The men were squatting on the dirt, talking while they waited for a minibus. They could stay there for half an hour.
I stood in a busy, dusty square in Kathmandu, about a head taller than most people around me and likely the only Westerner using this kind of transport. Each morning, I took the minibusses to the hospital, where I worked in traumatology.
The square was unpaved and crowded with commuters. A minibus that seemed built for ten people could actually fit 15 or 18 if everyone squeezed together. I kept watching those men rest comfortably in a position I rarely saw adults use back home.
Why wasn’t I doing that?
When I first tried, I could only hold the position for a minute or two before my legs went numb. It took time to get deeper into the squat. The numbness was a sign to stop, and I wouldn’t suggest pushing through it. I had to build up slowly over months.
Now, I include the squat in my hip-mobility routine. I also notice how everyday movements can become awkward for adults, like getting out of a car or lowering themselves to the floor.
I’m 47, and I don’t want to give up on these movements without seeing if I can keep them.
Before you blame your birthday
As a doctor, I don’t think age alone explains why we lose certain movements. If getting out of a chair or reaching the floor is hard, I want to understand the reason.
I also think we’ve gotten too used to spending our days moving from one chair to another. If you spend most of your week sitting, make time for the movements you want to keep. Don’t wait until it becomes a problem.
For me, the squat is important. For you, it might be kneeling in the garden or getting down to play on the floor. Pick a movement you care about and use it as your reason to practice. There’s no single squat shape to follow. Your stance and body shape will affect how it looks.[1]
Flexibility is how much your joints can move. Strength is what lets you move through that range. Getting down into a position, staying steady, and getting back up all take practice, not just stretching.
Think about getting out of a low car. You need to swing your legs around, place your feet well, and stand up. Where does it feel awkward for you? Maybe moving your leg is hard, or maybe standing up is the tough part. Noticing these details helps you explain what’s difficult if you need help, though it won’t tell you the cause on its own.
I’d pick one everyday task like that before choosing which exercises to focus on. Be clear about what you want to do comfortably. Getting down to the floor and back up is a good goal, even if you need a hand for support. Start practicing from your current level. If you work with a trainer or physiotherapist, share your goal with them. It gives you both a clear target and a reason for your exercise choices.
The LIFE trial asked a question I care about: could people still walk 400 meters? Its 1,635 participants were sedentary adults aged 70–89 with physical limitations. Over an average of 2.6 years, a walking-led program, with strength, balance, and flexibility work, reduced loss of that ability from 35.5% to 30.1% compared with health education and gentle upper-body stretching. Serious medical events were 49.4% versus 45.7%, a statistically uncertain difference; most hospitalizations were judged unrelated to the program.[2]
A 2024 review also found that exercise programs led to fewer fall injuries in older adults. Almost all these programs included balance, functional movement, and strength exercises.[3] I want to keep these abilities in my routine long before I ever need a fall-prevention program.
A few minutes you can keep doing
A 2025 review pooled 189 studies involving 6,654 adults. Their average age was 26.8, and 61% were male. Regular static stretching, where you hold a position, improved flexibility.[4]
The analysis suggested that improvements leveled off at about 10 minutes of stretching per muscle group each week. That’s a helpful starting point. The authors question if this is a real limit, so I wouldn’t treat it as a strict rule or a ten-minute total for the whole body.
The analysis didn’t find differences in results by age. A July 2026 review found the same, though only three of its 79 trials focused on people aged 40–64.[5] I think it’s worth working on flexibility in midlife, and you can adjust how much you do based on your own response.
A separate 2025 review examined what changes when people stretch regularly. It found a small reduction in tissue stiffness and increased stretch tolerance after repeated static stretching.[6]
Here, stiffness means the resistance measured as tissues are stretched. Tolerance describes how much resistance a participant would accept near the end of a stretch test. Both changed alongside improvements in range of motion. The review found no clear increase in muscle-fiber bundle length, another proposed explanation.
The evidence for these reasons was rated as low or very low certainty, and most participants were young. We still don’t fully know how extra flexibility develops, especially as we get older.
For someone starting at home, I’d use comfort and ease of movement to guide the practice. Pain or a persistent restriction deserves a closer look.
I’d begin with just a few movements and make sure you have time to repeat them. A routine that takes a long appointment is tough to fit into a busy week. I want the first version to be simple enough that you can do it again later in the week.
Keep your strength training, too. A review of 36 studies found that resistance training improved flexibility, with larger gains in the higher-intensity programs. The comparison came from studies of uneven quality, none rated at low risk of bias.[7]
That’s enough reason for me to keep adding more challenging strength work to my plan. It doesn’t mean lifting heavier always leads to better mobility. Pick a weight you can control through a comfortable range, and increase it as you get stronger. Starting light is fine; the important thing is to keep challenging yourself as you improve.
I had an hour anyway
This Thursday, the whole family made a special trip to an embassy. I’ll share more about that in the coming months.
We got there at eight. The doors opened at nine, and a line had already started. Some people stood or leaned against the wall. I dropped into a deep squat and waited.
I was the only person in the queue doing it.
Years after Kathmandu, I found myself using the same squat outside an embassy. Even waiting for a visa became part of my exercise routine.
Try this today
My mobility drill takes about seven to nine minutes after a walk. Try starting three times a week. I picked the sequence and starting amounts as a practical suggestion, though this exact routine hasn’t been tested in a study.
If you’ve been sitting, walk for five to ten minutes first.[8] Keep a fixed support within reach, and stop if you feel pain, numbness, or tingling; recent surgery, restricted joint replacements, or recurrent falls call for an individually adapted routine.
The counter squat. Hold a fixed counter, keep your feet planted, and lower only as far as you can control. Hold for 20–30 seconds, stand up, and repeat once. Begin shallow if you need to. Five slow rises from a stable chair are another way to practice getting up and down.[9]
The half-kneel. With padding under the rear knee and your other foot in front, keep your trunk upright and gently shift forward until you feel a stretch at the front of the rear hip. Hold for 30 seconds twice on each side. If kneeling bothers your knees, take a supported standing split stance and gently shift forward instead.[8,10]
The wall calf stretch. Put your hands against a wall, step one foot back, and keep that heel down with the knee straight. Bend the front knee gently until you feel the rear calf stretch. Hold for 30 seconds twice on each side.[8]
The one-leg stand. Stand beside the counter with your eyes open, using your fingertips for support as needed and keeping your free foot close to the floor. Try two 20-second holds per side. Start with five to ten seconds if that’s enough of a challenge.[11,12]
Find a way to track your progress. For the one-leg stand, use the same counter and start with the same amount of time. If you begin with ten seconds and a firm grip on the counter, that’s your baseline. As it gets easier, try using a lighter touch, but keep the support nearby. Work up to the suggested hold time without feeling like you have to make it harder every time.[11,12]
Change only one thing at a time. If you’re focusing on using less hand support, don’t change how long you hold the position yet. This way, you can see what’s getting easier. After each session, jot down which exercise you did, how much help you needed, and if it felt comfortable. After a few weeks, check back on the everyday movement you picked.
Keep regular strength sessions in your week along with this drill, starting with at least two days if you’re building the habit.[9,12] The supported squat helps you practice the position. As you improve, your strength work should get a bit harder. If the routine feels easy, that’s your cue to make it more challenging.
In my Upward ARC framework, this is Activate, with Capacity as the reason to continue.
Starting something new deserves some kindness. If you need both hands to get out of a chair, use them. If a shallow squat takes focus, give it your attention. Adults should feel okay about being beginners at a physical skill. I count the supported version as a real session and would do it again.
Also, be generous with others you see moving awkwardly. Watching someone struggle to get out of a car doesn’t tell you much about their story. As a doctor, I’d want to know their background before giving advice. As someone writing about health, I want to encourage you not to ignore a difficulty you could manage.
I’m also willing to look a bit unusual myself. I enjoy finding ways to use the squat outside of my regular practice time.
After about ten minutes in the squat outside the embassy, I stood up and walked around a bit. I still had plenty of time for a few rounds of deep squat holds.
Is there a movement you’ve started avoiding because it feels awkward? Let me know. I read every message!
Stay healthy.
Andre
PS: If you know someone who blames a tough movement on getting older, please forward this to them. That’s how this newsletter grows, and it’s the only way I want it to.
PPS: If someone sent this to you, you can subscribe at andreheeg.com.
References
[1] Demers, E., Pendenza, J., Radevich, V., & Preuss, R. (2018). The effect of stance width and anthropometrics on joint range of motion in the lower extremities during a back squat. International Journal of Exercise Science, 11(1), 764–775. https://doi.org/10.70252/BWZE8275
[2] Pahor, M., Guralnik, J. M., Ambrosius, W. T., Blair, S., Bonds, D. E., Church, T. S., Espeland, M. A., Fielding, R. A., Gill, T. M., Groessl, E. J., King, A. C., Kritchevsky, S. B., Manini, T. M., McDermott, M. M., Miller, M. E., Newman, A. B., Rejeski, W. J., Sink, K. M., & Williamson, J. D. (2014). Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE study randomized clinical trial. JAMA, 311(23), 2387–2396. https://doi.org/10.1001/jama.2014.5616
[3] Guirguis-Blake, J. M., Perdue, L. A., Coppola, E. L., & Bean, S. I. (2024). Interventions to prevent falls in older adults: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 332(1), 58–69. https://doi.org/10.1001/jama.2024.4166
[4] Ingram, L. A., Tomkinson, G. R., d’Unienville, N. M. A., Gower, B., Gleadhill, S., Boyle, T., & Bennett, H. (2025). Optimising the dose of static stretching to improve flexibility: A systematic review, meta-analysis and multivariate meta-regression. Sports Medicine, 55(3), 597–617. https://doi.org/10.1007/s40279-024-02143-9
[5] Oba, K., Matsuo, S., Nakamura, M., Nakao, G., Fukaya, T., Mizuno, T., & Takeuchi, K. (2026). Moderating effects of individual characteristics and the target lower limb muscle group on flexibility adaptations to chronic static stretching in healthy individuals: A systematic review and meta-analysis of randomized controlled trials. Sports Medicine – Open, 12, Article 95. https://doi.org/10.1186/s40798-026-01066-1
[6] Ingram, L. A., Tomkinson, G. R., d’Unienville, N. M. A., Gower, B., Gleadhill, S., Boyle, T., & Bennett, H. (2025). Mechanisms underlying range of motion improvements following acute and chronic static stretching: A systematic review, meta-analysis and multivariate meta-regression. Sports Medicine, 55(6), 1449–1466. https://doi.org/10.1007/s40279-025-02204-7
[7] Favro, F., Roma, E., Gobbo, S., Bullo, V., Di Blasio, A., Cugusi, L., & Bergamin, M. (2025). The influence of resistance training on joint flexibility in healthy adults: A systematic review, meta-analysis, and meta-regression. Journal of Strength and Conditioning Research, 39(3), 386–397. https://doi.org/10.1519/JSC.0000000000005000
[8] Mayo Clinic Staff. (2024, June 18). A guide to basic stretches. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20546848
[9] National Health Service. (2024, February 28). Strength exercises. https://www.nhs.uk/live-well/exercise/strength-exercises/
[10] My Joint Health Hub. (n.d.). Iliopsoas syndrome. https://myjointhealthhub.bnssg.nhs.uk/hip-pain/iliopsoas-syndrome/
[11] National Health Service. (2023, November 7). Balance exercises. https://www.nhs.uk/live-well/exercise/balance-exercises/
[12] American College of Sports Medicine, Exercise is Medicine. (2024). Being active as we get older. https://acsm.org/wp-content/uploads/EIM_Being-Active-as-We-Get-Older_Flyer_English.pdf