One of my passions, alongside assisting in musculoskeletal research, performing bone density scans, and being a bone density technologist instructor, is being a certified bone density and aging specialist physical trainer. Exercise is instrumental in maintaining and improving bone density. Just like muscle, bone development functions close to the same: if you don’t use it, you lose it. Without exercise or an active lifestyle, your bones will continue to disintegrate, and old bone cells won’t be replaced competently by new ones. 

Bone Resorption and Remodeling 

After we reach peak bone density around age 30, our bones continually undergo a resorption and remodeling process. Cells called osteoclasts aid in eliminating old bone, while osteoblasts replace the old bone with new. This process happens throughout our entire life. During this cycle, it’s important to understand that osteoclasts always work to eliminate old bone, even without much stimulation. However, osteoblasts will only abundantly replace old bone with new when they are stimulated. This stimulation occurs with physical activity—when you put loading or stress on your bones. 

The Importance of Exercise for Bone Health 

The best way to actively put loading on your bones is to exercise When working with patients with low bone density or osteoporosis, there are three main types of exercises that must be included in a bone density and osteoporosis program: 

1. Balance and Posture Training 

Balance and posture training are essential for preventing falls, which are the primary cause of fragility fractures. If we can prevent falls, we can prevent fractures. Teaching good posture ensures that patients are sitting and standing upright, performing their exercises effectively, and avoiding serious injuries such as fractures, all while improving balance. 

Balance training involves exercises that strengthen the muscles that help you stay upright, such as your legs and core. These exercises improve stability and help prevent falls. Common balance exercises include: 

• Standing on one leg: This can be done anywhere and helps improve stability. 

• Heel-to-toe walk: Walking in a straight line, placing one foot directly in front of the other. 

• Using equipment: Tools like balance boards or stability balls add an extra challenge by creating an unstable surface. 

Balance training is beneficial for people of all ages, especially older adults, as it helps maintain independence and reduces the risk of falls. 

2. Weight-Bearing Training 

Weight-bearing exercises involve moving against gravity while staying upright. These exercises are particularly beneficial for people with osteoporosis because they help build and maintain bone density, reducing the risk of fractures. Weight-bearing exercises are also great for cardiovascular health, giving you a two-for-one benefit. If you’re new to resistance training, weight-bearing exercises are a good starting point. 

Examples of weight-bearing exercises for osteoporosis include: 

• Walking: Walk as briskly as possible for maximum effectiveness. 

• Dancing, Yoga, Pilates, Tai Chi: Fun and engaging activities that also improve bone health. 

• Hiking: Walking on nature trails, especially uphill, helps with bone loading and improves balance. 

• Stair climbing or machine stair climber: Excellent for strengthening legs and hips. 

• Low-impact and step aerobics: Highly effective for bone health. 

• Bodyweight exercises: Push-ups, squats, planks, bridges, and lunges use your own body weight to build strength. 

These exercises work directly on the bones in your legs, hips, and lower spine, helping to slow bone loss. It’s important to choose activities you enjoy to stay consistent with your routine. 

3. Resistance Training 

Resistance training, also known as strength training or weightlifting, is highly beneficial for individuals with osteoporosis. This type of exercise helps increase bone density by stimulating bone growth and improving muscle strength. Resistance training reduces the risk of fractures, improves balance, and lowers the chance of falls. 

Resistance training is the most effective type of exercise for stimulating osteoblasts and promoting bone growth. Although bodyweight exercises and other forms of training are great, resistance training takes it to another level. Our bodies need more than just bodyweight exercises; they need progressive overload to become stronger. This applies to both muscles and bones. If we only use our body weight, our bodies adjust, and progress stalls. Adding weight stimulates bone and muscle growth. 

Effective resistance training exercises for osteoporosis include: 

• Free weights: Perform exercises like squats, deadlifts, and bench presses. 

• Resistance bands: Use bands for versatile exercises such as bicep curls, shoulder presses, and leg lifts. 

• Machines: Gym equipment like leg presses, chest presses, lat pulldowns, and back extensions can target specific muscle groups. 

It’s important to start with lighter weights and gradually increase resistance as your strength improves. Always focus on maintaining proper form to avoid injury. Consult a healthcare provider or fitness professional to help tailor a safe and effective resistance training program for your specific needs. 

Conclusion 

Incorporating balance, weight-bearing, and resistance training into your fitness routine is essential for maintaining and improving bone health, especially as we age. By actively engaging your bones and muscles through these exercises, you’re not only strengthening your body but also reducing the risk of fractures and falls. Remember, it’s never too late to start, and with consistency, you can make a significant impact on your bone density. Whether you’re walking, lifting weights, or practicing yoga, every bit of movement counts. So keep moving, stay active, and give your bones the attention they deserve!