By David P. Brungo, PT, Expert Contributor, Summerville PT & Balance Rehab for Adults

When it comes to training to improve physical health and well-being, there are five essential components to address: (1) strength, (2) flexibility, (3) balance, (4) core stabilization and (5) endurance (aka, “aerobic conditioning”).  Physical therapy is an excellent choice if you need help in any or all of these areas, but today we’re going to focus on the importance of having adequate functional endurance.

It doesn’t matter if you’re 18 and wanting to be your best on the football or soccer field, basketball or tennis court or in the ballet theatre, or 85 and wanting to be able to keep dancing with your favorite partner, improve how far you can mobilize your wheelchair or continue playing and walking safely in the community with your favorite grandchild, you would be wise to include endurance work on a regular basis.  It’s one thing to have good strength or power. It’s another matter all together to have good functional endurance.  After all, who really cares if you can take one or two strong steps if you can’t handle the 50 steps it takes to get to your restroom in the middle of the night because you run out of steam?

You can get stronger through endurance training, but you can’t improve endurance much at all by working solely on strength and power.  To improve your endurance, your muscles need to be engaged in healthy and progressively longer bouts of aerobic conditioning, so your heart and lungs will need to be able to sustain your level of activity as well as your muscles being able to go the distance.  This does not happen overnight, and you can easily over-do-it and wind up in the ER.  I like to tell my patients, “If you want to PLAY at a certain level, you have to TRAIN at a certain level.”  So, don’t think you can go from couch potato to running (or even walking) the local marathon the next weekend – you’re very likely to hurt yourself or even suffer a stroke or heart attack.  It takes time to condition your body to have better functional endurance – so you’ll need to be patient as well as diligent

Since improving your functional endurance necessarily requires cardiovascular training, if you want to improve your endurance, you must incorporate progressive cardio challenge regularly.  Examples of this might be: (1) walking or jogging at progressively faster speeds for progressively longer distances or periods of time; (2) exercising with a stationary bike, elliptical machine, treadmill or jump rope at progressively faster speeds for progressively longer periods of time; or (3) marching in place, mobilizing your wheelchair manually or performing sit to stand exercises for progressively more repetitions or progressively longer periods of time or distance.

How many times did you see the word “progressively” in those examples?  That’s because our bodies tend to acclimate to our typical amount of activity.  Or worse yet, our bodies will progressively decline in functional endurance if we engage in less and less physical activity.  So, when you try to do more than what your body is used to doing, you feel it in the form of rapid muscle fatigue, usually along with some burning in the muscles being worked, some muscle trembling due to simple muscular fatigue and shortness of breath.  There would also be increased risk of muscle injury if you’re not doing enough to keep your muscles adequately healthy to support the intensity of the work they’re being asked to perform.  The burning is lactic acid build up in the muscles and occurs when those muscles deplete their oxygen stores, which are used as fuel that allows the muscles to expend energy and continue working.  Only through regular and progressive amounts of aerobic conditioning activity will your body train to be able to handle more physical activity without having to wave the white flag and surrender because you can’t catch your breath or take another step without potentially falling.

Improving your functional endurance does not require misery – it just requires consistency and progressive challenge.  It’s very possible to work toward your goals of improved fitness and endurance without wiping yourself out for the entire day or subjecting yourself to substantial risk of injury.  However, it’s always best to get some good advice from the experts and you should make sure you’re healthy enough to engage in a fitness training regimen.  So, if you’re interested in “going the distance” by improving your functional endurance, you should start with your doctor to make sure you’re healthy enough to exercise in such a capacity.  Once medically cleared, consider seeing your favorite physical therapist or fitness trainer to properly guide you through a strength and conditioning program.  You’ll be glad you did and will actually be able to improve your quality of life, and isn’t that the kind of return on investment we all want?


Online Resources:

“Endurance: Endurance, or aerobic, activities increase your breathing and heart rate.” (NIH: Go4Life. found online July 12th, 2019 at:

“Fitness training: Elements of a well-rounded routine.” (Mayo Clinic: found online July 12th, 2019 at:

“Basics of strength and conditioning manual.” Dr. William A. Sands, Jacob J. Wurth & Dr. Jennifer K. Hewit: (The National Strength and Conditioning Association (NSCA): (found online July 12th, 2017 at: