The Prime Five: Your Path to Lifelong Fitness and Health

What is the Prime Five?

Maintaining fitness is crucial for living a long, healthy, and functional life. But where do you start?

Enter the Prime Five: Endurance, Strength, Balance, Flexibility, and Skillful Movement Integration. These five pillars form the foundation of what Science of Falling (SoF) believes creates a well-rounded fitness routine that promotes both healthspan and longevity. By focusing on these areas, you can enhance your quality of life and stay active well into your golden years. After all, what’s the point of living to one hundred years old if the last twenty years are spent confined to a bed. With the Prime Five we can make those last few years some of the best you have ever had!

In this article we are going to breakdown what each pillar of the Prime Five is, why its important, and give you some tips to start your health journey right away. And as a way to help you kickstart your journey even faster, I’ve added a sample week workout plan at the very end!

Endurance

Definition and Importance:

Endurance refers to the ability of your heart, lungs, and muscles to work efficiently over an extended period. Cardiovascular endurance, in particular, is linked to reduced risk of chronic diseases like heart disease and diabetes. (1) There is also evidence that individuals with higher levels of cardiovascular fitness have a significantly lower risk of mortality. For example, a study published in the Journal of the American College of Cardiology found that runners had a 30% lower risk of all-cause mortality and a 45% lower risk of cardiovascular mortality. (2) This means that incorporating regular cardio workouts can significantly improve your longevity.

Practical Applications:

Engaging in activities like running, cycling, or swimming can significantly boost your endurance and enhance your daily life capabilities. Improved cardiovascular health is linked to a longer lifespan, allowing you to enjoy more precious moments doing what you love with the people you cherish. Instead of feeling held back by physical limitations, you'll find yourself empowered with the choice to participate fully in life's activities. No more "I can't keep up"; instead, you'll confidently say, "I choose to join in!"

Tips and Recommendations:

• Starting Out: Begin with low-to-moderate intensity activities for 20-30 minutes, 3-4 times a week. Walking is a great starting point if you're new to endurance training.

• Progression: Gradually increase the duration and intensity as your fitness improves. For instance, you could start with brisk walking, then progress to jogging, and eventually running.

• Frequency: Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week, as recommended by the CDC. Incorporate different types of cardio exercises to keep it interesting and challenging.

Strength

Definition and Importance:

Strength training involves using resistance to build muscle mass and strength. This is essential for metabolic health, bone density, injury prevention, and being able to handle more rigorous physical activity. As we age, we naturally lose muscle mass at roughly 1-2% per decade after the age of 50 years old in a process known as sarcopenia. (3) Strength training helps counteract this loss, maintaining muscle mass and function well into the later years of life. (4, 5, 6) Additionally, according to a study in British Journal of Sports Medicine, strength training at least twice a week is associated with a lower risk of all-cause mortality. (7)

Practical Applications:

Incorporating exercises like weight lifting, bodyweight routines, and resistance band workouts can significantly enhance your overall physical capabilities. Increased strength translates to greater ease in handling life’s daily challenges, such as carrying groceries, getting up from the couch, managing a large dog, helping a friend move, or simply enjoying your favorite physical activities. By building strength, you'll be better equipped to face these tasks with confidence and energy.

Tips and Recommendations:

• Starting Out: Start with basic bodyweight exercises like squats, push-ups, and lunges. Focus on proper form to prevent injuries and build a solid base of control. Start with 3-4 basic exercises with the goal of performing 3 sets of 6-12 repetitions each.

• Progression: Increase the weight or resistance as you get stronger using various weighted implements or modifying your body position. Aim to progressively overload your muscles by gradually increasing the difficulty of your workouts. You should be aiming to exhaust yourself between 6-12 repetitions in a particular set of an exercise before increasing the difficulty.

• Frequency: The American College of Sports Medicine recommends strength training at minimum twice a week, targeting all major muscle groups. (8) Ensure you allow adequate recovery time between sessions for muscle repair and growth.

Balance

Definition and Importance:

Balance is the ability to maintain your body's center of gravity over its base of support. As we age, our balance can deteriorate, increasing the risk of falls and related injuries. Balance problems can begin as early as your 50s but may be covered up by compensatory patterns making them go unnoticed. (9) Improving balance not only helps prevent falls but also enhances coordination and athletic performance. (10, 11)

Practical Applications:

A lack of balance and the resulting falls are the most common issues I treat in my older patients. Balance exercises, such as single-leg stands, tai chi, and using a balance board, can significantly enhance your stability and reduce the risk of needing assistive devices or moving to an assisted living facility in your later years. By incorporating balance exercises into your routine, you can maintain your stability, prevent injuries, and create a solid foundation to express the other Prime Five skills effectively.

Tips and Recommendations:

• Starting Out: Begin with simple exercises like standing on one leg. Hold onto a chair or wall for support if needed.

• Progression: Incorporate more challenging movements, such as using a balance board, tandem walking, or performing balance exercises while performing other tasks. Try progressing to single-leg deadlifts or similar dynamic balance exercises as able. My personal favorite is setting a time for 10 minutes and freestyling on a balance beam.

• Frequency: Practice balance exercises at least 3 times a week to start. Build up to 10 minutes everyday as you find a rhythm. Consistency is key to improving and maintaining balance.

Mobility

Definition and Importance:

Mobility is the ability of a joint to actively move through its full range of motion without pain or interruption. This differs from flexibility, which refers to the ability of muscles, tendons, and ligaments to passively stretch and lengthen through a range of motion. While distinct, mobility and flexibility interact in practice. Increased mobility expands your available movement options and helps prevent compensatory movement patterns due to non-optimal joint mechanics. Maintaining mobility as you age ensures that you can move freely and comfortably in daily activities. Moreover, mobility training can help preserve athletic performance over time. Current research supports the benefits of mobility training for improving key performance variables without impairing performance​ (12) However, research on flexibility and its impact on functional ability in older adults has been inconclusive, with static stretching not shown to be a priority for aging purposes​. (13)

Practical Applications:

Mobility work, achieved through active stretching and full range of motion exercises, lays the foundation for optimal movement. Enhancing your controllable joint range of motion expands your movement options in life. Essentially, greater mobility provides more freedom and accessibility in everyday scenarios, especially when paired with appropriate levels of strength, balance, and endurance. This holistic approach ensures you can move efficiently and effectively in various situations, contributing to a more active and fulfilling life.

Tips and Recommendations:

• Starting Out: The key to mobility work is using active movement to improve ranges of motion. This can be done through a type of stretching called active stretching which has you moving through a chosen range of motion (think squatting) and holding the end range for 3-5 seconds before coming out of it and repeating for typically 10+ repetitions.

• Progression: Gradually increase the depth and intensity of your stretches as your body allows. Once progress plateaus, you've likely reached your optimal joint range of motion. At this point, focus on maintaining this ability during other exercises by emphasizing controlled, full range of motion movements. This approach will help you preserve and utilize your mobility effectively.

• Frequency: To enhance mobility, aim to perform active stretching 2-3 times per week. This can be incorporated into your warm-ups, cool-downs, or as standalone sessions. Once you achieve optimal mobility in a movement, maintain it by utilizing the full joint range of motion during your workouts. This approach ensures you preserve your mobility without needing additional exercises outside of your regular workout routine long-term.

Skillful Movement Integration (SMI)

Definition and Importance:

Skillful Movement Integration (SMI) involves combining the other four Prime Five skills for functional tasks. This holistic approach ensures you’re prepared for the physical demands of daily life. By integrating these skills, you can perform tasks more efficiently and reduce the risk of injury.

Practical Applications:

Excelling in just one aspect of the Prime Five won't significantly benefit long-term aging. Having exceptional endurance is futile if you lack the strength to stand. Similarly, possessing immense strength is useless if you don't have the balance to utilize it. And perfect balance won't help if you're too stiff and immobile to move. To live a long and functional life, you must be a jack-of-all-trades, teaching your body to use these abilities synergistically and variably to meet life's challenges. This could involve engaging in hobbies like parkour, playing sports, or everyday activities like carrying groceries or playing with your kids. Integrating these skills helps maintain them, even during times when structured exercise isn’t possible. For instance, playing a non-repetitive sport that uses both sides of the body equally requires endurance, strength, balance, and flexibility, making it a perfect example of SMI. This area of the Prime Five is where the secret sauce is for improving your overall healthspan.

Tips and Recommendations:

• Starting Out: Identify activities you enjoy that incorporate multiple aspects of the Prime Five. This could be a sport, a hobby, or a functional task.

• Progression: Challenge yourself with new tasks or increase the complexity of existing ones. Incorporate obstacle courses or functional fitness routines that mimic real-life movements. The more varied and novel the activities, the more they will enhance your movement competence and, consequently, improve your healthspan.

• Frequency: Incorporate these activities into your routine at least 2-3 hours per week. The more you practice, the more natural and effective your movements will become long-term.

The Prime Five Training Philosophy

My approach to exercise emphasizes balance, variety, and enjoyment to create a lifelong fitness habit. By integrating the Prime Five into your routine, you create a comprehensive fitness plan that’s sustainable and effective while targeting all major aspects of fitness that contribute to your healthspan. This approach ensures that you’re not only improving your physical health but also enjoying the process and building the foundations that will stick with you well into your 90s.

Combining these elements ensures a well-rounded approach to your fitness. For instance, a single workout might include a cardio warm-up (Endurance), weight lifting (Strength), single leg exercises (Balance), a fun activity like parkour (Skillful Movement Integration), and active stretching for cooling down (Mobility). This not only keeps your workouts interesting but also ensures you’re addressing all aspects of fitness with a well defined recipe.

Sustainable Practices

Make exercise a lifelong habit by listening to your body and adjusting routines as needed. Consistency is key, but it’s also important to enjoy what you do. Sometimes you might heavily emphasize one aspect of the Prime Five to achieve a major goal, such as focusing 75% of your efforts on endurance training to complete a marathon. This is perfectly acceptable and encouraged. However, it is crucial not to neglect other areas of fitness. Maintain a lower volume of work in the other areas until your goal is achieved, then shift back to a balanced focus. Incorporate activities you love and vary your routines to prevent boredom. Fitness is a journey, so explore, experiment, and celebrate small victories along the way. While aging well is the overall goal, there is no real finish line. Short-term goals can help sustain motivation.

Wrap-Up

To recap, the Prime Five—Endurance, Strength, Balance, Flexibility, and Skillful Movement Integration (SMI)—are essential for lifelong fitness and healthspan. By focusing on these areas, you can enhance your quality of life and stay active well into your golden years. Start incorporating the Prime Five into your routine today with the example weeklong workout plan below! Adjust to fit your interests and current workout routine.

If you need guidance, consider reaching out for personalized coaching through Science of Falling. Together, we can transform your current health and get you on the path to optimal aging! Remember, fitness is a journey. With the Prime Five, you’re equipped to make the most of it and enjoy a healthier, longer life. Let’s embark on this journey together and make your golden years truly golden.

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Example Week-long Prime Five Program

Goals:

• Incorporate Endurance, Strength, Balance, Flexibility, and Skillful Movement Integration (SMI) into a week routine for an introductory program.

• Keep the workouts attainable for the busy individual with the main goal of building a sustainable habit.

• Keep each workout to 30-45 minutes for efficiency, while limiting pressure to accomplish recommended frequency until more advanced on wellness journey.

Monday: Endurance + Mobility

• Warm-Up (~5-10 min): Brisk walk or light jog

• Endurance (~20 min):

  • 3 minutes running at a moderate pace

  • 1 minute walking

  • Repeat 5 times

• Mobility (~10 min):

  • Active Hamstring stretch

  • Active Quad stretch

  • Active Adductor stretch

  • Active Third World Squat (using KB for balance as needed)

  • Active Lat stretch

  • Hold each stretch for 5 seconds, repeat 10-20 times

Tuesday: Strength + Balance

• Warm-Up (~5 min): Jumping jacks

• Strength (~20 min):

  • Squats: 3 sets of 12 reps

  • Push-Ups: 3 sets of 12 reps

  • Bent Over Rows: 3 sets of 12 reps

  • Plank: 3 sets of 30 seconds

• Balance (~10 min):

  • Single-leg stands: 5 x 30 seconds each leg

  • Heel-to-toe walk: 5 minutes

Wednesday: Skillful Movement Integration (SMI)

• Skillful Movement (30+ min):

  • Parkour basics: precision jumps, rolls, falling practice, vaults

  • Functional movements: carrying objects, lifting from the ground, lying on floor to stand, gardening, chasing dog in the yard

Thursday: Endurance + Strength

• Warm-Up (~5-10 min): Light jogging

• Endurance (~15 min):

  • Interval training: 1 minute sprint, 1 minute walk, repeat 7 times

• Strength (~20 min):

  • Deadlifts: 3 sets of 12 reps

  • Bench Press: 3 sets of 12 reps

  • Dumbbell Shoulder Press: 3 sets of 12 reps

  • Bicycle Crunches: 3 sets of 15 reps

Friday: Flexibility + Balance

• Warm-Up (~5 min): Gentle active stretching

• Flexibility (~20 min):

  • Yoga flow: Sun Salutations, Downward Dog, Child’s Pose, Warrior Poses

• Balance (~10 min):

  • Tai Chi or Pilates exercises focusing on slow, controlled movements

Saturday: Active Rest + Skillful Movement Integration (SMI)

• Activity (30+ min):

  • Outdoor hike, brisk walk with family, playing with kids/dogs, gardening

Sunday: Rest or Light Activity

• Activity (Optional):

  • Light active stretching, leisurely walk

  • Focus on recovery and rest

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References

1. Physical activity and your heart benefits. www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/heart/physical-activity/benefits#:~:text=Inactive%20people%20are%20more%20likely,activity%20are%20safe%20for%20you. Published March 24, 2022. Accessed July 28, 2024.

2. Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-Time running reduces All-Cause and cardiovascular mortality risk. Journal of the American College of Cardiology. 2014;64(5):472-481. doi:10.1016/j.jacc.2014.04.058

3. Von Haehling S, Morley JE, Anker SD. An overview of sarcopenia: facts and numbers on prevalence and clinical impact. Journal of Cachexia Sarcopenia and Muscle. 2010;1(2):129-133. doi:10.1007/s13539-010-0014-2

4. Shen Y, Shi Q, Nong K, et al. Exercise for sarcopenia in older people: A systematic review and network meta‐analysis. Journal of Cachexia, Sarcopenia and Muscle. 2023;14(3):1199-1211. doi:10.1002/jcsm.13225

5. Hurst C, Robinson SM, Witham MD, et al. Resistance exercise as a treatment for sarcopenia: prescription and delivery. Age And Ageing. 2022;51(2). doi:10.1093/ageing/afac003

6. Cannataro R, Cione E, Bonilla DA, Cerullo G, Angelini F, D’Antona G. Strength training in elderly: An useful tool against sarcopenia. Frontiers in Sports and Active Living. 2022;4. doi:10.3389/fspor.2022.950949

7. Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. British Journal of Sports Medicine. 2022;56(13):755-763. doi:10.1136/bjsports-2021-105061

8. American College of Sports Medicine, Esco MR HFS, CSCS*D. Resistance training for health and fitness.; 2013. https://www.prescriptiontogetactive.com/static/pdfs/resistance-training-ACSM.pdf.

9. Hall KS, Cohen HJ, Pieper CF, et al. Physical performance across the adult life span: correlates with age and physical activity. The Journals of Gerontology Series A. June 2016:glw120. doi:10.1093/gerona/glw120

10. Brachman A, Kamieniarz A, Michalska J, Pawłowski M, Słomka KJ, Juras G. Balance Training Programs in Athletes – A Systematic review. Journal of Human Kinetics. 2017;58(1):45-64. doi:10.1515/hukin-2017-0088

11. Hrysomallis C. Balance ability and athletic performance. Sports Medicine. 2011;41(3):221-232. doi:10.2165/11538560-000000000-00000

12. Skopal LK, Drinkwater EJ, Behm DG. Application of mobility training methods in sporting populations: A systematic review of performance adaptations. Journal of Sports Sciences. 2024;42(1):46-60. doi:10.1080/02640414.2024.2321006

13. Stathokostas L, Little RMD, Vandervoort AA, Paterson DH. Flexibility Training and Functional Ability in Older Adults: A Systematic review. Journal of Aging Research. 2012;2012:1-30. doi:10.1155/2012/306818

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Thanks for reading this article on the Prime Five! Comment below on you are incorporating these areas of fitness into your routine already and help others find their gateway into a longer and healthier life.

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