It is a well-known saying that “life is exercise”, but not all exercises are suitable for everyone. Appropriate and suitable exercise to strengthen the body and prolong life, and the opposite is to destroy the body and reduce life. Especially for the elderly, it is worth exploring what kind of exercise to choose to exercise and how to exercise in order to achieve beneficial and harmless to the body. First of all, let’s discuss the physiological characteristics of the elderly. The physiological characteristics of our human body are from the prime of life to aging, is a process of degeneration. Our bones, muscles and internal organs are gradually aging with age. According to statistics, between the ages of sixty-five and eighty years old, the average annual decline in muscle strength of 1% to 2% and explosive strength of 3% to 4%. The characteristics of men and women are different, women in the 50s after menopause, estrogen levels decline, began to cause significant osteoporosis, the impact on muscle strength and joint cartilage degeneration is more obvious. So the elderly will not be able to do as much exercise as the young, confrontational sports. Rather, they should choose the right type of exercise, frequency and amount of exercise according to their age and physiological characteristics. ”Doctor, I often exercise, climbing every week, why still leg pain” “I climb the stairs every day, 6 floors, several trips up and down, this is not considered exercise” “Do not look at me 60 years old, shuttlecock can play well, but recently I play ping pong for two to three hours every day, but my shoulder still hurts”, these are the questions we orthopedic surgeons often hear in the clinic. Some elderly people come to the hospital for various reasons of joint pain, but they mostly think that it is due to cold and aging, not understanding that these are actually caused by the choice of sports programs and methods that are not suitable for them. The decline in muscle strength in older adults significantly reduces joint protection, especially in the knee joint. Exercise that is too long or too intense can cause damage to the joints. In terms of the characteristics of the knee and shoulder joints themselves, the knee is a weight-bearing joint and is most likely to cause damage to the cartilage and meniscus during exercise. I saw an elderly male who was in very good general health and had been a long distance runner for many years, but had knee pain. An MRI examination revealed cartilage damage in the knee joint. He eventually underwent arthroscopic knee surgery to improve his condition. What was the cause of his injury? Long-distance running is a good exercise and habit, but there are some specific considerations: for example, choosing a relatively soft exercise place such as a plastic sports field, dirt or sand, so that the recoil force will be significantly reduced, reducing the damage to the knee joint; wearing special running shoes for exercise; adjusting the frequency and time of exercise according to age and one’s physical strength. I also encountered many middle-aged and elderly people who came to see me for shoulder pain, and they usually thought, “It’s all about frozen shoulder, I can’t even shake my arm or climb the wall. This is actually a misconception. The shoulder joint is a special joint, and its injury is caused by long-term chronic impact, except for serious trauma, which is a low-energy injury. The most common type of injury is rotator cuff injury. The term frozen shoulder is too general and is no longer defined as such. Most rotator cuff injuries stem from several causes; abnormalities in one’s own physiological bone structure, injuries from professional sports, and chronic strain work, most commonly in baseball players who pitch. However, current statistics show that 100 percent of chronic shoulder pain in people over the age of 65 is related to rotator cuff injuries. Let’s talk about what sports can cause injuries to older adults and what kind of injuries they can cause. The sports that older people should not choose are speed sports, confrontational sports, weight-bearing sports, and sports that involve too many position changes. Speed sports refer to fast running and jumping, such as running, jumping rope and so on. Running and brisk walking on hard surfaces for long periods of time is very damaging to the knee joint, as we have seen in the example above. Climbing is not a desirable exercise for the elderly, it is very bad for the patellofemoral joint of our knee. The muscle strength of the thighs is significantly reduced in the elderly and the control of the patella is poor, resulting in severe wear and tear on the patellofemoral joint when walking up and down hills or stairs. Confrontational sports refer to various sports such as basketball and soccer, which are very intense, often with impacts and falls, and are very vulnerable to various injuries for the elderly. Weightlifting and tug of war are weight-bearing sports, which can cause damage to the spine and joints of the elderly, and can also cause cardiovascular and cerebrovascular problems in the case of breath-holding. There are many sports that change position, such as dancing, shuttlecock, etc. My clinic often has patients with knee meniscus injuries caused by these sports, because the meniscus of the elderly is obviously brittle and degenerative and vulnerable to injury. Once damaged, surgery may be the only way to resolve the problem. What kind of exercise should older adults choose to do in order to be beneficial and harmless? First of all, we have some general requirements for exercise in the elderly. For exercise, it should be low weight, low confrontation, soothing and quiet. For elderly people, they should choose the exercises according to their own condition, insist on three to five times a week, not more than one hour each time, not cause excessive fatigue, and insist on one or two items of exercise for a long time. We recommend several sports for the elderly. Jogging, swimming, gateball and cycling, etc. These sports need to be selected by the elderly for their own health conditions and need to have suitable venues and equipment. Jogging should be done on sand and soft ground, with attention to time and heart rate control. Swimming should be done indoors, at a slightly higher water temperature, and slowly, not at the same speed as young people. Cycling is even more demanding to be done in a safe place. Senior dance and tai chi, softball and other sports are also suitable sports for the elderly fitness is very good. Indoor piano, chess, calligraphy and painting are also very suitable for the elderly, not only to cultivate the sentiment, but also to exercise the body. Finally, the advice we want to give to the elderly is to choose the right type of exercise and the amount of exercise according to their own situation and interests, and to minimize injuries during exercise, so as to bring the elderly a healthy body and achieve the purpose of strengthening the body and slowing down the aging process.