Reversing Sarcopenia
- Dr. Brian Abelson
- 3 days ago
- 13 min read
Sarcopenia, the progressive loss of muscle mass and strength associated with aging, is one of the most underestimated threats to health and independence. Beyond causing frailty, it dramatically increases the risk of falls, fractures, hospitalization, and dependency. Yet, there is hope. Sarcopenia is neither inevitable nor irreversible. With the right combination of exercise, nutrition, lifestyle changes, and manual therapy, it is possible to preserve, restore, and even build muscle well into later decades of life.
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How Common is Sarcopenia?
Sarcopenia affects approximately 10% of people over the age of 60, 30% of those over 70, and more than 50% over 80. Men are often more affected, particularly when compounded by conditions like obesity, diabetes, and cardiovascular disease. Sarcopenia's toll isn't just physical — it undermines social engagement, leads to isolation, and can trigger depression due to reduced independence and quality of life.
Fortunately, research consistently shows that sarcopenia can be slowed, halted, and even reversed through integrated, science-based interventions.
Why Muscles Weaken: The Underlying Causes
The Biochemical and Biomechanical Drivers
Several key factors drive sarcopenia:
Anabolic resistance: Older muscle is less responsive to protein and exercise stimuli.
Chronic inflammation: Persistent low-grade inflammation (“inflammaging”) promotes muscle breakdown.
Oxidative stress: Damages muscle fibers and mitochondria.
Hormonal changes: Decreased levels of testosterone, growth hormone, and IGF-1 impair muscle synthesis.
Mitochondrial dysfunction: Reduces the muscle’s energy capacity and repair potential.
Neuromuscular Junction Degeneration
The connection between nerves and muscles — the neuromuscular junction (NMJ) — deteriorates with age. This disconnect limits the nervous system’s ability to fully activate muscle fibers, contributing to weakness and poor coordination.
Progressive Resistance Training (PRT)
Progressive Resistance Training (PRT) remains the most effective, evidence-based intervention for both the prevention and reversal of sarcopenia. Numerous randomized controlled trials and meta-analyses have confirmed that PRT improves skeletal muscle mass, muscular strength, neuromuscular coordination, functional mobility, and metabolic health—even in adults well into their 70s and 80s.
From a physiological standpoint, progressive resistance training (PRT) works by sending powerful signals to the muscles that tell them to grow and get stronger. It does this through a process called mechanotransduction—where mechanical stress from lifting weights is converted into biochemical signals. These signals activate muscle satellite cells, which are essential for muscle repair and growth, and stimulate a key growth pathway known as mTORC1 (mechanistic target of rapamycin complex 1). This pathway plays a central role in triggering muscle protein synthesis—the process by which the body builds new muscle tissue.
In older adults, one of the major challenges is anabolic resistance, which means the muscles don’t respond as effectively to exercise or protein intake. However, research shows that regular PRT can significantly reduce this resistance, helping aging muscles regain their ability to grow and strengthen in response to both movement and nutrition.
Core Training Principles Backed by Science:
Train with sufficient intensity: Targeting ~70–85% of 1-repetition maximum (1RM) and aiming for momentary muscular failure is essential to maximizing type II fiber recruitment and triggering hypertrophic signaling cascades (Mitchell et al., 2012; Morton et al., 2016).
Progressive overload: Gradually increasing resistance or training volume enhances neuromuscular adaptation and maintains muscle responsiveness over time, preventing training plateaus and promoting continual remodeling (Kraemer & Ratamess, 2004).
Emphasize compound, multi-joint exercises: Movements like squats, deadlifts, rows, and presses engage larger muscle groups, enhance motor unit recruitment, and elicit a more significant systemic hormonal response than single-joint exercises (Schoenfeld, 2010).
Prioritize eccentric contractions: Eccentric training, characterized by controlled lengthening under load, generates greater mechanical tension and microtrauma per unit of force, which enhances hypertrophy, tendon resilience, and joint control—particularly important for older adults with declining proprioception (Roig et al., 2009).
Minimum effective dose: As little as two sessions per week of structured PRT has significantly increased muscle mass and strength while improving mobility and reducing fall risk (Liu & Latham, 2009).
One of the Biggest Mistakes Older Adults Make
One of the most common reasons older adults fail to see results from weight training is that they repeat the same exercises with the same light weights week after week. Without progressive overload—the gradual increase of resistance or training intensity—the body has no reason to adapt. As a result, muscles stop responding, leading to plateaus in strength and mobility. To truly stimulate muscle growth and improve function, resistance must be increased over time and training must be performed with enough intensity to challenge the muscle near its limit. Simply “going through the motions” won't reverse sarcopenia.
Coordination and Balance Training: A Key Strategy in Combating Sarcopenia
Sarcopenia is not solely a loss of muscle mass—it also involves a decline in neuromuscular function, including impaired balance, coordination, and proprioceptive control. This is largely due to age-related degradation of the neuromuscular junction (NMJ), the vital connection through which nerves stimulate muscle fibers to contract. As NMJs deteriorate, muscle activation becomes less efficient, leading to weakness, slower reaction times, and a greater risk of falls and functional decline.
Older adults who maintain superior physical function—often called “superagers”—frequently engage in activities that challenge coordination, precision, and dynamic stability. Practices like Tai Chi, ballroom dance, and racket sports have been shown to preserve NMJ integrity, improve motor unit recruitment, and reinforce corticospinal pathways that regulate voluntary movement. These activities also enhance proprioception, or the body's awareness of joint position and motion—critical for maintaining posture, preventing falls, and supporting overall mobility as muscle strength declines.
MSR Insight: Motion Specific Release (MSR) can serve as a powerful adjunct to coordination and balance training in sarcopenia management. MSR techniques stimulate fascial mechanoreceptors, improve joint mobility, and restore afferent feedback pathways to the central nervous system. By enhancing proprioceptive signaling and reducing soft-tissue restrictions, MSR supports more accurate neuromuscular control, helping older adults maintain stability, reduce fall risk, and compensate more effectively for muscle loss.
Optimizing Protein Timing and Nutritional Support to Counter Sarcopenia
In older adults, one of the key biological challenges in combating sarcopenia is anabolic resistance—a reduced sensitivity of muscle tissue to the anabolic effects of both dietary protein and resistance exercise. To overcome this, research suggests that total protein intake alone is not enough; how and when protein is consumed is just as important.
To stimulate muscle protein synthesis (MPS) throughout the day, aging individuals should aim for 25–30 grams of high-quality protein per meal, spaced evenly across breakfast, lunch, and dinner. This approach helps maintain circulating amino acid levels and ensures repeated activation of the mTOR signaling pathway, which governs muscle repair and growth. Consuming the majority of protein in a single meal, as is common in older populations, leaves large windows of time when muscles are deprived of the raw materials needed for maintenance and recovery.
Additional Nutritional Interventions with Evidence-Based Benefits:
Creatine MonohydrateWell-established for enhancing muscle phosphocreatine stores, creatine supports high-intensity muscular contractions and has been shown in numerous trials to increase lean muscle mass and strength in older adults—especially when combined with resistance training.
Omega-3 Fatty AcidsFound in fatty fish and high-quality supplements, omega-3s reduce systemic inflammation, improve muscle protein metabolism, and may enhance muscle cell membrane integrity. Studies also show improvements in grip strength and functional performance in older adults supplemented with omega-3s.
Antioxidants and Anti-inflammatory PhytochemicalsCompounds such as curcumin, resveratrol, and polyphenols found in berries, dark leafy greens, and colorful vegetables help combat oxidative stress—a key driver of muscle cell damage and mitochondrial decline in sarcopenia. These nutrients support muscle recovery and protect against age-related degeneration.
Inflammation Management: A Critical Factor in Combating Sarcopenia
Chronic low-grade inflammation—often referred to as “inflammaging”—is a key, yet under-recognized, contributor to the development and progression of sarcopenia. Elevated levels of inflammatory cytokines such as IL-6, TNF-α, and CRP (C-reactive protein) promote muscle protein breakdown, impair anabolic signaling, and inhibit satellite cell activation, all of which reduce the muscle’s ability to repair and regenerate.
Even in individuals engaging in resistance training or consuming adequate protein, persistent inflammation can blunt the muscle-building response and accelerate sarcopenic decline. Therefore, managing inflammation is essential for preserving both muscle mass and function.
Evidence-Based Strategies to Lower Inflammation:
Prioritize High-Quality Sleep (7–8 hours/night):Sleep disruption elevates cortisol and pro-inflammatory cytokines, directly contributing to catabolic muscle loss. Deep, restorative sleep supports growth hormone release and tissue repair.
Adopt a Fiber-Rich, Microbiome-Friendly Diet:A diverse intake of soluble and insoluble fiber from fruits, vegetables, legumes, and whole grains promotes a healthy gut microbiota. This reduces intestinal permeability (“leaky gut”) and systemic inflammation by lowering endotoxin translocation.
Engage in Regular Moderate-Intensity Exercise:Activities like brisk walking, cycling, or swimming reduce circulating inflammatory markers and enhance mitochondrial function—both of which are protective against sarcopenia. Avoid chronic overtraining, which may worsen inflammation in older adults.
Incorporate Anti-Inflammatory Nutrients:Natural compounds such as curcumin (from turmeric), omega-3 fatty acids, and polyphenols found in berries, olive oil, and green tea help inhibit NF-κB activity, a central regulator of inflammatory gene expression.
MSR Insight:Manual therapy techniques used in Motion Specific Release (MSR) can support inflammation management by improving lymphatic drainage, enhancing circulation, and promoting autonomic balance. Specifically, MSR's influence on the parasympathetic nervous system may reduce sympathetic dominance, which is associated with heightened systemic inflammation and stress-related catabolism.
The Power of Vitamin D, Micronutrients, and Mild Stressors
Vitamin D & Micronutrients
Optimal Vitamin D status (>40 ng/mL) is essential for muscle protein synthesis, balance, and strength. Older adults often require 2,000–4,000 IU daily.
Synergistic nutrients:
Vitamin K2: Guides calcium to bones, preventing arterial calcification.
Magnesium, Zinc, Selenium, B12: Support muscle contraction, repair, and nerve function.
Creatine: Enhances muscle energetics and strength.
Harnessing Hormetic Stress
Mild, intermittent stress, when applied strategically, strengthens muscles and cellular resilience.
Evidence-based hormetic practices include:
Brief cold exposure (cold showers, plunges)
Sauna use
Intermittent fasting (8–10-hour eating window)
Short-duration isometric exercises
Sleep: The Overlooked Factor in Muscle Preservation
Sleep plays a foundational yet often overlooked role in the prevention and reversal of sarcopenia. During deep sleep, the body enters a critical anabolic phase where it releases growth hormone (GH)—a key regulator of muscle protein synthesis, tissue repair, and satellite cell activation. Inadequate or poor-quality sleep disrupts this process, leading to impaired muscle recovery and accelerated tissue breakdown.
Moreover, sleep deprivation increases levels of cortisol, a catabolic hormone that promotes muscle degradation and suppresses the anabolic pathways responsible for regeneration. At the same time, disrupted sleep impairs insulin sensitivity, reducing nutrient delivery to muscle cells and increasing fat accumulation—both of which worsen sarcopenic outcomes.
Emerging research also links insufficient sleep with elevated inflammatory cytokines (e.g., IL-6, TNF-α), further contributing to the chronic low-grade inflammation known to drive muscle loss in aging populations.
MSR Insight:
Motion Specific Release (MSR) techniques, particularly those focused on the cranial and cervical regions, can enhance parasympathetic tone by stimulating the vagus nerve—a key regulator of the body’s rest-and-recovery state. By promoting relaxation and reducing sympathetic overactivation, MSR may improve sleep onset, duration, and quality, thus indirectly supporting the hormonal and regenerative processes essential for muscle preservation in older adults.
Integrating Manual Therapy into Sarcopenia Management
While progressive resistance training and targeted nutrition are the primary therapeutic pillars for sarcopenia, manual therapy plays a powerful complementary role in optimizing musculoskeletal function and improving treatment outcomes. In particular, Motion Specific Release (MSR) offers a multimodal, biomechanically and neurophysiologically informed approach that addresses the structural and sensory limitations often present in older adults.
Age-related changes such as joint degeneration, myofascial stiffness, and neuromuscular inhibition can impair movement efficiency and increase pain, limiting an individual's ability to engage safely and effectively in exercise. Manual therapy helps resolve these barriers by modulating both mechanical properties and neural input to the musculoskeletal system.
How MSR Enhances Sarcopenia Treatment:
Improves Joint Mechanics:MSR’s targeted osseous mobilization techniques help restore segmental alignment and range of motion, reducing compensatory movement patterns that contribute to joint overload and disuse atrophy.
Restores Fascial Glide and Muscle Extensibility:Through precise fascial decompression and manipulation of fascial lines, MSR reduces adhesions and improves tissue elasticity, enabling full, pain-free joint excursion and better force transmission during exercise.
Supports Autonomic Nervous System Regulation:By activating mechanoreceptors and stimulating parasympathetic tone, MSR promotes a shift from sympathetic (stress-dominant) to parasympathetic (restorative) balance, enhancing recovery and reducing inflammatory load.
Enhances Proprioception and Neuromuscular Control:MSR techniques improve afferent feedback from joints, fascia, and muscle spindles to the central nervous system, strengthening the body’s ability to recruit and coordinate muscle fibers efficiently—especially critical when neuromuscular junctions are in decline.
Aligns with Traditional Chinese Medicine (TCM) Principles:MSR incorporates TCM-inspired strategies such as meridian-specific fascial release, which may improve circulation, interstitial fluid dynamics, and energetic balance, thereby supporting whole-body resilience and tissue vitality.
Clinical Insight:
When integrated with resistance training, MSR reduces movement restrictions, alleviates musculoskeletal pain, and improves motor control—empowering older adults to engage more fully in exercise. This integrated strategy not only enhances strength and mobility but also accelerates the reversal of sarcopenia and supports long-term functional independence.
Conclusion
Sarcopenia is one of the most significant, yet modifiable, health challenges facing the aging population. While muscle loss was once seen as an unavoidable consequence of aging, science now tells a different story. The integration of progressive resistance training, targeted nutrition, proper sleep, inflammation management, and neuromuscular reeducation provides a powerful toolkit to prevent further decline and actively restore strength, mobility, and independence. These strategies go beyond symptom management—they target sarcopenia's cellular and neurological roots, offering tangible and lasting improvements in both function and quality of life.
Manual therapy, especially Motion Specific Release (MSR), adds a critical and often overlooked dimension to sarcopenia care. By enhancing joint mechanics, releasing fascial restrictions, and optimizing proprioceptive input, MSR supports the body’s ability to engage fully in movement and adapt to exercise. When combined with a structured, evidence-based lifestyle approach, this integrative strategy can help patients of any age reclaim their vitality, reduce the risk of injury, and thrive well into their later decades. It is never too late to begin reversing sarcopenia—the path to strength, resilience, and independence starts with your next informed choice.
References
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DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical experience and having treated more than 25,000 patients, Dr. R. Brian Abelson is the creator of the Motion Specific Release (MSR) Treatment Systems—a powerful, evidence-based approach designed to achieve effective, lasting results.
As an internationally best-selling author, Dr. Abelson is dedicated to sharing knowledge and techniques that benefit the broader healthcare community. His passion for continuous learning drives him to integrate cutting-edge methodologies into the MSR programs, with a strong focus on multidisciplinary collaboration.
At the heart of his work is a commitment to patient-centered care, constantly evolving to advance treatment methods. Dr. Abelson practices at Kinetic Health in Calgary, Alberta, Canada, where he helps patients move beyond pain to achieve lasting health and improved function.
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