The Pain Exchange

Ageing Exercise and Immunity



By Sharon Morgans 

References for facts and figures in this blog are taken from an article written by Helen Thomson in the New Scientist dated April 18th   2020, and from a lecture for The Academy of Medical Sciences given by Professor Janet Lord who is a professor in Immune cell biology at the University of Birmingham


As individuals we all vary greatly in our love of exercise. Some of us do not like exercise in any shape or form and at the other end of the spectrum, some of us are rather fanatical about it.

There are many reasons why we might not be keen on exercise. Pain experience is one of the factors that can reduce our enjoyment of exercise and result in a more sedentary lifestyle. This blog seeks to help those who fall into this category.


Over the last 150 years average life span has been increasing but this has not been mirrored by average life health. Some data indicate that, on average women experience poor health over the last 19 years of their life, whilst men experience poor health over the last 16 years of their life. 

Questions that we are exploring in this blog are: -

1. What happens to our musculoskeletal system as we age?

2. What happens to our immune system as we age?

3. Is ageing affected by exercise?

4. What exercises can we do if we suffer from persistent pain and long-term conditions?


There is evidence to show that we start to lose 5% of our muscle mass every decade from our 30s and this process seems to speed up once we hit our 70s. During ageing our muscle fibres change, the muscle fibres that help us bear loads for short periods are replaced by muscle fibres that are more efficient over longer periods. In addition as we age our muscles become less efficient at repair with injury and recovery post activity. 

These changes are triggered by several factors including: - alteration in hormone levels such as testosterone and by reorganization of brain cells that control movement.

For a longtime we have known that the strength of our bones diminishes, as we age and you may be familiar with the terms osteopenia and osteoporosis. The strength of our bones is governed by many factors. Osteoporosis is a condition where our bones are weakened and we are more at risk of breaks. Simply put our bones weaken when the rate of bone cell death exceeds the rate of new bone cell formation.


The purpose of the immune system is to

1. Detect and kill infections; viruses, bacteria, fungi and parasites

2. Kill or remove damaged, old or changed cells

3. React better when it encounters infection for a second time (immune memory)

4. Not damage itself (auto immune response)

As we age (over 75) there is evidence that we are more prone to infections and less able to fight them. Our response to vaccination is less marked, our immune memory fades and we are more likely to develop autoimmune conditions.



In a study that looked at keen cyclists aged between 55 and 79, results indicated that compared to a less active similar age group they did not loose muscle mass, their body fat did not increase. They maintained the cells that fight infection and the cells that store a memory of how to fight infection. However aspects of the ageing immune system that did not change in the cyclists was the part of the immune system that make us more likely to develop auto immune disease.


Studies that have looked at the effects strength exercises have shown that strength exercises reduce the risk of osteoporosis by stimulating bone cell growth. A study that investigated the effect of strength exercises performed twice per week over a 14-week period in residents living in a nursing home.  Showed that overall strength increased by 60% .The impact of this was demonstrated by improved independence, one measure was an improved ability to get the bathroom independently.


Age related diseases include, cancer, cardiovascular disease (heart), Alzheimer’s, osteoarthritis, diabetes and blindness.

Is there any evidence to suggest that exercise and in particular strength exercise can reduce the risk of developing these age related diseases?

The answer is yes; there is some evidence that having stronger muscles reduces the risk of cardiovascular disease, type 2 diabetes and the risk of cancer. There is stronger evidence to suggest that strength training can improve memory and prevent cognitive decline. 


The current guidelines in the UK indicate that we should aim for 150 minutes of aerobic exercise per week and 2 sessions of strength exercises per week. 

This I am sure could feel quite daunting and even impossible for those for whom exercise and activity result in an increase in pain experience.

Age and circumstances (including pain experience) influence the amount of aerobic exercise and strength exercise that are possible.

It is my belief that life is about balance and context. I firmly believe that doing some form of physical activity is better than nothing. There are many ways of maintaining physical and mental performance if we are living with long-term conditions and persistent pain.

If you are living with a long term condition and persistent pain remember  

Staying active is good for my body and my brain

And consider 

What does staying active look like in my current situation?

Ways to stay active 

Find something that you enjoy or something that helps maintain independence or gives you a sense of achievement

Staying active can include walking, gardening, shopping, dancing, exercise class, swimming, marching on the spot, sitting and marching.

Or staying active might mean being able to continue with activities of daily living, dressing, bathing, cooking, feeding, getting on/off chair and in/out of bed, climbing stairs.

How much should I do?

An amount of activity, that causes a comfortable increase in rate of breathing. Make a note of how long you can do an activity before your breathing rate increases.

Try to do this every day or aim for 3-4 times per week. 

The activity that you choose should be relevant to your ability. 

Ideas might be marching on the spot in standing for others it might be marching on the spot in sitting or for others it might be walking or jogging or cycling, Choose the level of activity that is achievable for your current level of ability.

Any activity that causes your muscles to feel tired will result in an improvement in strength Studies show that exercise that makes your muscles tired performed 2-3 times per week results in an increase in strength.

The number of repetitions possible to point of fatigue will vary depending on your current level of strength. Explore this for yourself or ask for some guidance from your physiotherapist.

You can expect aching in the muscles that get tired this is a normal response of a muscle to strength training. 

Exercise that takes you into a pain experience that is not related to muscle aching but results in a marked increase in your particular pain experience is not the desired outcome. In this case re think your activity and the amount.

But I can’t do any activity without experiencing pain, what can I do?

There is some evidence to suggest that imagining movement and imagining performing strength exercises can improve muscle strength and in some cases reduce pain experience. Why not try imagining a favourite activity or exercise for a few minutes every day.