For ZEM, longevity means preserving the capacity to keep doing what matters to you in the years ahead. Building and maintaining muscle is an important part of that purpose, alongside balance, mobility and aerobic fitness. Our approach begins with clinical assessment and personalised guidance, shaped around your abilities, health needs and goals. Together, these elements connect the work you do today with everyday ambitions: travelling independently, enjoying an active life and moving with confidence as you grow older.
Muscle mass, stregnth and power
Muscle mass refers to the amount of muscle tissue in your body. In the context of movement and healthy ageing, the focus is on skeletal muscle: the muscles that help you walk, lift, climb stairs and maintain your posture.
Muscle mass and strength are related, but they are not the same. Mass describes how much muscle you have, strength describes how much force it can produce, and power describes how quickly that force can be generated. All three contribute to physical function, but strength and power are particularly important for maintaining independence as we age.
Our muscles contain different types of fibres. Type I, or slow-twitch fibres, are more resistant to fatigue. Type II, or fast-twitch fibres, can contract more rapidly and are particularly important for generating strength and power during demanding or explosive movements.
With ageing, type II fibres tend to experience more pronounced reductions in size and function. This contributes to the age-related loss of muscle power, which can affect everyday abilities such as climbing stairs quickly, getting out of a chair or reacting when we lose our balance.
“Preserving muscle is not just about maintaining its size. It is also about retaining the ability to produce force, and to produce it quickly when needed. That is what makes muscle so important for healthy ageing.”
– Dr Ricardo Ramos Malagón, Integrative medicine | Sports & Exercise Medicine specialist
Muscle vs fat: what does your weight really tell you?
Body weight alone provides limited information about body composition. Two people of similar height and weight may have substantially different proportions of muscle and fat, with important implications for metabolic health and physical function. Similarly, improvements in body composition, such as gaining muscle while reducing body fat, may occur without significant changes on the scales.
From a clinical perspective, understanding these changes is essential for effective weight management. Weight loss does not necessarily reflect fat loss alone; it may also involve a reduction in muscle mass, potentially compromising strength and physical function. Body composition assessments therefore provide valuable information to guide nutritional and exercise strategies, with the objective of reducing excess body fat when appropriate while preserving or improving muscle mass and function.
At ZEM, weight management is approached within a broader framework of metabolic health, physical performance and longevity. Doctors, nutritionists and personal trainers work together to integrate body composition measurements with assessments of muscular strength, metabolic health and individual needs. This multidisciplinary approach allows for personalised nutrition and exercise programmes that prioritise not only changes in body weight, but also the preservation of physical capacity and long-term health.
“A change on the scales does not tell us whether we are moving in the right direction. We also want to know what is happening to muscle mass, strength and function, because these are essential for long-term Health.”
– Dr Ricardo Ramos Malagón
How are muscle mass and function assessed?
Assessing muscular health requires more than measuring muscle quantity. At ZEM, body composition analysis, using methods such as bioelectrical impedance (BIA), helps estimate muscle mass and monitor changes over time. Complementary 3D body scanning provides information about body shape and proportions. However, muscle mass alone does not tell us how effectively our muscles function, making strength and power assessments equally important.
These functional assessments reflect the combined response of the nervous system and muscles. The central nervous system activates and coordinates muscle contractions, while the muscles generate the force required for movement. Therefore, strength and power depend not only on muscle mass, but also on neuromuscular activation, coordination and the ability to recruit muscle fibres effectively.
One of the best ways to assess muscle function is handgrip dynamometry, which measures the maximum force generated when squeezing a handheld device. Beyond grip strength, it provides valuable information about neuromuscular function, with lower values consistently associated with poorer physical performance and increased mortality risk. For a more advanced assessment, force platforms such as ForceDecks can provide additional insights into lower-limb strength, power and overall neuromuscular performance, helping guide more personalised exercise strategies.
Together, these measurements provide a more complete picture of muscular and neuromuscular health, helping identify individual limitations and guide targeted exercise programmes aimed at preserving strength, power and independence.
How can I estimate my brain age?
“Assessing muscle health means looking beyond muscle mass. Strength and power reflect how effectively the nervous system and muscles work together to produce movement, a capacity that is essential for maintaining physical function as we age.”
– Dr Ricardo Ramos Malagón
What can assessment change in practice?
Consider someone who struggles to rise from a chair. The limitation may result from insufficient strength, pain, reduced mobility or balance difficulties, each requiring a different approach.
If weakness is the main problem, training might begin with assisted sit-to-stand exercises, progressing towards greater resistance as strength improves. If the movement is controlled but excessively slow, training may also emphasise producing force more rapidly.
The objective is to identify the individual’s limitations and translate assessment findings into targeted exercise strategies that improve everyday function.
What are common mistakes to avoid when trying to get stronger?
Common mistakes include lifting weights that compromise technique, progressing too quickly, neglecting recovery and following programmes that do not reflect individual abilities or limitations.
Another important mistake is assuming that every exercise set should continue until muscular failure. As fatigue accumulates, repetitions generally become slower, reducing the ability to produce force rapidly. Although training close to failure can be useful for muscle growth, excessive fatigue is not always desirable when the objective is to improve strength and particularly power.
This is especially relevant to type II (fast-twitch) muscle fibres, which contribute substantially to rapid force production and tend to undergo greater age-related deterioration. Preserving the ability to generate force quickly should therefore be an important consideration in training for healthy ageing.
Velocity-based training: using movement speed to guide exercise
Velocity-based training (VBT) uses sensors to monitor the speed of repetitions during resistance exercises. For example, during a set of squats, movement speed progressively decreases as fatigue develops.
By measuring this reduction, a trainer can establish a velocity-loss threshold at which to end the set, rather than always continuing until failure. This allows exercise intensity and fatigue to be managed according to the training objective. Lower velocity losses are generally favoured when prioritising speed and power, while greater fatigue may be appropriate for certain muscle-growth programmes.
Although specialised technology is not essential for effective training, VBT illustrates a valuable principle: training quality matters as much as training volume.
“More repetitions are not always better. Monitoring movement speed can help manage fatigue and preserve the quality of strength and power training.”
– Dr Ricardo Ramos Malagón
Manual Muscle Test (MMT)
A manual muscle test (MMT) is a clinical assessment used to evaluate the strength of individual muscles or muscle groups. A trained healthcare professional asks you to perform a movement or hold a position, first against gravity and, where appropriate, against resistance applied by hand. For example, you may be asked to keep your elbow bent while the examiner gently tries to straighten it.
The test helps identify weakness and compare strength between sides, but it does not measure muscle mass. Results depend on the testing technique and can be influenced by pain, restricted movement and the resistance applied by the examiner. Manual testing is useful within a broader physical assessment, although small differences in strength can be difficult to detect, particularly in stronger muscles. Findings help a clinician decide whether further assessment is needed and guide an appropriate exercise or rehabilitation plan.
The Oxford scale for muscle strength
Manual muscle testing and the Oxford scale are directly related: the test is the assessment, while the scale is a way of grading its results. During the test, a healthcare professional assesses muscle contraction, movement against gravity and the ability to resist pressure applied by hand. The Oxford scale records this performance using grades from 0 to 5.
0 –> No detectable muscle contraction.
1 –> A visible or detectable contraction, without movement.
2 –> Movement with gravity eliminated or minimised.
3 –> Movement against gravity, without added resistance.
4 –> Movement against gravity and some added resistance, with reduced strength.
5 –> Strength judged normal for the muscle being tested.
The score describes strength in the tested movement; it does not measure muscle mass or overall fitness. A grade of 5 is not a measure of peak athletic performance, and small changes in strength may not alter the grade. Results are interpreted alongside symptoms, movement quality and the wider physical assessment.
Understanding your strength and body composition with ZEM
ZEM’s Weight Management Programme combines body composition analysis, 3D body scanning and strength assessment with personalised nutritional and exercise guidance.
By considering muscle quantity alongside strength, physical performance and individual health objectives, our multidisciplinary team helps develop strategies that go beyond weight management to support long-term physical function.
Ultimately, longevity is not simply about maintaining muscle mass, but about preserving the strength, power and independence needed to continue living well.
Sources and references:
- National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health — Manual Muscle Testing Procedures. United States.
- Chartered Society of Physiotherapy (CSP) — Oxford muscle grading scale. United Kingdom, 2018.
- Regterschot et al. (2015), European Review of Aging and Physical Activity.
- National Institute on Aging (NIH), Workout to Go: A Sample Exercise Routine. United States.
- Centers for Disease Control and Prevention (CDC). About Body Mass Index (BMI). United States, 2025.
- Cruz-Jentoft et al. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16–31.
