Oh Snap!: Exercise for bone density
Rigid and lifeless as they appear in Halloween skeleton decorations, bones are made up of everchanging living tissue. Early in life, bones remodel at a fast rate, resulting in more bone being made than destroyed. This net-positive process is consistent until around the age of 30 years old, when bone density peaks. After this point, slightly more bone is destroyed than made in the remodeling process. Bone mass decreases slightly and steadily until menopause, when the protective elements of estrogen drop out, and bone mass decreases dramatically. Women can lose up to 20% of their bone mass in the 5 to 7 years after their final menses. As bone mass decreases, bones become more porous and susceptible to break. If bone mass decreases past a certain threshold, a woman may be told that she has osteopenia or osteoporosis.
Osteoporosis is characterized by low bone mass density and degradation of micro-architecture in the bone. It is often detected by a DEXA scan (dual-energy X-ray absorptiometry). While men can also develop osteoporosis, 80% of people diagnosed with osteoporosis are women. Osteoporosis can lead to bone fractures with minimal trauma. Half of women above 50 years old will experience a bone break due to osteoporosis! It can result in chronic pain and functional disability. Many people with osteoporosis will also exhibit a curve in their upper spine called kyphosis.
Osteopenia is when your bone density falls below a normal range but is not at the severity of osteoporosis. Osteopenia does not always develop into osteoporosis, but it can be an indicator that you could be doing more to support your bone health.
I’m not here to bum you out! There are preventative and preservative measures that can be taken! Physical exercise, in the form of resistance training and high-impact training, can be incredibly effective at preserving or even reversing the degradation of bone. Talk to your doctor about supplements and medications that can help save your bones along with exercise.
Similar to muscle, bones remodel to meet the demands of the body. Frost’s Mechanostat theory identifies the high mechanical load of exercise on the bone as a cause for improved bone structures. Subjecting your bones to more force than day-to-day life can result in high-density, more break-resistant bones!
Resistance Training
Muscles move your body by tugging on bones using tendons. This pull on your bone stresses the tissue and triggers rebuilding. The heavier you lift, the greater the pull on the bone and the greater the stimulus for remodeling. That’s one of the reasons women in midlife and beyond are encouraged to LIFT HEAVY!
If you do not currently lift weights, do not start with the heaviest weights you can pick up. Build a foundation of strength and stability with the guidance of a professional before you attempt anything that feels risky.
Jump Training
The best way to get a lot of strain on the bone is to jump around. The impact of your weight and gravity on your bones is a great way to strain them and stimulate bone growth. Please get clearance from your doctor and consider seeking a personal trainer if you have osteoporosis.
Dancing, basketball, pickleball, and other multidirectional high-impact movements are great bone stressors/stimulators (shameless plug for BodParty). Although counterintuitive, running does not help with bone-building because it only applies impact in one direction and, in some instances, can dull your body's receptivity to these stressors. This is also why cycling, swimming, and other low-impact activities must be supplemented with something else, as they do not have this protective effect on your bones.
*If jumping is a problem for your pelvic floor/continence, you might want to work on that with a professional, too!
Balance Training
This activity won’t do anything for the bone tissue in the moment but is essential in reducing the risk of injury later. Many bone breaks occur due to falling. Working on plantar proprioception (the amount you can feel the bottom of your foot) and stability muscles will do wonders to reduce the risk of falling.
I recommend standing on one leg or with one foot directly in front of the other. You can start by keeping your eyes on one still point and focusing hard, but eventually, you want to integrate more distractions and destabilizers as they will best mimic real-life scenarios. To build proprioception, I recommend wearing shoes with minimal padding or not wearing shoes at all, as springy running shoes mute your foot's receptivity to the floor. Mind-body movement practices like yoga, qigong, and tai chi can direct your attention to bodily sensations, improve proprioception, and reduce falling.
In conclusion, maintaining bone health is crucial, especially for women over the age of 50 who face heightened risks of osteoporosis. By recognizing the impact of targeted physical activity — such as resistance training, high-impact exercises, and balance training — you can take proactive steps to preserve your bone density and reduce the likelihood of fractures. If you have osteoporosis, please consult with healthcare professionals to find the right treatment for you in addition to exercise. Remember, your bones are living tissues that thrive under the right conditions, and with the right lifestyle choices, you can protect your bone health well into later life.
Sources
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Shojaa, M., Von Stengel, S., Kohl, M., Schoene, D., & Kemmler, W. (2020). Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporosis International, 31, 1427-1444.
Watson, S. L., Weeks, B. K., Weis, L. J., Horan, S. A., & Beck, B. R. (2015). Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporosis International, 26, 2889-2894.
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https://www.niams.nih.gov/health-topics/exercise-your-bone-health
