by Dr Sasha Nair (Endocrinologist and yellow belt at Auckland Seido Karate Club)
Beginning a new exercise programme in your 50s, 60s, or beyond is one of the most powerful investments you can make in your long-term health. Movement supports strength, balance, heart health, bone density, mood, and independence — and many people rediscover confidence, community, and joy when they return to physical activity later in life.
As we grow older though, it’s also important to know that certain health factors can change quietly in the background, sometimes without any noticeable symptoms. Bone density, muscle mass, balance, heart health, nutrition, and medications can all influence how safely and comfortably someone begins or progresses with a new activity. Understanding these factors helps to make the transition into exercise both safer and more rewarding. Here we highlight the essentials to consider when beginning a new exercise programme later in life.
1. Why Your Health Changes With Age: An Endocrine Perspective
Bone Density & Hormones
- Hormonal changes happen to everyone with age.
In women*, declining oestrogen after menopause can contribute to gradual bone loss.
In men*, testosterone naturally decreases, affecting bone and muscle strength.
These shifts are normal and simply explain why training may need small, thoughtful adjustments. - Medical conditions such as thyroid disorders, coeliac disease, or autoimmune conditions can also influence bone strength.
Bone loss is often silent. Sometimes the first sign is a fracture after a relatively minor fall.
Muscle, Balance & Reaction Time
It’s normal to experience changes in strength, reaction speed, and balance with age — but the encouraging reality is that all of these respond extremely well to regular practice, progressive training, and good recovery. Improvements can be seen at any age.
Under-Fuelling & Low Body Weight
Low body weight (BMI <20) or unintentional weight loss can weaken bones and reduce muscle strength. Some people unintentionally under-fuel when they begin new exercise.
A nutrition review can help ensure you have:
- enough protein
- adequate energy for training
- stable, safe weight
- the nutrients needed for strong bones
*assigned at birth
2. A Doctor’s Check: A Helpful Starting Point
A quick check-in with your GP before starting a new activity can provide reassurance and help identify anything that may benefit from small adjustments. This shouldn’t feel like a barrier to getting moving!
Your doctor is likely to review:
- any history of fractures
- heart or breathlessness symptoms
- dizziness or balance concerns
- medications affecting bone strength or stability
- any recent unintentional weight loss
Reviewing these can clarify whether any simple adjustments are needed and give you a clear starting point for beginning exercise safely.
3. What Older Adults Should Know Before Exercising
Why Bone Health Matters
Bone strength naturally changes over time and often without obvious symptoms. Many wrist, shoulder, spine, and hip fractures in adults over 50 occur after low- or moderate-impact events. A simple trip, slip, or awkward landing during karate, dance, gardening, or even everyday activities can lead to injury if bone density has reduced.
Understanding your bone health helps you start or progress with exercise safely and confidently.
Should you get a DEXA (bone density) scan?
A DEXA scan may be recommended if you:
- are over 50 and starting a new or higher-impact activity
- have had a fracture from a low or moderate fall
- have thyroid disease, rheumatoid arthritis, coeliac disease, or inflammatory bowel disease
- have a BMI <20 or unintentional weight loss
- use medications that can weaken bones (e.g., long-term steroids, aromatase inhibitors)
For women*:
- early menopause
- surgical menopause
- chronic low-oestrogen states (e.g., hypothalamic amenorrhoea from under-fuelling or intensive exercise)
In Aotearoa NZ, DEXA is also commonly considered when:
- women* are 65+, or
- men* are 75+,
especially when additional risk factors are present.
A fragility fracture (a fracture from a minor impact) warrants a DEXA at any age.
Your GP can arrange the initial DEXA scan and review the results.
If the scan shows low bone density or you have had a low-impact fracture, your GP may refer you to an endocrinologist — for example, to us at ERH Associates — for further assessment and long-term bone-health planning.
*assigned at birth
4. Heart Health: A Core Part of Safe Training
Exercise is excellent for cardiovascular health — but certain symptoms need review first.
Red flags that warrant medical assessment:
- chest pain or pressure with exercise
- unexplained breathlessness
- dizziness or fainting
- irregular heartbeat/palpitations
- untreated or uncontrolled high blood pressure
- circulation issues (e.g., severe varicose veins or peripheral vascular disease)
These doesn’t mean you can’t participate, but it is important to have clear guidance from your doctor about any cautions or restrictions needed for your safety.
5. Balance, Mobility & Falls Prevention
Balance naturally declines with age due to:
- reduced muscle mass
- slower reflexes
- medication side effects
- sensory changes (vision, hearing, proprioception)
The good news: balance improves significantly with training.
Martial arts, tai chi, yoga, dancing, and strength training can all help to reduce fall risk.
For martial arts and similar activities, learning falling and rolling techniques early can also be helpful.
6. Strength Training Supports Healthy Ageing
Strength training can be a valuable addition to any exercise routine as we get older. Even light or bodyweight exercises, done once or twice a week, help improve:
- muscle strength
- balance
- bone density
- joint stability
Starting with manageable movements allows your body to adapt safely and build confidence over time.
For structured support specifically aimed at improving bone density, the team at OSSIS offer supervised classes using the LIFTMOR protocol. This protocol has showed in studies that targeted, weight-bearing resistance training can increase bone density in midlife and older adults. Because LIFTMOR involves heavier resistance exercises, it should only be undertaken with trained supervision to ensure safe progression and correct technique. If you’re interested, ask your doctor if the Ossis program might be suitable for you.
7. Prioritise Recovery
When you’re starting a new activity, your body may need a little more recovery time than you’re used to between sessions. Good sleep, balanced nutrition, and staying well hydrated all help support training and reduce injury risk
8. Nutrition for Safety and Performance:
Nutrition is important at all ages. To support healthy bones and effective exercise pay attention to:
- adequate protein
- enough calories to prevent muscle loss
- calcium-rich foods (dairy, fortified milks, leafy greens)
- vitamin D from sunlight or supplements when needed
If you have a low body weight or tend to lose weight easily:
checking in with a dietitian can be really useful. They can help you:
• maintain a healthy weight and avoid unintentional weight loss as you become more active
• fuel to support your training
Low body weight can affect bone health, but addressing it early helps with fracture prevention.
See our other article on fuelling here
10. Past Injuries: What to Check Before You Start
If you have previous or lingering injuries — especially involving the back, hips, knees, shoulders, or ankles — it’s a good idea to have these reviewed before starting a new activity. Your GP or physiotherapist can assess whether the injury has fully healed and whether you need any movement modifications.
If you would prefer to see an exercise specialist, Axis Sports Medicine has Sport and Exercise Physicians, Physiotherapists, Orthopaedic Surgeons, Occupational Therapists, Dietitians, and other specialists who provide care for injuries, exercise readiness, and concussion assessment.
11. Final Thoughts: It’s Never Too Late to Start!
You can build strength, flexibility, confidence, and bone health at any age.
Starting exercise carefully, checking in with your doctor before hand if needed, and working with instructors who value safety to create a supportive foundation for progress. Whether you choose karate, tai chi, walking, pilates, or resistance training, the goal is the same: move confidently and enjoyably for life.
With the right preparation, the years ahead can be some of your strongest.
Acknowledgements
This article has been developed in collaboration with Jun Shihan Lou Wickham of the Auckland Seido Karate Club, to support their Master’s Class programme (you’re never too old to be a ninja!).
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