DEAR DOCTOR,

I’m in my 70s, and I work about 35 hours a week doing shipping, cleaning and light lifting. I’ve stopped visiting the gym because I’m too tired after work. My back hurts, and I’ve had heart issues recently, leaving me with a pacemaker and defibrillator. Are the 10,000 steps I walk at work each day enough exercise?

— SIT DOWN AND LISTEN

DEAR SIT DOWN,

The 10,000 steps you are logging each day are to be celebrated at any age. Add in a physically active job and your wish to stay connected to your work community, and we think you are making many good choices.

The interactions of a workplace offer purpose and camaraderie. And the health benefits of human connection — particularly among the elderly — are well-documented. These include a reduced risk of cardiovascular problems, inflammatory issues and cognitive decline.

In discussing the scope and rigor of exercise with our older patients, we encourage them to listen to their bodies. They themselves are the best teachers when it comes to what types of exercise to take part in, and how much to do.

Our approach is to break physical exercise into four basic categories — endurance, resistance, flexibility and balance. In terms of plain old numbers, the American Academy of Family Physicians recommends at least 2.5 hours of moderate aerobic exercise spread out over the course of a week. This is exercise that raises the resting heart rate, such as brisk walking.

Your work, which in addition to those 10,000 daily steps has some strenuous elements, is contributing to that recommendation. However, to balance things out, you might consider adding resistance exercises, like lifting free weights. Resistance exercise helps prevent osteoporosis and frailty, builds and maintains muscle mass, improves balance and improves mood and cognition.

Flexibility exercises such as yoga or tai chi are also an important element of regular exercise, and they also help with balance. Senior and community centers often offer these and other flexibility classes targeted to older bodies. Just be sure to let the instructors know about any physical problems you have, including the back issues you mentioned in your letter.

You wrote of having heart problems in the recent past. Since you have both a pacemaker and a defibrillator, we strongly recommend that you see your primary care physician to discuss your current and any future exercise regimens. While moderate exercise with either of those devices is generally considered safe, certain adjustments may need to be made to accommodate the implanted devices.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu

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