Whether your challenge is impaired mobility or you're just deconditioned and out of shape, you can still improve muscle strength. In fact, if you're living in a wheelchair or have difficulty getting around, maintaining and gaining muscle mass and strength is crucial for your overall health and safety. Here's how to keep the muscles you have and build the muscles you want.

"We're seeing a lot more people with impaired mobility these days due to the aging of our population, chronic illnesses, obesity, injuries and sometimes from just a lifetime of being sedentary," says Patrice Winter, spokesperson for the American Physical Therapy Association and Assistant Professor in Rehabilitation Science at George Mason University in Fairfax, Virginia. She says it really comes down to this: If you don't move it, you lose it. but no matter what shape you're in, you can always improve your fitness level and muscle strength by focusing on the following six areas.

1.    Nutrition

Think of your body as a machine. You have to feed it the right fuel for it to work well. As part of a well-balanced, healthy diet, foods rich in protein are especially important for building muscle. Just how much protein depends on a person's size, but on average, 60 grams per day from eggs, lean meats, dairy, beans, fish, and nuts is a good target to aim for.

2.    Hydration

Many older, disabled and mobility-impaired adults limit their fluid intake because they don't want to go to the bathroom too often or they're afraid of incontinence. "Without proper hydration however, muscles, nerves and other tissues don't function properly. Muscles become sore and joints won't move smoothly. The urine becomes concentrated, the bladder becomes irritated and a person is likely to have more problems with incontinence, not less," says Winter. Aim for eight glasses of water per day and avoid dehydrating fluids like caffeinated beverages.

3.    Range of Motion

Your joints need to be put through their paces in order to support muscle mass. That means exercising them so they move through their full range of motion. "Flexibility is key to maintaining muscle strength," stresses Winter. Even if you're in a chair, stretch out your legs, rotate your feet and ankles, flex and bend your knees, shift your hips from side to side, bend at the waist, lift, bend and rotate your hands, arms, wrists, elbows and shoulders and neck.

4.    Balance

"Muscle strength and balance go hand in hand-and that goes for people who can stand and those in a chair," says Winter.

  • If you're in a chair, be mindful of your posture and practice mindful sitting. With both feet on the floor, bring your shoulders back and pull your spine up to its full height. Note that your abdominal muscles pull in. Move your body from side to side, lean forward and back and shift your hips. Your body has to accommodate these changes of position by balancing. 
  • If you can stand, have someone put a stable chair near your kitchen counter. Stand with both hands on the counter and the chair behind you (so you can sit if you tire). Then, with your hands hovering over the counter, lift one foot, then the other. Work towards lengthening the time you can balance on each foot until you can stand for two minutes per foot.

5.    Strength Training

Building and maintaining muscle requires strength training, but you don't need special equipment to start. Winter recommends starting in your pantry. "Grab some canned goods, even if it's just a four ounce can of tomato paste and practice arm curls and lifts. As you get stronger, choose heavier cans or a bottle of dishwashing soap." Eventually, your muscles will be strong enough so you can engage in more vigorous exercise.

6.    Stretching

Lift your arms over you head, bend at the waist, reach down to your toes and stretch your muscles to increase flexibility and prevent post-exercise stiffness.

See your doctor before starting any exercise program and have someone nearby in case you get wobbly.

Winter says, "Don't worry about how out of shape you are. Start where you are and you'll notice right away that you feel more energetic, stronger and more empowered. If you stick with it, you'll build upon that quickly."

Patrice Winter reviewed this article.