Hand grip strength is one important measure used by hand therapists to assess and monitor the status of the upper limb and specifically hand/wrist strength for a variety of conditions, such as fractures to the hand, wrist and elbow; post surgical repairs of the upper limb; ligament injuries to the wrist and nerve pathologies, such as carpal tunnel syndrome.
However, there is growing recognition that hand grip strength may also act as an important biomarker to one’s overall health especially in the older adult. Two recent scientific reviews [Vaishya et al., 2024 and Bohanon, 2019] make the case for grip strength as an important biomarker for overall health, and its use in routine health assessments to help identify health issues at an earlier stage, enabling timely interventions and improved patient outcomes.

Grip strength has a clear association with sarcopenia (age-related progressive loss of muscle mass and strength). Sarcopenia is analogous to the bone density loss experienced with age resulting in in osteopenia and if severe enough leading to osteoporosis. However, what is interesting is that grip strength is not just an indication of upper limb strength; it has also been associated with an accompanying decrease in lower limb strength as well [Bohannon, 2012].
The review researchers describe associations between a lower grip strength and lower physical activity, malnutrition, metabolic conditions such as diabetes, cardiovascular disease and cognitive decline. In fact, one study into risk factors for all-cause mortality found low grip strength to be the 3rd overall highest predictive risk factor (below tobacco use but ahead of a poor diet, hypertension and diabetes). And if we consider ‘frailty’ as a condition (a clinical syndrome that results in increased vulnerability to multiple bodily systems) then we find there is evidence that a low grip strength has a stronger association to it than chronological age itself.

So what should one’s grip strength be and should you work to increase this?
This is a difficult question to answer as you can imagine the sheer number of factors that may influence this, not the least of which would include age, sex, weight and hand dominance. For example, hand grip strength is typically 10% stronger in the dominant hand and various studies have shown peak strength occurs in the age group of 30 to 39 years. Researchers have developed reference values for different populations but these should be taken with a grain of salt due to their specificity.
It is also important to note that the above mentioned conditions describe ‘associations’ with grip strength rather than a definitive causal effect. So although we won’t suggest you need to go out immediately to buy a pair of hand grip strengtheners; there is a clear protective benefit from a healthy level of strength and physical activity and a healthy grip strength will often come of this.
References
Ageberg et al, (2010). Feasibility of Neuromuscular Training in Patients with Severe Hip or Knee OA: The Individualised Goal Based NEMEX-TJR Training Programme. BMC Musculoskeletal Disorders
Bannuru,R.R et al ( 2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis
https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/knee-and-hip-osteoarthritis
Blog Written by
Paul Tho
Physiotherapist