The Argument for Grip Strength as a Vital Sign

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The Argument for Grip Strength as a Vital Sign

Most people hear “firm handshake” and automatically think “business world.” A cursory search reveals articles with titles like “Seven Super-Revealing Things Your Handshake Says About You” (Forbes) and “How a Handshake Can Tell You Everything You Need to Know About a Person” (Inc).

Those in the know, however, understand what a handshake really reveals: Current health and vitality. The amount of force you can generate with your hand is a valid proxy for total-body strength. And total-body strength is one key to healthy aging.

Body temperature, weight, heart rate, and blood pressure inform any patient appointment. Should physicians include grip strength in that group?

Grip-strength testing is easy, fast, and noninvasive. It can be monitored over time. All it requires is a handgrip dynamometer, a tool that may cost less than a stethoscope, and a chair.

“Many studies have looked at strength as a predictor of positive health and weakness as a predictor of negative health outcomes,” says Mark Peterson, PhD, an associate professor at the University of Michigan who’s worked on dozens of those studies.

Among the health risks associated with low grip strength:

The prognostic merits of grip strength have been documented across continents and cultures. Although most of those studies have focused on older adults, they aren’t the only age group researchers have looked at.

Grip Strength and Muscle Function

“Declining muscle function is the first step of the disabling process,” says Ryan McGrath, PhD, an assistant professor at North Dakota State University. “That’s what you can measure with a handgrip test. It helps you identify individuals at risk for the next step of the process, which is declines in physical performance.”

For one thing, your age matters. Grip strength typically peaks for men in their late 20s and declines rapidly in middle age and beyond. For women, it plateaus in their 20s and gently declines until their 50s. So, at minimum, you should consult the age-based standards you’ll find included with a dynamometer.

Another caveat: Peterson says grip strength tests aren’t very meaningful for people who actively train for strength, though he suggests dedicated athletes make up a relatively small percentage of the population — even as low as 10%.

The size of the person taking the test is also important.

“You absolutely must account for body mass in the context of understanding how grip strength, or any strength measure, is reflective of health and function,” Peterson says.

To calculate your strength-weight ratio, which Peterson calls “normalized grip strength,” simply divide your grip strength in kilograms by your body weight in kilograms. For men, a ratio greater than 0.70 puts you in the higher percentiles. For women it’s 0.50.  (You can find a complete chart of normalized grip strength percentiles here).

And if the results suggest that the person in question is objectively weak? “For me, that’s easy,” Peterson says. “They need to exercise.”

Common sense suggests doing a lot of forearm exercises for grip strength. Not so, says Peterson. The strength of your hand and forearm muscles reflects what they can do along with all your other muscles moving together.

A 2019 study found that, for older adults, a variety of exercise programs can lead to modest but meaningful increases in participants’ grip strength — and they don’t necessarily have to include actual gripping exercises. The programs ranged from Tai Chi to water aerobics to walking, stretching, and all kinds of resistance training.

Peterson’s advice to everyone is pretty straightforward: Get stronger. It doesn’t really matter how you do it, or how much strength you ultimately gain. Even a little more strength means a little less weakness, and a little more life.

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