There are many factors that go into improving bone health, but exercise is one of the key lifestyle changes you can make to improve your osteoporosis. Osteoporosis is a condition that causes your bones to become weak and fragile, increasing your risk of fractures. But exercise, in particular weight-bearing and resistance exercises, can help improve bone density and reduce the risk of fractures, even for people who have already been diagnosed with osteoporosis (Bone Health and Osteoporosis Foundation). In this article, we'll explore how exercise in general can help improve your bone health and the ways that different types of exercise can do that.
How does exercise help build bone?
Building bone density may sound like a daunting task, but it’s actually quite doable with the right exercises. Exercise can help build bone mineral density by putting stress on your bones, which triggers your body to produce more bone tissue (Bolamperti, 2022). Walking, running, and hiking are all great weight-bearing exercises that force your bones to work against gravity and create tiny micro-fractures. These micro-fractures stimulate the production of new bone tissue, leading to improved bone density. This process is called bone remodeling, and it's the body's way of adapting to the new stresses placed on bones by physical activity (Rowe, 2022).
When your bones experience stress, specialized cells called osteoblasts produce new bone tissue to repair and strengthen the bone (Rowe, 2022). Over time, this process can lead to improved bone density, making your bones stronger and less prone to fractures. The key is to continue to engage in bone-building activities to keep the process going.
Keep in mind that certain activities such as running and jumping are not appropriate for everyone. If you have a history of falls, fractures or have been diagnosed with osteoporosis, it is best to start with low-impact weight-bearing activities such as walking (Brooke-Wavell, 2022). For people with osteoporosis who have not had a compression or low trauma fracture, high-impact exercises can be beneficial for bone health (Brooke-Wavell, 2022; Kistler-Fischbacher, 2021). However, it’s never a good idea to participate in high-impact exercises without preparing your body for them first. Unsure what’s right for you? A physical exam and/or assessment by your physical therapist or doctor can help determine what type of exercise is best for you.
How much stress is right for your bones?
It's important to note that the “right” amount of stress needed to stimulate bone growth can vary depending on your bone density, age, health status, and other factors. Exercises that place excessive stress on your bones can increase your risk of injuries, including fractures. Depending on your bone density and overall health, certain high-impact exercises, heavy weightlifting, and exercising without proper form can put excessive, harmful stress on your joints and bones.
It's important to listen to your body and gradually increase the intensity and duration of your exercise routine over time, rather than trying to do too much too soon. If you're unsure about how much stress is right for your bones or if you're concerned about specific bone-related issues, it's a good idea to talk to your doctor or physical therapist who can help you develop a safe and effective exercise program for bone health.
Now, let’s dive into some of the specific types of exercise that can help you build bone, and how each one of them does just that.
Weight-bearing exercises improve bone mass by working against gravity
Weight-bearing exercises are essential for building and maintaining bone strength, especially for those with osteoporosis or osteopenia. These exercises are designed to put pressure on the bones, forcing them to work against gravity. This pressure stimulates the production of new bone tissue, leading to an improvement in bone density. Weight-bearing exercises include walking, hiking, stair climbing, and tai chi (NIH, 2018).
Aerobic vs weight-bearing exercises
When it comes to aerobic exercises and bone health, not all types of exercise are created equal. Weight-bearing aerobic exercises, such as walking, hiking, and dancing, are great exercises for osteoporosis because they are low-impact exercises that put pressure on the bones and stimulate bone growth. Even a few weeks of these aerobic exercises can have a positive impact on your bone as well as cardiovascular and muscular health (Wen, 2017).
On the other hand, studies have shown that certain low-impact aerobic exercises, such as swimming, cycling, and the elliptical, provide mixed or minimal benefits for bone health since they don't put as much pressure on the bones (Wochna, 2019; Su, 2020). These exercises, however, are still great for overall health and fitness, so don't hesitate to incorporate them into your exercise routine as a complement to bone-building exercises.
Resistance training and how it improves bone mass
Resistance training, also known as strength training or weight training, can help build bone density by putting stress on the bones, stimulating bone growth and improving bone strength (Huovinen, 2016). During resistance training, you use free weights, resistance bands, or your own body weight to work against gravity, which can increase muscle strength and also place an additional force on your bones. This force stimulates your body to build new bone tissue to adapt to the demands of the new challenges, which can lead to increased bone density and strength over time.
Resistance training can also improve your posture, balance and coordination, which can reduce the risk of falls and fractures (Harvard Health Publishing, 2021). By improving your overall physical function and muscle strength, resistance training can also help you perform everyday tasks more easily and with less risk of injury. When doing resistance training, it's essential to focus on proper form and gradually increase the number of repetitions and amount of weight lifted. Begin the movements without weights or resistance to perfect the posture and positioning, then you can add external resistance to further challenge your body in a healthy and safe way. By gradually increasing your weight (resistance) and repetitions, you can build stronger bones and improve your overall bone density.
Balance exercises to reduce your risk of falls
Balance exercises, such as tai chi, are low-impact exercises that challenge your body’s ability to stay upright. These types of exercises can help improve bone health by reducing your risk of falls and fractures (Hamed, 2018). By improving balance and coordination, these exercises can help reduce the risk of injury and keep you active and healthy for years to come. Incorporating these types of exercises into your routine, along with weight-bearing and resistance exercises, can help you build strong, healthy bones and reduce your risk of osteoporotic fractures.
Exercise and bone health
So there you have it: exercise is the way to go if you want to keep your bones strong and healthy. Regular exercise can be an effective way to improve bone density and reduce the risk of fractures, particularly in individuals with low bone density or osteoporosis. Weight-bearing exercises, aerobic exercises, strength training, and balance exercises all have unique benefits for building strong bones and improving overall bone health.
If you're comfortable with unsupervised exercise, you can get started with Wellen's at-home exercise program for osteoporosis. If you've recently fallen or experienced a fracture, it's important to work with a healthcare provider such as a doctor or physical therapist to develop an exercise program that is safe and appropriate for your individual needs before embarking on an unsupervised program. Whichever option is best for you, it is certain that incorporating regular exercise into your routine can improve your bone health and maintain strong bones throughout your life.