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The Protective Power of Barbell Training in Older Adults
In this episode of the Progressive Rehab & Strength Podcast, Dr. Rori Alter and Dr. John Petrizzo break down how strength training allowed a 75-year-old barbell trainee to avoid inpatient rehab after fracturing both her hip and wrist. Her story is a testament to how barbell training preserves function, independence, and quality of life—even after serious injury.
“The stronger you go into these sorts of situations, the better off you're going to be—because you're going to have more lean body mass, more muscle mass, more bone mineral density… So that if you lose some of it, you’re not going to be as negatively impacted as someone who has low levels going in.”
– Dr. John Petrizzo, PT, CSCS, PRSCC, SSC
Key Topics Discussed
The role of strength training in rehab for older adults
How physical therapists and orthopedic surgeons can safely use barbell exercises
Adapting barbell training during recovery from fractures and surgery
The benefits of building “physiological reserve” through strength
Strategies to maintain training with one-sided injuries
Using machines, bands, and unilateral work as part of barbell-based rehab
Key Takeaways
Strength training can prevent the need for inpatient rehab
You can apply progressive overload without a barbell
Barbell lifts can be safely modified in rehab
Muscle and bone strength serve as protection, not risk, as we age
0:00 – 1:39 – Episode intro + Pat’s story setup
1:40 – 5:00 – Pat skips inpatient rehab after hip + wrist fractures
5:00 – 9:30 – Strength training keeps older adults independent
9:30 – 10:50 – Rehab often unnecessary if strong enough
10:50 – 13:18 – Medical disclaimer + conceptual discussion
13:19 – 17:00 – How to train lower body post-fracture
17:01 – 22:00 – How to train upper body with one arm
22:01 – 25:00 – Applying progressive overload in rehab
25:01 – 30:00 – Healing timelines + early rehab mobility
30:01 – 35:00 – Managing PT visits + training around insurance limits
35:01 – 41:00 – Transitioning from rehab to barbell training
41:01 – 45:00 – Strength as physiological reserve in aging
45:01 – 52:00 – Doctors dismissing lifting + final takeaways
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Email: podcast@progressiverehabandstrength.com
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[00:00:00] Dr. Rori Alter, PT, PRSCC: Alright guys, welcome back to the Progressive Rehab & Strength podcast. I'm your host, Dr. Rori Alter, head clinical coach here at Progressive Rehab & Strength, with my lovely husband, also a clinical coach here at Progressive Rehab & Strength. We're both physical therapists. This question that today we're actually doing one of our questions for our Q&As. And this question is really a pretty awesome one and it's not really along the lines of a power lifter. It kind of ties in the actual outpatient and acute care setting into barbell training and all that kind of stuff. So it's exciting. Alright. So this question that we received is a very special question because I think it really shows us how strength training is very important as we age, and how it can also be used in the rehab setting for the aging population. And so this question comes from not a client of PRS, but a long time follower of PRS who actually has taken some of our courses and she is a 75 year old barbell trainee. She's been barbell training for about ten years, and she sustained a wrist fracture and a hip fracture in March because of some sort of incident with a dog. I'm not really quite sure. I think the dog was coming at her or something like that and she fell and fractured two areas of her body and ended up in the hospital and was discharged relatively quickly to home.
[00:01:39] Dr. Rori Alter, PT, PRSCC: So when we think of a 75 year old who has fallen, whether it's just a trip and fall or you're getting attacked by a dog or scared by a dog, a lot of the times with these injuries, you'll end up staying in the hospital for a bit longer. You might have to go to rehab, especially if you're non-weight bearing, or you can't use a leg and you can't use an arm. A lot of people can't just go home after that, especially at 75 years old, but Pat did not qualify for rehab, so she went straight home. So I think that's a testament to really how protective strength training is and why strength training is really important as you age. So props to Pat for being strong and being able to handle this unfortunate circumstance much better than a lot of 75 year olds would handle it. But she reached out to us to ask about how she can stay strong and continue to strength train or get back into strength training during or after the rehabilitation process with this injury. So just a little bit about it, so like I said, she's 75 years old, she fractured her left hip and her left wrist. Both the radius and the ulna were fractured and she had surgery. I believe the surgery was on her arm the same day. And she's weight bearing as tolerated, meaning she can put weight through that fractured leg, but she cannot put weight through her upper extremity because of the surgery that she had.
[00:03:18] Dr. Rori Alter, PT, PRSCC: She was discharged home after three days, but didn't go to rehab. And she's currently using a walker but progressing towards a cane. And hopefully obviously the goal would be to not use any assistive device after she's fully rehabbed. And she said that she's not really having much pain. She's having more pain in her wrists than in her hip, which makes sense, because she had surgery on the wrist. So that fracture was probably pretty bad and unstable. And she gave us a little bit of info about her former working weights where her deadlift was about 120 pounds, her squat was about 55 pounds, overhead press 40 pounds, and her bench press 55, which is funny because her bench and her squat are very close together, and I actually see that a lot in the older population, especially when they've started barbell training much later in life in the later decades. A lot of times their squat and their bench press are pretty similar. Okay, so, John, one thing, her goal, like I said, is to integrate barbell training into rehab and ultimately stay strong through this process and not let the injuries deteriorate her as they would for many people who don't barbell train or don't go into these types of injuries with strength as their foundation. So, John, what are your initial impressions about this lovely woman?
[00:05:00] Dr. John Petrizzo, PT, CSCS, SSC: Well, just to kind of reiterate some of the things that you said, the fact that she's 75 years old and had a hip fracture on top of a wrist fracture and didn't have to go to rehab says a lot about her just general health and physical capability because typically rehab is a place that you go because you're not healthy enough or well enough to go back strong enough, right? You're not physically capable of being safe in your own home, of being able to navigate in your own home. So rehab is kind of this intermediary between the hospital and being discharged home. So the fact that it's 75 with those injuries, she's able to go right home, I think says a lot about her.