Mixing cardio, strength, balance and flexibility

What should a balanced week of activity include?

A balanced week has two core parts: aerobic activity, such as walking or cycling, and activities that strengthen your muscles.

For aerobic activity, aim for at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity, or an equivalent mix¹. US guidance gives 150 to 300 minutes of moderate activity, or 75 to 150 minutes of vigorous activity⁴. These amounts are a minimum to aim for, and going beyond them is fine. At moderate effort you can talk but not sing.

For strength, do activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week¹. The WHO says this brings additional health benefits beyond aerobic activity⁵. Strength sessions are done as well as your aerobic minutes, and they can fall on the same days as aerobic activity or on different days, whichever suits you¹.

Balance and flexibility fit around these. The American College of Sports Medicine suggests balance, agility and coordination exercises on 2 to 3 days a week, and flexibility exercises for each major muscle-tendon group (a total of 60 seconds per exercise) on at least 2 days a week³.

If those amounts feel far off, start with what you can manage. Doing less than the targets still helps³.

Do you need all four kinds of exercise?

No. Doing less than the recommended amounts still helps³, and any exercise is better than none⁶. People who do the least gain the most from even modest increases⁴. Everyday movement counts too, including walking, housework, gardening and dancing⁷.

A mix is still the standard advice. The American College of Sports Medicine considers regular aerobic, strength, flexibility and balance-type training essential for most adults³. Strength activity is linked with a lower risk of early death, heart disease, some cancers and diabetes, and combining it with aerobic activity may give more benefit than either alone⁸. These are links, not proof that strength work is the cause.

So you can build up in steps:

• Start with what feels manageable. If you only have the energy for one kind of activity at first, begin with that. Walking is a fine way in.
• Add the others gradually, one at a time, as each starts to feel easy.
• Count everyday movement. It all adds up.

It's never too late to make a start⁹.

How do you fit strength and balance around walking?

Treat strength and balance as add-ons to your walking. Do muscle-strengthening on at least 2 days a week, on the same days as walking or on different ones¹. Your walking minutes count towards the 150 minutes of aerobic activity, but strength work doesn't².

For each strength exercise, work until you need a short rest before repeating it¹⁰. The effects of strength work are limited to the muscles doing the work, so over the week aim to cover legs, hips, back, abdomen, chest, shoulders and arms⁴. Strength work on at least 2 days a week helps keep muscles, bones and joints strong, and lowers the chance of frailty and falls⁹.

Balance matters more with age. Older adults should be as active as their abilities allow. Adults aged 65 and over should aim for varied activity that emphasises balance and strength on at least 3 days a week, and older adults with poor mobility are advised to do balance-focused activity on 3 or more days a week⁷. Exercise lowers the rate of falls in older adults, and programmes that mix balance and strength probably do so most¹¹.

Choose activities you enjoy. Doing them at home is fine, and home-based programmes for older adults work as well as centre-based ones¹².

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio. They can help you choose the type and amount of balance and strength work that suits you.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

If you feel sick, sweaty or unwell, have unexplained discomfort, or have breathlessness or dizziness that doesn't settle during or after activity, don't push on. Use the emergency advice above, or see a doctor if it is mild and passing. A sore muscle or joint, or soreness a day or two later, is a reason to ease off, and to get advice if it persists or gets worse.

In pregnancy and after birth, bleeding, fluid leaking, regular painful contractions, the baby moving less, calf pain or swelling, or a bad headache or changes in vision need the midwife, doctor or maternity unit straight away. A midwife or doctor can advise on the right type and amount of activity.