Muscle Loss After Hospital Stay: Why & What Helps

By Jaclyn Jiang, Senior Physiotherapist, Thrive Healthcare

MPhysioPrac, B.HSc Physiotherapy, AHPC-registered

"She went in for a chest infection. She came home a week later and could barely get off the sofa."

Grandma was a strongly independent woman and always wanted to do things by herself. After staying in the hospital for 2 weeks from a chest infection, she is now not able to even sit out of bed by herself.

We hear some version of this from families every week. The infection has been treated, the doctors are happy, and yet the person who comes home seems weaker and less steady than the one who went in.

This is not unusual, and it is not simply "old age." It is a well-documented effect of time spent in bed, and the good news is that much of it can be rebuilt with the right support.

How Quickly Muscle Is Lost

Muscle responds to use. When we walk, climb stairs and get up from chairs, our muscles receive a steady signal to stay strong. In hospital, that signal largely disappears. Much of the day is spent lying or sitting, often while the body is also dealing with illness, poor appetite and disrupted sleep.

The effect can be surprisingly fast. In a well-known study published in JAMA, healthy older adults who stayed in bed for 10 days lost around 1 kg of leg muscle and roughly 16% of their knee strength. These were healthy volunteers, not unwell patients, so for someone recovering from illness or surgery, the loss can be greater.

Research has also found that around one in three adults over 70 leaves hospital less able to manage daily activities, such as bathing, dressing or walking, than before they were admitted. Doctors call this hospital-associated disability.

Why Older Adults Are Hit Harder

Muscle mass and strength gradually decline with age. When this loss becomes significant enough to affect strength and everyday function, doctors call it sarcopenia. Many older adults are already living with some degree of sarcopenia, which puts them closer to the threshold where everyday tasks start to feel difficult. A hospital stay can speed this process up considerably. A younger adult who loses some strength during a hospital stay may barely notice.

An 80-year-old who loses the same amount may suddenly find that standing up from the toilet, or stepping onto a bus, is no longer manageable.

Several other factors add to this:

• Illness and inflammation speed up muscle breakdown

• Reduced appetite means less protein to rebuild muscle

• Fear of falling after a hospital stay leads many people to move less once they are home

• Well-meaning family members may do everything for their loved one, removing the everyday movement that would help them recover

The Cycle of Muscle Loss to Watch For

Weaker legs make walking harder. Walking less leads to weaker legs. Add a loss of confidence, and many older adults slowly move less and less in the weeks after discharge. This is often when falls happen, and falls are a common reason for readmission to hospital.

Breaking this cycle early is one of the most helpful things families can do.

What Helps: Rebuilding Strength After Discharge

Start moving early and often. Once your doctor confirms you are medically stable, gentle movement should begin as soon as possible. Short, frequent walks around the home are better than one long outing.

Build strength, not just stamina. Walking helps, but targeted strength exercises for the legs, such as sit-to-stands from a firm chair, step-ups and heel raises, are what rebuild the muscle that was lost. These should start at a level that feels manageable and progress gradually.

Eat enough protein. Muscle is rebuilt from protein. Including a source of protein at each meal, such as eggs, tofu, fish, chicken, beans or milk, can support recovery. If appetite is poor, speak to your doctor or a dietitian.

Let them do it themselves, safely. It can feel kinder to help with everything. But every time your loved one stands up, walks to the kitchen or dresses themselves, they are rebuilding strength. Supervise and support rather than take over.

Get guidance early. A physiotherapist can assess strength, balance and walking, spot fall risks at home, and build a programme that progresses safely as your loved one improves.

How Home Physiotherapy Fits In

For many older adults, travelling to a clinic in the first weeks after discharge is tiring or simply not practical. Home physiotherapy brings the care to them.

At Thrive Healthcare, our AHPC-registered physiotherapists visit homes across Singapore. Sessions are one-to-one and built around the person's own environment. We practise standing up from their own sofa, walking along their own corridor and managing their own bathroom, so the strength they rebuild carries straight into daily life. We also guide family members and caregivers on how to help safely between sessions.

As strength and confidence return, many of our patients move on to our clinic in River Valley, and older adults often continue into our Legends Programme, physiotherapist-led group classes that help them keep building strength for the long term.

Frequently Asked Questions

How soon after discharge should physiotherapy start?

Usually within the first one to two weeks, once your doctor confirms you are medically stable. Starting early helps limit further loss of strength and confidence.

Can muscle lost in hospital be regained?

In many cases, yes. Muscle responds to strength training at any age. Progress depends on the person's health and the reason for their hospital stay, which is why an individual assessment matters.

Do I need a referral for home physiotherapy?

No referral is needed. You can book directly, and appointments are usually available within 2 business days.

Coming home from hospital is the start of recovery, not the end of it. If you or a loved one has recently been discharged and feels weaker than before, our physiotherapists can help you rebuild strength, safely and at home.

Thrive Healthcare | 5 Mohamed Sultan Road, Singapore 239014 | +65 8949 8760 | hello@thrivehealthcare.com.sg

References

• Kortebein P, Ferrando A, Lombeida J, Wolfe R, Evans WJ. (2007). Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA, 297(16), 1772–1774.

• Covinsky KE, Pierluissi E, Johnston CB. (2011). Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure." JAMA, 306(16), 1782–1793.