The Overlooked Key to Aging Well: Why VO₂ Max Might Be More Important Than You Think
Strength is typically viewed as the single most important tool we have to protect our independence and longevity as we age. And that’s true. But there’s a second—less obvious—pillar that most people over 55 don’t talk about enough. It’s not your cholesterol. It’s not your blood pressure. It’s your VO₂ Max. “VO…What?”
VO₂ Max stands for your maximum oxygen consumption—in simple terms, it’s your body’s ability to deliver and use oxygen efficiently during exercise. It’s a reflection of how well your heart, lungs, muscles, and blood vessels all work together under stress. It’s not just for runners or triathletes. In fact, Dr. Attia calls it the single most powerful predictor of future lifespan, across all categories. And yet… most people have never even heard of it.
Strength vs. Endurance: The Two Gears of Longevity
Most of my clients intuitively understand the concept of strength. They know if their legs are weak, stairs are harder. They can feel their grip get softer or their knees get wobbly. They see and feel strength loss. But VO₂ Max? That’s sneakier.
Here’s how low VO₂ Max shows up:
You’re winded walking up one flight of stairs
You avoid hikes because you “don’t have the energy”
You have to pause halfway through carrying groceries
You struggle to keep up with your grandkids
You feel “tired all the time” but can’t pinpoint why
Sound familiar?
These aren’t just signs of aging. They’re red flags of deteriorating cardiovascular capacity. And the scary part? VO₂ Max naturally declines 1% per year after age 30—unless you train it.
Meet Bill: From Winded to Walking Tall
Let me tell you about my patient, Bill. He came into our clinic not because he was in pain, but because he was frustrated. He had retired early to enjoy time with his wife and grandkids, but he was finding it hard to keep up. “I used to be active,” he told me. “But lately I get winded walking out to the mailbox.” Bill was strong enough. He could leg press, do light weight training, and even balance fairly well. But when we did a simple cardiovascular stress test, the truth was clear:
His VO₂ Max was very low.
His heart and lungs had deconditioned.
Not because of disease.
Because of disuse.
So we got to work.
How We Improved His VO₂ Max
We didn’t throw Bill on a treadmill for 30 minutes a day. That’s not how this works.
We built a progressive plan, tailored to his baseline. Here’s what it looked like:
Zone 2 Training: We started walking at a pace that kept his heart rate just under threshold—where he could talk but not sing. He did this 4-5 times a week, starting with 20 minutes and gradually building up to 45 minutes.
Intervals: Once his baseline built up, we introduced short bursts of higher intensity—30 seconds of faster effort followed by 90 seconds of slow recovery. This trained his heart to adapt.
Functional Cardio: Bill also trained by carrying light weights across the room, getting up from the floor multiple times in a row, and walking up slight inclines—because longevity isn’t about performance… It’s about life.
After just 12 weeks, Bill’s energy was up, his heart rate at rest was down, and—his words, not mine—“I can finally walk with my grandson again without pretending I have to tie my shoe just to catch my breath.” That’s not fitness. That’s freedom.
The Real-Life Impact of VO₂ Max
You don’t need to become a marathoner. But you do need to understand this:
VO₂ Max isn’t about exercise. It’s about access.
It’s about having enough energy to:
Get off the floor after playing with your grandkids
Walk with confidence on vacation
Climb the stairs without feeling your chest thump
Recover quickly when life throws stress your way
Live fully, not cautiously
How to Improve Your VO₂ Max After 55
Here’s how to get started safely and effectively:
Get assessed: Know your baseline. A good physical therapist or wellness coach can help test your cardiovascular fitness.
Train Zone 2: This is your “all-day pace.” Walking, light cycling, swimming, or rowing at a conversational intensity—4 to 6 days per week, 30-45 minutes.
Add intervals once a base is built. These don’t need to be all-out sprints. Just a little discomfort followed by recovery.
Use a heart rate monitor to stay honest. Many people think they’re training hard enough—they aren’t.
Track your progress. More distance, lower resting heart rate, faster recovery… these are wins.
A Final Word
You can’t out-supplement or out-medicate a declining VO₂ Max. You must train it. And the beautiful part? Every step you take, every walk you complete, every round of intervals you finish—you’re literally adding years to your life. Just like strength, VO₂ Max is trainable. But unlike strength, it slips away without obvious warning signs… until it’s gone. Don’t let that happen.
Be like Bill.
Catch it early.
Train for tomorrow, today.
Your future self will thank you for it.
The author, Rob Sumner, is a Doctor of Physical Therapy and owner of Sumner Specialized Physical Therapy, Specialized Strength, and Specialized Massage. He's happy to answer any questions about this article, wellness, or physical therapy overall by phone at (509) 684-5621 or by email at Rob@SumnerPT.com
