Glute strength reveals aging risk, experts say

While gray hair and wrinkles are common markers of aging, physical rehabilitation specialists focus on a different indicator: the glutes. These muscles determine whether an individual can rise from a seated position steadily. More than one in four Americans over 65 experience a fall annually, yet fewer than half report these incidents to their physicians. For many, such falls signal underlying changes in strength, balance, or mobility.

The role of leg muscles

Scott McAfee, an orthopedic physical therapist, describes legs as "the engine of independence." They facilitate rising from chairs, stabilize the body during weight shifts, and maintain upright posture during movement. A 2014 study published in BMC Geriatrics examined 58 adults over 65 who had fallen within the previous year compared to those who had not. While muscle changes appeared throughout the lower body, the glutes showed the most significant deterioration. Among those who fell, fat content in the gluteus maximus was double that of non-fallers. Researchers suggested these alterations may contribute to reduced balance and increased fall risk.

Assessing functional strength

To evaluate this muscle group's capability, McAfee employs the 30-second chair stand test. Participants cross their arms and repeatedly stand up and sit down within thirty seconds. The count matters, but so does the form. "A fit 62-year-old woman knocking out 18 is in great shape," McAfee noted. Conversely, if the same woman manages only nine or ten repetitions, it indicates a climbing fall risk. If a person must push off their thighs or armrests to stand, the score drops to zero, marking them as automatically high-risk.

The descent phase also provides critical data. "A strong mover lowers under control, while a rising fall risk drops the last few inches into the seat because the muscles that decelerate the body are already failing," McAfee explained. He monitors the downward motion with the same scrutiny applied to the upward movement.

Observing movement patterns

Priyank Patel, a Brooklyn-based chiropractor treating older adults for hip, low back, and gait issues, examines trunk and hip mechanics during the standing process. "If they pitch their torso forward a lot to get momentum going, that tells me their quads and glutes aren’t generating enough force on their own, so the body is borrowing momentum instead," Patel stated. Asymmetry serves as another warning sign. Patel looks for instances where one hip hikes up before the other or the knee wobbles inward during the rise.

Stabilization during weight transfer represents another key function of the glutes. Austin Misiura, an orthopedic physical therapist, tests this alongside rising ability. His protocol requires patients to get down to the floor and back up without using hands, followed by balancing on one foot. This floor-rise assessment captures mobility deficits that the chair stand misses. "For the chair stand there’s almost no mobility requirement," Misiura said. He added that the mobility component of the floor stand is largely absent from other standardized tests, which typically assume standing or sitting positions offer little insight into actual mobility.

Detecting hidden instability

Misiura argues these tests reveal more than simple observation of walking. "People walk all types of ways, and change how they walk based on being tested," he observed. The true limitation appears when individuals cannot compensate. Clients often resist getting on the floor or require immediate assistance. When standing, these same individuals may move slowly and close to the ground, employing a shuffling gait to place their feet quickly.

Dr. Alexander Acosta, a physician and medical consultant with SonderCare, highlights turning movements as diagnostic tools. "A turn is a move that causes someone to place load on one leg for a moment, revealing balance and strength," Acosta said. He notes that sicker patients cannot disguise these deficiencies. Acosta counts the steps required to complete a full rotation. Healthy adults typically take three or four steps. Attention increases when five or more steps are needed, or if the patient reaches for a wall or chair. One patient required six steps and hand support on a wall for a single turn. "The difference between four steps and six isn’t subtle once you know what to look for," Acosta added.

Home testing guidelines

Experts recommend several at-home assessments, advising caution and having someone nearby to stop if dizziness occurs. First, perform the 30-second chair stand. According to Centers for Disease Control and Prevention scales, men in their early 60s should achieve at least 14 stands, while women should manage at least 12, with expectations decreasing each decade. Monitor for arm usage during ascent and control during descent.

Second, attempt to get down to the floor and back up safely without using hands or furniture. Third, balance on one foot with eyes open, aiming for 10 seconds on each side; losing balance in the first few seconds warrants attention. Finally, stand by a door frame and turn a full circle, counting steps. Acosta emphasizes that completing this in three or four steps is standard, while five or more steps or grabbing the wall signals potential issues.