look at the evidence

Increased daily step count reduces all cause mortality

A study in 2020 of 4840 adults in the US found a connection with increased daily steps and reduced rates mortality from cancer and cardiovascular disease.  Their was a significant drop when with step rates increased from 4000 per day to 8000 per day.

Cardiovascular disease mortality per 1000 person years dropped from 3.16 (<4000 steps per day) to 6.6 (4000-8000 steps per day) and 2.1 for this doing more than 8000 steps per day.

Cancer mortality per 1000 person years dropped from 10.5 (<4000 steps per day) to 6.4 (4000-8000 steps per day) and 2.3 for this doing more than 8000 steps per day.

There was no apparent additional benefits of increasing intensity or step rates. It's clear from this research that simply walking more every day helps us to live longer.  

Sleep is not for the weak

Sleep has been identified as an important factor in optimising athletic performance.  It also plays a vital role in our recovery process. Speed, accuracy & reaction times have been shown to improve with better sleep.

"An increase in sleep of approximately 2 hours per night significantly increased athletic performance in college varsity tennis players". (Swartz & Simon, 2015).

"Inadequate sleep impairs maximal muscle strength in compound movements when performed without specific interventions designed to increase motivation". (Knowles, 2018).

Research from the British Nutrition Foundation revealed that 43% of adults reported sleeping less than the recommended minimum of 7 hours.  Links have been made to poor sleep and increased weight, 

​A minimum sleep regimen was implemented in the Isreali Army together with reduced cumulative marching, resulting in a reduction of stress fractures by 62%.

Stop the training errors that lead to getting injured, use the 10% rule

One of the main reason runners get injured is down to simple training errors.  Doing too much too soon too fast.  60% to 70% of injuries are thought the blue to training error.

Does this sound familiar?  Start of marathon training, already running a regular 20-25 miles per week, with 7-8 miles being the longest run.  So week 1 we do a 9 mile run, week 2 longest run is 10 miles, then we add 2 miles to our longest run every week.  In 5 weeks we have doubled our longest run and our weekly mileage is now around 30 miles.  It doesn't sound much, but all the time we are increasing the load by adding miles to that long run.

Now lets look at what an injury is, it's when the load on a tissue exceeds the tolerance of that tissue to take the load.  A bit like a bridge, a 4 ton capacity bridge will collapse when a 6 ton lorry drives over it.

Our tissues need time to adapt to the increasing loads we are putting on then.

If we constantly increase the load every week then there is not enough time for adaptation to occur. Recovery should be incorporated in to the training plan.  This allows time for the muscles and all the connective tissues, ligaments and tendons, to adapt before you ask more of them. Take a step back every 4 weeks, drop that long run distance and the weekly total so you get some recovery. Ensure you have proper recovery days during the week too.  You won't lose fitness in one week by reducing that long run.  You'll still make the start line, but you won't be as fatigued.

Don't try and increase distance and intensity at the same time, do one or the other.

Monitor your training load and try to not increase that load by more than 10% per week.  Going from 10 miles to 14 miles in 2 weeks is a 40% increase, This rate of increase in distance has been shown to increase the chances of running injuries. (Nielsen, 2014).

 

Osteoarthritis and running

 

Osteoarthritis is the most common type of arthritis in the UK that causes joints to become painful and stiff.

Running has been associated with a lower rate of knee and hip osteoarthritis.  More so recreational runners are at lower risk than competitive runners.  

A sedentary lifestyle and or a history of high intensity running is associated with an increased risk of osteoarthritis.

Running was found to have a beneficial association with hip and

knee osteoarthritis risk in runners with less than 15 years of running exposure.

It should be pointed out that studies may suggest a lower risk of osteoarthritis among runners, however most studies are of poor quality with insufficient numbers to be totally conclusive.  

However, there is no data to suggest that running causes

osteoarthritis, so don't let the doctor tell you that running is bad for your knees!

A recent paper (2021) found that high intensity strength training and no benefit over low intensity strength training in people with osteoarthritis, however the study group had an average age of 65 and a BMI ranging between 20 & 45.  it could be argued that high intensity strength training for this group of participants would be inappropriate anyway.

Another study in 2010 concluded that Middle‐aged, sedentary persons with mild early knee osteoarthritis benefited

from strength training, self‐management, and a combination of both. Their results suggest that both strength training and self‐management are suitable treatments for the early onset of knee osteoarthritis in middle‐aged adults.

Overall, consistent evidence suggests that exercise therapy and specific strengthening exercise or strength training for the lower limb reduce pain and improve physical function in knee OA. 

WHO 2020 Updated Exercise Guidelines

 

In 2010 the World health Organisation (WHO) published their "Global Recommendations on Physical Activity for Health". Latest estimates suggest that globally 27.5% of adults & 81% of adolescents do not meet these recommendations for aerobic activity. This is now updated, based on the latest evidence, and a 2020 guidelines and recommendations has been published.

There are a few changes to the guidelines in the new 2020 recommendations:

First, they no longer recommend that activity should be in bouts of at least 10min, reflecting that physical activity of any bout duration is associated with improved health outcomes, including all-cause mortality.

Second, physical activity should be of 150–300min moderate intensity, and 75–150min of vigorous intensity per week, (previously this was 150 min of moderate or 75min of vigorous intensity per week). This change acknowledges that there is a range of physical activity which captures the maximal risk reductions for health outcomes associated with physical activity and going beyond this range does not appreciably further decrease the risk of major outcomes such as all-cause or CVD mortality.

Third, with respect to older adults, it is now recommended that ALL older adults emphasise functional balance and strength training to enhance functional capacity and prevent falls. This acknowledges the large volume of evidence demonstrating unequivocal beneficial effects of this physical activity type on the functional capacity and risk of falls in older people with a range of functional abilities.

Adults (aged 18–64 years) including those with chronic conditions and those living with disability

For Physical Activity it is recommended that:

► All adults should undertake regular physical activity;

► Adults should do at least 150–300 min of moderate intensity aerobic physical activity, or at least 75–150 min of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate intensity and vigorous intensity activity throughout the week for substantial health benefits;

► Adults should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits.

Strong recommendation

► Adults may increase moderate-intensity aerobic physical activity to >300 min, or do >150 min of vigorous intensity aerobic physical activity, or an equivalent combination of moderate-intensity and vigorous intensity activity throughout the week for additional health benefits (when not contraindicated for those with chronic conditions).

For Sedentary Behaviour it is recommended that:

► Adults should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits;

► To help reduce the detrimental effects of high levels of sedentary behaviour on health, adults should aim to do more than the recommended levels of moderate to vigorous physical activity.

Children and adolescents (aged 5–17 years), including those living with disability.

For Physical Activity it is recommended that:

► Children and adolescents should do at least an average of 60 min/day of moderate-to-vigorous intensity, mostly aerobic, physical activity, across the week;

► Vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone should be incorporated at least 3 days a week.

For Sedentary Behaviour it is recommended that:

► Children and adolescents should limit the amount of time spent being sedentary, particularly the amount of recreational screen time.

Older adults (aged 65 years and older) including those with chronic conditions and those living with disability

For Physical Activity it is recommended that:

► As part of their weekly physical activity, older adults should do varied multicomponent physical activity that emphasises functional balance and strength training at moderate or greater intensity on 3 or more days a week, to enhance functional capacity and to prevent falls.

For Sedentary Behaviour it is recommended that:

► As for adults

Pregnant and postpartum women

For Physical Activity it is recommended that:

► Undertake regular physical activity throughout pregnancy and post partum;

► Do at least 150 min of moderate intensity aerobic physical activity throughout the week for substantial health benefits;

► incorporate a variety of aerobic and muscle strengthening activities. Adding gentle stretching may also be beneficial.

For Sedentary Behaviour it is recommended that:

► Pregnant and postpartum women should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits.

 

Additional on safety considerations when undertaking physical activity for pregnant women are:

► Avoid physical activity during excessive heat, especially with high humidity;

► Stay hydrated by drinking water before, during and after physical activity;

► Avoid participating in activities which involve physical contact, pose a high risk of falling or might limit oxygenation (such as activities at high altitude, when not normally living at altitude);

► Avoid activities in supine position after the first trimester of pregnancy;

► Pregnant women considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from a specialist healthcare provider;

► Pregnant women should be informed by their healthcare provider of the danger signs for when to stop, or limit physical activity and to consult a qualified healthcare provider immediately if they occur.

► Return to physical activity gradually after delivery and in consultation with a healthcare provider in the case of delivery by caesarean section.

Key Messages

► For all populations, the benefits of doing physical activity and limiting sedentary behaviour outweighed the potential harms.

► Risks can be managed by gradual increase in the amount and intensity of physical activity.

► Some physical activity is better than none for those not currently meeting these recommendations,

► Individuals should start with small amounts of physical activity and gradually increase frequency, intensity and duration over time.

Do you need to touch your toes when running?

There has been a long running debate about the validity of stretching. For many years we were told to stretch before exercise and after exercise, indeed daily stretching has been suggested. However, there is little evidence showing that stretching benefits performance or reduces injury risk. Herbert and Gabriel (2002) found that static stretching before or after exercise had no effect in reducing muscle soreness. Haddad et al. (2013) found that static stretching in the 24 hours prior to performing had a negative effect on explosive power, whereas dynamic stretching improved sprint and long jump performance.

When to do static stretching

Whilst being able to touch our toes when running may not be important, some flexibility is definitely good. Muscle flexibility will help range of motion, the point of the muscles is to move a joint, lack of flexibility therefore will result in a reduced range of motion around that joint. Therefore, if you have identified a lack of range of motion then stretching is definitely a good thing in order to improve that. But not immediately before exercise. One set of muscles that a lot of people typically find is restrictive would be the hip flexors (e.g. Illiacus, Psoas Major, Rectus Femoris). If you’re sitting down, and most of us spend a lot of the day sitting down, then those muscles spent a lot of time shortened. They then get used to being shortened and don’t like to be lengthened.

Their opposing muscles, the hip extensors (e.g. Glute Max, Hamstrings) spend a long time stretched, so do we need to do more hamstring stretches? Possibly we need to stretch the hip flexors, which in turn works the hip extensors by making them contract, an important part of running power getting that hip extension.

To perform stretches to increase range of motion, hold the stretch for 30 seconds, anything longer has no additional benefit. Do this twice each side, that’s only 2 minutes a day.

Whilst having good flexibility will produce good range of motion, it is worth noting that flexibility without the muscular strength to manage it can result in hyperextension or balance issues and lead to injuries. Therefore, marry stretching with proprioceptive and strength training,

Dynamic Stretching

Before any exercise, especially running, and even more so before high intensity running such as sprinting, dynamic stretching is very important. This gets the joints mobilised as well as the muscles activated, as we sore in part 2 of this series.

 

Summary

If you believe that static stretching helps then carry on, but the evidence suggests that there are no benefits to it. However, if you identify a lack of range of motion then static stretching will benefit. It’s about identifying a need rather just doing it because it’s always been done.

Running form & technique

If we do something wrong or badly we increase the risk of harm, and do it often enough and over a long period of time and the chances keep going up. Undoubtedly that will also be the case in running. Poor form and technique will increase the likelihood that injuries could occur, that’s not to say that perfect form and technique eliminates any chance of injury, but that likelihood will be greatly reduced if our technique is good.

Francis et al. (2018) found that 28% of all running related injuries were in the knee, 26% ankle and foot and 16% in the shank. Women were more likely to incur knee injuries, whilst men are more likely to incur ankle/foot injuries.

Factors that contribute to increased load and ground reaction force

  1. Excessive vertical displacement: or too much bounce. The higher you go when you leave the ground the further you fall back to earth again, the further you fall the harder you land. Therefore, excessive vertical excursion will result in higher landing forces with every step. This increases the chances of overuse injuries.

  2. Overstriding: Foot strike ahead of the centre of mass, it doesn’t matter if you forefoot, midfoot or heel strike. Landing ahead of your centre of mass adds stress. This is usually associated with the with knee being straight and locked when your foot strikes the ground. 

  3. Feet crossing to land in line: as if running along the white lines in the road. This might look good for models on the catwalk but not so good for running as it encourages too much hip adduction and rotation.

  4. Over pronating: most people pronate a little, but when it becomes excessive then it can be an issue. Keeping a knee gap as you run means your feet travel in a straight line and increases the likelihood of a good foot strike and reducing that overpronating.

Running economy.

If we run with lots of bounce and moving up and down with every stride this is not going to be economical. We run horizontally, meaning that any vertical movement is wasted energy. If we land ahead of our centre of mass we effectively apply the brakes every foot strike, again this wastes energy that we put in to that stride. Increasing our step rate by 5%-10% actually improves our running economy as well as reducing the impact load of each foot strike. (Heidercheit et al., 2010). Increasing step rate by 10% does not significantly increase oxygen consumption either (Chumanov et al., 2012).

Changing foot strike patterns

Simply changing from a rearfoot strike to a forefoot strike was promoted as the answer to all our running problems in the book ‘Born To Run’ indeed we were even told that running barefoot was the way to go. However, it really isn’t as simple as that. Whilst being a rearfoot striker increases the load in the knee and hip, forefoot striking will engage the calf muscles more. Simply running on the forefoot but still over striding still results in excessive loading compared to a shorter stride with a flexed knee (Shih et al., 2013)

 
 

Strength training for injury prevention

Strength training (explosive and/or heavy weight) improves long-distance running performance and/or running economy (Yamamoto et al. 2008). After his team won the 2006 High school cross country, the coach said that he knew they could run in the mud because of our strength training. There is little doubt that strength training improves running, that’s why all top level athletes include strength work in there training routine. In a further study of masters athletes (>35 years of age) running economy improvements as a result of strength training were similar to those of much younger athletes (Piacentini, M, 2013).

In a meta-analysis Lauersen et al. (2013) found that strength training reduced sports injuries to less than 1/3 and overuse injuries by half. Proprioception training also had positive results whereas no benefits were noted to stretching before or after exercise.

There is an area of concern with strength training, and that is the cross over effect. This is when the ratio of strength raining to endurance training can affect the endurance training in the short term. Fernandez et al. (2015) suggests that 30% of the training sessions being strength training eliminates this effect, however, a minimum of two strength sessions a week is needed to attain decent strength improvements.

A strength-training program consisting of 2-4 resistance exercises at 40-70% 1-RM (1 rep max, the most you can lift once) without reaching failure, plus plyometric exercises performed 2-3 times per week for an overall 3:1 endurance:strength training elicits the best results. Just as in running training where a periodised programme works to provide peak performance at the right time, the same works for strength training. Strength training has a number of elements that produce different types of result. A programme of general strength training, following some maximum strength, strength endurance and strength power ending at the right time for peak performance and in conjunction with the endurance programme is the ideal model.

In addition to improving running economy and reducing risk of injuries, strength training also has positive benefits in our daily activities, especially as we age. From the age of 40 our muscle mass begins to decrease, as does bone density. Strength training while not reversing this does slow it down and reduces the risk of falls and fractures as we age.  Running economy also improves with strength training, Johnson et al. (1997) showed that female endurance runners who included strength training improved their running economy compared to those who only ran. At the same time they found that there was no real change in VO2 max or body composition, so ladies, don't worry that lifting weights will give you unwanted muscles.

 

How to

Don’t jump straight in with big weights hoping for fast results, sorry it doesn’t work that way! Before loading with weight, it is important to be able to control your own body weight. Before doing any single leg exercises make sure you can do them on double leg first. Body weight squats before front squats or back, body weight squats before single leg squats. Suspension trainer (e.g. TRX) are a great way to begin doing bodyweight exercises and can be used at home if you don’t like the gym.

Some good exercises to start with:

  • Legs: Squats; Lunges; step ups;

  • Back: TRX row, Pull ups

  • Chest: Press ups

  • Core: Deadbugs; crunches; leg raises; Glute bridge

As you get stringer it is important to add weight, the way we get stronger is by the overload principle, if you can do 3 sets of 10 reps and you can’t do 2 more that’s good. If 3 sets of 10 is easy and you could easily do another set then add more reps. If you’re doing 3 sets of 15 reps add more weight and go back to 8-10 reps. This is overload, at this point your muscles recognise that they need to be stronger to what you want them to do so they increase the number of fibres.

RICE, or not?

R.I.C.E. (Rest, Ice, Compression, Elevation)

Mirkin and Hoffman (1978) came up with the idea of RICE for the treatment of strains and sprains, this has been the standard treatment method ever since. R.I.C.E. is widely used by coaches and therapists and other medical professionals as the early stage treatment of sprains and strains. There is conflicting evidence on efficacy of this treatment. A study by Bleakley et al. (2010), found that patients with ankle inversion sprains who incorporated therapeutic exercises during the first week had improved mobility in the short term. This suggests that complete rest in the first week will slow the healing process.

Recently Dr Mirkin reversed his original thinking (Dr Gabe Mirkin, 2015) on the back of studies which determined that rest and ice can delay healing.

RICE is not a four stage protocol where one step follows the other, often two or three or all four are used simultaneously.

Rest.

This is supposedly a key element in injury recovery, giving the body time to heal without putting further strain on the injured tissues. But as we have just see there is now evidence to suggest complete rest is not always ideal (Bleakley et al., 2010).

Ice.

Used for the reduction of inflammation as well as pain relief. The British Medical Association (BMA, 2019) suggests applying ice for 10 minutes every 2 hours for the first 3 days, this would appear to be both impractical and excessive if followed to the letter. Mirkin (2015) tells us that applying ice more than six hours after the injury occurs is unnecessary. His advice is to use ice only for pain relief and to apply for up to 10 minutes, remove it for 20 minutes, then repeat up to two more times. A major consideration with the application of ice to acute muscle injuries is the depth of the injured site. Most studies have been performed on small mammals such as rats and based on crush injuries, as highlighted by Bleakley, Glasgow and Webb (2012). 

Compression.

This involves the use of bandaging to provide support, limit swelling and reduce blood flow to the injured site. There is little study evidence for this, and therefore, scant evidence regarding the true effect of compression around acute muscle injuries. Due to the nature of compression it is not possible to apply a placebo effect. Most research has been conducted with regard to compression socks in recovery following training or competition. Brophy-Williams et al. (2015) attempted to study the effect of compression socks on recovery, they found that those who believed they would have a positive effect were more likely to benefit from wearing them post exercise.

Elevation.

According to the American Academy of Orthopaedic Surgeons (2015) Elevating the injury above the level of the heart will help reduce swelling and pain. It is most commonly used in conjunction with compression bandaging. As with compression there is little scientific research evidence to suggest this is truly effective in injury recovery compared with not elevating.

 

More to recovery than just RICE.

The R.I.C.E. acronym has been expanded and adapted to create new versions based on updated thinking over the years.

P.R.I.C.E. adds Protection to the same protocol, and certainly there will be instances in more serious sprains where this would be justified. This would particularly benefit athletes with a history of sprains, who should consider the use of braces.

P.O.L.I.C.E also advocates Protection but adds Optimal Loading over Rest, similarly, Bleakley, Glasgow and MacAuley (2012) promote the idea of early activity via a well balanced rehabilitation programme to promote early recovery.

M.I.C.E. Swaps Rest for Movement. Khan and Scott (2009) discuss mechanotransduction as “the process by which the body converts mechanical loading into cellular responses”, in other words, movement stimulates tissue healing.

 

Which running shoes are best?

There is a temptation to have a free gait analysis which some running shoe shops offer. Whilst it is undeniable that having a gait analysis is a good idea, it is questionable whether this should be done solely for the purpose of selecting which shoes one should wear for running.

Apparently 70% of runners pronate, if that were the case then perhaps pronation is normal? Shoe shops and shoe manufacturers would have you believe this is bad and will lead to injuries, therefore you should wear corrective running shoes.

What is the most important aspect of a running shoe? is it one that makes you run faster? is it one that corrects your over pronation or under pronation (supination)? 

I suggest it should be neither of these, the most important thing to consider when buying running shoes is………… comfort, yes that’s it, find a pair of shoes that fit right, that are comfortable and don’t give you blisters.

Training error is thought to be responsible for 60-70% of running injuries (Neilsen et al. 2012). Saragiotto, B and Yamato, T. (2014) conducted a systematic review of the main risk factors for running related injuries, running shoes were not mentioned and therefore it could be said is not a factor to consider.

So the answer to the question is that the best shoes for you are the most comfortable, not necessarily the ones the correct your foot strike.

The most intimidating experience life  can throw at you...

According to a survey by fitness equipment brand Opti, British people actually find going to the gym to be the most intimidating thing one can do. The survey also found that over 57 per cent of us will have set ourselves the goal of losing weight and getting fit this year, blaming a lack of time and the expense only a quarter will last a fortnight.

However, the need to exercise regularly becomes more important as we hit our 40s, with a number of physiological and hormonal changes during this decade that can cause loss of muscle, reduction in bone quality and loss of functional capacity. As a result it therefore becomes a whole lot more important to stick to the fitness goals you set yourself

The answer, get a personal trainer with a studio or other set up where you can get a proper workout with all the equipment you would need.

Someone who will be able to coach you and train you while also protecting other injuries and aches and strains etc.

Knowing when to progress, how to progress and also understanding that at times regression may be necessary, this is what your personal fitness coach will give you.

A research study found that those whose training was directed by well qualified coaches using evidence based training regimens achieve significantly greater improvements in lean body mass and other dimensions of fitness than those who direct their own training.

Women who are fit at 50 are 5 times less likely to get dementia

A Swedish study of 191 women examined their fitness levels in mid life, before tracking them for 44 years. Participants were asked to carry out exercise tests on a bike to measure their cardiovascular activity.

The research found that those with the highest fitness levels when first assessed had just a five per cent chance of developing dementia in subsequent decades. This compared with rates of 25 per cent among those who performed moderately. Rates were even worse among those with low fitness and among those so unfit they could not complete the tests, the study by the University of Gothenburg in Sweden found. Overall, those who dropped out of the tests had dementia rates of 45 per cent in later life.

And when highly fit women developed the disease, on average it came 11 years later than among those with moderate levels of fitness - at age 90 instead of age 79.

For the study, 191 women with an average age of 50 took a bicycle exercise test until they were exhausted to measure their peak cardiovascular capacity. The average peak workload was measured at 103 watts. A total of 40 women met the criteria for a high fitness level, or 120 watts or higher, while 92 women were in the medium fitness category. A total of 59 women were in the low fitness category, defined as a peak workload of 80 watts or less, or having their exercise tests stopped because of high blood pressure, chest pain or other cardiovascular problems.

Over the next 44 years, the women were tested for dementia six times. During that time, 44 of the women developed dementia. Five per cent of the highly fit women developed dementia, compared to 25 per cent of moderately fit women and 32 per cent of the women with low fitness.

Dr Hörder added: "This indicates that negative cardiovascular processes may be happening in midlife that could increase the risk of dementia much later in life."

Dr David Reynolds, chief scientific officer at Alzheimer’s Research UK, said: “We know that exercise can improve heart health and it has also been linked with a reduced risk of dementia. By working with participants over many years, this study has highlighted how fitness in mid-life can help predict dementia risk years later.

"While studies like this can’t definitively show cause and effect, it adds to research suggesting that middle age is key time for people to take steps to promote their brain health.”

Dr Reynolds said boosting exercise did not have to meet major exertion.

“Physical exercise doesn’t necessarily mean going to the gym or running a marathon, but something that can easily be fitted in as part of the normal routine, like a jog or a brisk walk with friends. Alongside regular exercise, the current best evidence to maintain good brain health as we age is to eat a balanced diet, maintain a healthy weight, not smoke, and keep blood pressure and cholesterol in check,” he said.

 
 

Exercise keeps you young & healthy

 

A group of older people who have exercised all of their lives, were compared to a group of similarly aged adults and younger adults who do not exercise regularly. The results showed that those who have exercised regularly have defied the aging process, having the immunity, muscle mass, and cholesterol levels of a young person.

The researchers set out to assess the health of older adults who had exercised most of their adult lives to see if this could slow down ageing.

The study recruited 125 amateur cyclists aged 55 to 79, 84 of which were male and 41 were female. The men had to be able to cycle 100 km in under 6.5 hours, while the women had to be able to cycle 60 km in 5.5 hours. Smokers, heavy drinkers and those with high blood pressure or other health conditions were excluded from the study.

The participants underwent a series of tests in the laboratory and were compared to a group of adults who do not partake in regular physical activity. This group consisted of 75 healthy people aged 57 to 80 and 55 healthy young adults aged 20 to 36.The study showed that loss of muscle mass and strength did not occur in those who exercise regularly

The cyclists also did not increase their body fat or cholesterol levels with age and the men's testosterone levels also remained high, .

suggesting that they may have avoided most of the male menopause.

More surprisingly, the study also revealed that the benefits of exercise extend beyond muscle as the cyclists also had an immune system that did not seem to have aged either.

The findings come as figures show that less than half of over 65s do enough exercise to stay healthy and more than half of those aged over 65 suffer from at least two diseases. Professor Janet Lord, Director of the Institute of Inflammation and Ageing at the University of Birmingham, said: "Hippocrates in 400 BC said that exercise is man's best medicine, but his message has been lost over time and we are an increasingly sedentary society.

"However, importantly, our findings debunk the assumption that ageing automatically makes us more frail.  "Our research means we now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier."

Dr Niharika Arora Duggal, also of the University of Birmingham, said: "We hope these findings prevent the danger that, as a society, we accept that old age and disease are normal bedfellows and that the third age of man is something to be endured and not enjoyed."

Professor Stephen Harridge, Director of the Centre of Human & Aerospace Physiological Sciences at King's College London, said: "The findings emphasise the fact that the cyclists do not exercise because they are healthy, but that they are healthy because they have been exercising for such a large proportion of their lives.

"Their bodies have been allowed to age optimally, free from the problems usually caused by inactivity. Remove the activity and their health would likely deteriorate."

Norman Lazarus, Emeritus Professor at King's College London and also a master cyclist and Dr Ross Pollock, who undertook the muscle study, both agreed that: "Most of us who exercise have nowhere near the physiological capacities of elite athletes.

"We exercise mainly to enjoy ourselves. Nearly everybody can partake in an exercise that is in keeping with their own physiological capabilities.

"Find an exercise that you enjoy in whatever environment that suits you and make a habit of physical activity. You will reap the rewards in later life by enjoying an independent and productive old age."