial of structured physical activity and walking disability in older adults.
- [Guirguis-Blake et al., 2024, JAMA](https://doi.org/10.1001/jama.2024.4166): exercise interventions and falls in older adults.
- [Ingram et al., 2025, Sports Medicine](https://doi.org/10.1007/s40279-024-02143-9): static stretching dose and flexibility.
- [Oba et al., 2026, Sports Medicine – Open](https://doi.org/10.1186/s40798-026-01066-1): age and other characteristics in stretching adaptations.
- [Ingram et al., 2025, Sports Medicine](https://doi.org/10.1007/s40279-025-02204-7): possible mechanisms behind changes in range of motion.
- [Favro et al., 2025, Journal of Strength and Conditioning Research](https://doi.org/10.1519/JSC.0000000000005000): resistance training and flexibility.
- [NHS balance guidance](https://www.nhs.uk/live-well/exercise/balance-exercises/) and [strength guidance](https://www.nhs.uk/live-well/exercise/strength-exercises/): supported starting exercises and gradual progression.
Audio note
Andre reads the written newsletter, adapted for speech. Some figures are rounded and inline citations are omitted. The written edition contains the full references and exact reported figures.
Medical note
This episode provides general education. Adapt exercise to your health and current ability. Stop for pain, numbness or tingling. Recent surgery, restricted joint replacements or recurrent falls call for individual guidance from your clinician or physiotherapist.
