Biden’s Fall, A Reminder About Leg-Strength for us All

by Mike Mutzel



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Show Notes:

00:20 Leg muscle strength is important, especially as you age. Age-related muscle loss is accelerated in the lower body, especially in women.

01:30 Strength training in the elderly prevents falls from loss of strength.

02:45 If you don’t exercise as you age, your muscle mass atrophies. There is infiltration of fatty acids and more insulin resistance, accompanied by chronic inflammation. There is a reduction in mitochondria, as well as an accumulation of dysfunctional mitochondria. Mitophagy is autophagy of the mitochondria.

02:50 Exercise is essential business.

04:25 Posterior Chain: Getting up off the ground and getting out of a chair requires posterior chain muscle strength: glutes, hamstrings, quads and low back muscles. The hip thrust is a great way to strengthen the posterior chain.

05:14 You should be working your legs at least 2 days a week. You can use bands or body weight.

06:20 About 57% of whole-body muscle in women is in their lower body. As women age, there is a greater loss of lower body muscle, making them more susceptible to falling.

06:50 Leg muscle becomes insulin resistant earlier than muscle in the upper body. Part of this process is inflammation and mitochondrial dysfunction.

07:35 Mechanical unloading is atrophy. You should do resistance training, walk up hills and sprint.

09:00 The stronger that elderly people can make their legs, the higher probability that they are going to live independently longer. Strength training is a preventative fall intervention.

10:50 Work every major muscle group at least 1 day per week. Resistance training sends signals that prevent insulin resistance and the ensuing inflammation.

12:35 Frailty, loss of strength, is linked with increased probability of being hospitalized with COVID. Resistance training and having muscle is linked with lower probability of having a severe infection.

14:00 Growth hormone and testosterone helps with healthier muscle in the elderly, men and women. Diet and lifestyle affect your hormones. Hormone challenges are occurring in younger and younger people.

17:15 First examine diet/nutrition and lifestyle. NMN would not be the first course of action.

17:30 It can be challenging to get the dosing correct using TRT pellets. TRT and HRT shuts down natural production.

17:50 Pellets may work well for women. The pellets are injected under the skin. Doses too high can be agitating and can accelerate hair loss.

18:30 Mike suggests that women use topical testosterone and rub it around the clitoris, or even the anus. That is the most absorptive tissue.

18:47 Mike suggests for men with topical testosterone, that it be concentrated to the smallest amount and applied around the rectum. Another effective option is subcutaneous injections every other day or every day.

19:12 A healthy male will release around 10 milligrams of testosterone per day.

19:25 Androgel is not advised. It is applied to the abdomen, but there is a lot of aromatase enzyme in the fat around the abdomen.

19:52 Testosterone should peak in the morning for men. If you use pellets, it will be high all the time. There may be a circadian rhythm disruption with the pellets.

20:00 Propionates have a shorter half-life. That is beneficial if you are doing regular injections.

20:35 Older women need to go to failure with resistance training to build strength/muscle.

21:20 Sprinting is better for leg muscle than slow jog, which is catabolic.

21:30 Red light on testicles can help with testosterone, for men under 50. Over 50, not so much.

21:50 Fat bun syndrome affects legs and low back.

22:40 Loss of strength is an independent risk factor for early mortality.


 (2021). Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019. Mayo Clinic Proceedings, 96(1), 32–39. 

Cheval, B., Sieber, S., Maltagliati, S., Millet, G. P., Formanek, T., Chalabaev, A., et al. (2021). Muscle strength is associated with COVID-19 hospitalization in adults 50 years of age and older. medRxiv, 2021.02.02.21250909–21. 

Moreland, J. D., Richardson, J. A., Goldsmith, C. H., & Clase, C. M. (2004). Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta‐Analysis. Journal of the American Geriatrics Society, 52(7), 1121–1129. 

Cawthon, P. M., Fox, K. M., Gandra, S. R., Delmonico, M. J., Chiou, C.-F., Anthony, M. S., et al. (2012). Do Muscle Mass, Muscle Density, Strength, and Physical Function Similarly Influence Risk of Hospitalization in Older Adults? Journal of the American Geriatrics Society, 57(8), 1411–1419. 

Frailty—A promising concept to evaluate disease vulnerability. (2020). Frailty—A promising concept to evaluate disease vulnerability. Mechanisms of Ageing and Development, 187, 111217. http://doi.org/10.1016/j.mad.2020.111217


Gao, Y. (2018). Muscle Atrophy Induced by Mechanical Unloading: Mechanisms and Potential Countermeasures, 1–17. http://doi.org/10.3389/fphys.2018.00235

  1. Something I noticed about Biden and his fall is that he was able to get up easily although some help from the hand rail. I don’t know what kind of condition he is in or if he exercises. but some old people wouldn’t have been able to recover that fast. At least he isn’t obese. That said, I agree with you. I’m 80 and have exercised my entire life. Still Squat twice a week and Deadlift once. Upper body twice a week. Back exercises after Deads. Also walk 45 minutes to an hour almost every day. My dogs seldom give me a day off from their walk. Everyone should read your advice on this. It could save a life. Thanks for the video.

    • Thanks, you make a good point!

      Great for you that you’re squatting and deadlifting at 80, fantastic work!!

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