The Overlooked Connection

When people think about leg strength, they usually think about speed, power, or athletic performance. Emerging research suggests that muscle strength—especially in the legs—may play an important role in brain health too. [2,3,7]

The brain and body are deeply connected. Skeletal muscle doesn’t just move you; it behaves as a metabolic and signaling organ, sending information to the brain through blood flow, hormones, and other chemical messengers. [2]

Large observational studies in middle-aged and older adults show a pattern: people with greater muscle strength tend to have a lower risk of developing dementia and experience slower cognitive decline over time. Staying physically active and maintaining fitness are also linked with healthier brain structure and better cognitive performance as we age. [1,5,6]

One long-term twin study found that leg strength in midlife predicted better cognitive aging over a ten-year period, suggesting that maintaining lower-body strength may play a role in protecting brain function later in life. [7,3]

Why Leg Strength Matters

Leg muscles are among the largest muscle groups in the body. When they work—during walking, squatting, climbing stairs, or running—they trigger several physiological responses that may benefit the brain. [2]

Improved circulation

Exercise involving large muscle groups increases cardiovascular output and brain blood flow, helping deliver oxygen and nutrients and support vascular health, which is closely tied to cognitive function. [5,6]

Muscle-to-brain signaling

Active muscles release chemical messengers called myokines that can influence inflammation, metabolism, and neural function, and may help support neuron growth, synaptic plasticity, and brain repair. [2]

Cognitive and neurochemical benefits

Resistance training and regular physical activity have been associated with changes in brain chemistry and electrical activity related to memory and cognition, and with better cognitive performance in older adults. [4,6]

Translation:
Strong legs don’t just move you better. They may also help your brain stay healthier, especially as you age.

The Role of Resistance Training

Resistance training is one of the most efficient ways to build and maintain muscle strength, especially in the lower body. It can be done with bodyweight, free weights, machines, or resistance bands and can be scaled to almost any fitness level. [5]

Research in older adults and people with cognitive impairment suggests that resistance exercise can improve strength, functional capacity, and may offer modest cognitive benefits by improving blood flow, reducing inflammation, and promoting neurotrophic factors like BDNF. While it cannot guarantee prevention of dementia, it appears to be a promising strategy to support overall brain and body health across the lifespan. [1,2,3,4]

Translation:
Lifting isn’t just for performance or aesthetics anymore. It’s one of the most effective levers you can pull for long-term brain and body health.

Only Have 15 Minutes?

No gym. No equipment. No problem! Just 15–30 minutes and a bit of space. That’s enough to train your legs—and challenge your brain with coordination, balance, and effort.

Here are five leg exercises that will train both your body and your brain:

Squats
Targets quads, glutes, and core while reinforcing motor control and neutral alignment.

Step-ups
Single-leg strength and dynamic stability that carry over directly to stairs, running, and sport.

Lateral lunges
Trains side-to-side control, hip strength, and prepares for deceleration work — key for cutting and change of direction.

Glute bridges
Focuses on glutes and hamstrings, supporting hip extension and pelvic control.

Calf raises
Builds calf and ankle strength, helping with balance, walking, and running efficiency.

If you’re new to exercise, have pre-existing medical conditions, or are unsure where to start, check in with a healthcare or rehab professional before ramping up intensity.

The Bottom Line

Strong muscles support more than performance. Building and maintaining leg strength is critical for movement, mobility, and independence — and may also help support cognitive function and healthier brain aging over time.

The takeaway:
Train your legs now.
Load gradually.
Keep them strong across the lifespan.

Because you’re not just training for today’s workout. You may also be investing in how your brain works years from now.

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References

1. Jin, W., Liu, S., Huang, L., Xiong, X., Chen, H., & Liang, Z. (2025). Association between muscle strength and dementia in middle-aged and older adults: A nationwide longitudinal study. Journal of psychiatric research, 191, 189–197. https://doi.org/10.1016/j.jpsychires.2025.09.043

2. Brisendine, M. H., & Drake, J. C. (2025). Integrative physiology of skeletal muscle for maintaining cognitive health. The Journal of physiology, 10.1113/JP286748. Advance online publication. https://doi.org/10.1113/JP286748

3. Vaughan, B. A., Muniz-Terrera, G., Simon, J. E., Grooms, D. R., Clark, B. C., Davatzikos, C., Erus, G., Tian, Q., Ferrucci, L., Resnick, S. M., & Simonsick, E. M. (2025). The predictive power of brain-predicted age and leg strength on mobility decline in aging: findings from the Baltimore Longitudinal Study of Aging. The journals of gerontology. Series A, Biological sciences and medical sciences, 80(12), glaf222. https://doi.org/10.1093/gerona/glaf222

4. Song, Y., Jia, S., Wang, X., Wang, A., Li, S., Ding, F., Ma, T., & Wu, X. (2025). Muscle strength, EEG biomarkers, and working memory as interacting predictors of cognitive function in cognitively impaired older adults. Frontiers in aging neuroscience, 17, 1641209. https://doi.org/10.3389/fnagi.2025.1641209

5. Chen, C., & Nakagawa, S. (2023). Physical activity for cognitive health promotion: An overview of the underlying neurobiological mechanisms. Ageing research reviews, 86, 101868. https://doi.org/10.1016/j.arr.2023.101868

6. Tari, A. R., Walker, T. L., Huuha, A. M., Sando, S. B., & Wisloff, U. (2025). Neuroprotective mechanisms of exercise and the importance of fitness for healthy brain ageing. Lancet (London, England), 405(10484), 1093–1118. https://doi.org/10.1016/S0140-6736(25)00184-9

7. Steves, C. J., Mehta, M. M., Jackson, S. H., & Spector, T. D. (2016). Kicking Back Cognitive Ageing: Leg Power Predicts Cognitive Ageing after Ten Years in Older Female Twins. Gerontology, 62(2), 138–149. https://doi.org/10.1159/000441029

What is an Athletic Trainer?

While both are casually referred to as “trainers”, personal trainer and athletic trainers are two very different roles. Personal trainers generally work in gyms and health clubs, helping the general public improve their level of fitness; Athletic trainers are most often found at colleges, hospitals, clinics and with professional sporting or performance organizations, helping patients or athletes recuperate from injuries and safely continue to participate in sports and physically demanding professions. Below, we’ll dive into the two professions in greater detail:

Personal Trainers

Personal trainers evaluate a person’s fitness level and then design with an exercise program to improve the individual’s health, cardiovascular endurance and body composition. They teach clients how to perform exercises properly, while creating an atmosphere of accountability. Personal trainers with additional credentialing can also education clients on how to live a healthier lifestyle, coaching them on nutrition basics and recovery strategies.

While there is no governing body for personal training, it’s highly recommended to select a personal trainer who has completed a certification program; there are several institutions that offer certifications in personal training, including the American Council on Exercise (ACE) and the National Academy of Sports Medicine (NASM). However, some people may prefer to work with a coach who has learned personal experience in fitness such as a former athlete, rather than someone who has completed a certification program. In any arrangement, it is important to start smart-

1. Check with your doctor before beginning a new fitness program

2. Opt for simple movement patterns at low to moderate weights while you are still learning to limit your risk of injury

3. Stay hydrated and take rest breaks as needed

4. Stop exercising if you feel dizzy, lightheaded, nauseated, experience chest pain, or have an unexpectedly difficult time breathing

5. Don’t do anything you’re not comfortable with

Athletic Trainers

Athletic trainers are clinicians who provide injury preventative services, emergency care, clinical diagnosis of injuries, therapeutic intervention and rehabilitation of both injuries and medical conditions. Athletic training is recognized by the American Medical Association (AMA), Health Resources Services Administration (HRSA) and the Department of Health and Human Services (HHS) as an allied health care profession. As a part of the healthcare system, athletic trainers work under the direction of a physician, and work collaboratively with physical therapists, massage therapists, and chiropractors. As part of an athletic department, they partner with the coaching and strength and conditioning staff, as well as nutrition and sport psychology teams to promote the overall health of the athlete.

Athletic trainers undergo rigorous academic and clinical training, supervised by the Commission on Accreditation of Athletic Training Education (CAATE). The current minimum entry point into the profession of athletic training is at the master’s level. Upon completion of a CAATE-accredited athletic training education program, students become eligible for national certification by successfully completing the Board of Certification, Inc. (BOC) examination. Once certified, athletic trainers are required to complete several hours of continuing education every year in an effort to ensure all professions remain current on the latest recommendations within sports medicine.

Comprehensive Care

There’s not a lot of crossover between the two occupations. This isn’t to say the roles can’t go hand in hand. After working with an athletic trainer to rehabilitate a sprained ankle, for example, an athlete may choose to enlist the help of a personal trainer to return his strength and endurance to the levels they were before the injury.

Physical TheraPT is a multi-faceted clinic, centered on patient success. By placing the individual at the hub of the system, instead of siloing by speciality, we’re able to streamline a truly comprehensive recovery. Our athletes are able to seamlessly work with the professionals they need- physical therapists, athletic trainers, massage therapists, and strength coaches- all in one place. Our athletic trainer offers:

• Urgent Injury Assessment: Streamline your recovery by seeing an athletic trainer first. With extensive orthopedic education, athletic trainers are able to quickly determine the severity of an injury, determine next-steps and make referrals to local physicians, and provide you with home care instructions

• Rehab: Apply the same proven approaches used with elite athletes to your unique situation and goals. Our expertise includes post-operative rehab, as well as rehab for both chronic and acute injuries and conditions.

• Return-to-Play Training: We offer evidence-based programs, utilizing technology like force plates, dynamometer testing, blood flow restriction training (BFR), biofeedback and motion analysis to formulate your plan. Following a comprehensive evaluation, we can problem-solve with you to optimize your movement potential.

• Injury Prevention: By using similar tools as detailed above, we are able to assess athletes and individuals before an injury occurs. Underlying movement compensations and imbalances are often evident even in healthy athletes. By prescribing corrective exercise strategies, and customized strength and conditioning programming, these vulernabilities can be targeted.

To learn more, check out these resources:

1. American Counsel on Exercise

2. National Athletic Trainers’ Association

3. National Academy of Sports Medicine

4. CT.gov

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Flexor Hallucis Longus Tendinopathy: Part II

If the symptoms from the last post sound familiar, it’s important to seek care to prevent the condition from advancing. The good news is FHL tendinopathy does not require imaging for diagnosis. You can see a PT or AT directly- they’ll evaluate and diagnose your condition, and will refer you to a physician as needed.

After assessing your leg, your clinician will be able to ascertain contributing factors that led to the injury and how to address them with an individualized exercise program including neuromuscular re-education and functional training. Neuromuscular re-education helps reprogram the way you move- focusing on specific muscle activation and timing. This strategy takes the whole kinetic chain into consideration, looking for inefficient habits that may seem unrelated to your injury.

For example, many athletes diagnosed with FHL tendinopathy present with excessive pronation- or arch collapsing- a faulty pattern that can contribute to overloading the FHL in running. Strengthening the hip, pelvis and core muscles, combined with improved running mechanics can reduce this problem for the long term!

If you are able to see a clinician in-person, manual therapy may be beneficial to reduce inflammation, muscular tension, and any joint stiffness.  

Until your appointment, follow these recommendations at home:

1. Rest from the aggravating activity - running, dancing, etc.

2. For pain management, try over the counter NSAIDs (ie Advil, Aleve)

3. Use contrast therapy to reduce inflammation:

   • Submerge foot for 10-15’ total following the pattern below:

     • 2-3’ in ice water

     • 2-3’ warm water

     • 2-3’ ice water

     • 2-3’ warm water

     • 2-3’ ice water

4. Self-massage the outer calf by rolling with a tennis ball or something similar on the floor

5. Perform a seated calf stretch with a towel at the toes, being sure to pull the big toe back with the foot

Jump Into Prenatal Fitness

The literature has shown exercise can decrease pain, improve function, and limit time off work due to pregnancy-related back and pelvic pain. In general, strengthening routines should focus on muscles of the back, core and pelvic floor. Bonus circuits can also include upper body strengthening in preparation to lifting and carrying your bundle of joy. Depending on your experience with exercise, you can choose between independent sweat sessions, or working one-on-one with a coach. Prenatal group exercise classes are recommended for individuals who find themselves needing modifications for greater than 50% of the class. But what if you feel too pregnant to exercise?

Enter water aerobics.  While the class may conjure images of senior citizens in shower caps, aquatic therapy is frequently used with patients who are pregnant. Being in the water up to chest level takes off 70% of your body weight. This can be extremely helpful for soon-to-be moms who are having painful back and pelvic girdle issues, allowing for exercise until they can tolerate more land therapy.

A 2016 systematic review of literature, found strong evidence demonstrating benefit of combined aquatic and resistance for maternal cardiorespiratory fitness and prevention of urinary incontinence. Additionally, a 2011 study found that aquatic therapy is effective in reducing peripheral edema (swelling in the ankles and feet). 

Depending on your community, access to a pool may vary. Some health clubs and specialty physical therapy clinics offer individual and group classes depending on local health regulations. Your OB-GYN can be a great resource for other options. Just be sure to double-check with your primary medical team before jumping in the nearest lake!