Exercise plays a significant role in maintaining and building strong bones, particularly for those diagnosed with osteopenia. Specifically, weight-bearing exercise will stimulate bone growth. However, it is important to note that weight-bearing exercise is just one of several types of exercise needed to help maintain and build bone. Strength training and balance training are also required to help prevent falls and maintain healthy bones.
Strength training, also referred to as resistance training, builds muscle. Muscle mass and bone density go hand in hand, meaning those with strong muscles are likely to have strong bones (Jang, 2020). Strength training can vary from weight lifting to using machines to bodyweight exercises, allowing for plenty of activities to build muscle and support bone health.
Balance exercises are also crucial for those with compromised bone health. Improved balance lowers your risk of falls. For those with fragile bones, a fall can be detrimental to your health and function, which is why it is essential to work on these types of exercises as well.
What is weight-bearing exercise?
Weight-bearing exercise is any physical activity that involves supporting your body weight against gravity. Weight-bearing exercise can vary in impact. This means that some weight-bearing exercises are low impact and more gentle on your bones, while others are high impact, putting more force through your bones. Depending on your bone density and physical fitness, high-impact exercises may or may not be appropriate.
High-impact weight-bearing exercises include:
- Jumping / jumping rope
- Climbing stairs
Low-impact weight-bearing exercises include:
A common thought for other low-impact exercises is cycling and swimming. However, it must be noted that although these exercises provide a low impact on your bones, they are non-weight-bearing exercises. In swimming, the body is supported by the water, and it is not working against gravity. In cycling, the seat supports a majority of your weight. Therefore, although these exercises provide many benefits for health and physical fitness, they should not be your only form of exercise since they are not the most beneficial for bone health.
Weight-bearing exercise vs. resistance training
Both weight-bearing exercises and resistance training exercises are necessary for healthy bones. However, because there is some overlap between these two types of exercise, it’s essential to know the difference to ensure that you check all the right boxes for your health.
Resistance training is a type of exercise that strengthens your muscles. Your muscles must be challenged to elicit a strength-building response. These exercises typically involve performing an exercise for multiple repetitions (think of that “3 sets of 10”). The “challenge,” or resistance, for your muscles can be provided by using your body weight, free weights, weight machines, or resistance bands. As you might guess, body weight exercises, such as squats, lunges, and push-ups, are muscle-strengthening exercises and also provide a weight-bearing benefit.
Although walking, running, gardening, and hiking use your muscles, these exercises are not considered resistance training since they do not challenge your muscles enough to elicit a muscle-building response. If you enjoy these exercises, you are definitely reaping the benefits of weight-bearing exercise, but you should also incorporate resistance training exercises into your routine as well.
How weight-bearing exercise boosts bone health
When you are weight-bearing, gravity and the weight of your body are putting a gentle force through your bones. This force stimulates a bone-building process within your body. To maintain the ability to keep your body upright against gravity, your bones will produce more bone cells. Over time, this preserves and builds bone strength and can improve bone mineral density. Without this, your body doesn’t see the need to produce more bone cells, so bone density can decrease.
The Bone Health and Osteoporosis Foundation suggests performing an exercise program including weight-bearing and resistance training exercises. They recommend weight-bearing exercise for 30 minutes a day on most days of the week and muscle-strengthening exercises 2-3 days per week.
A 1-week example of this would include:
- Monday: 30-minute walk + 20-minutes of resistance band exercises for the upper and lower body
- Tuesday: 30-minute yoga
- Wednesday: 30-minute walk + 20-minutes of bodyweight exercises for the upper and lower body
- Thursday: 30-minute yoga
- Friday: 30-minute walk + 20-minutes of dumbbell exercises for the upper and lower body
- Saturday: 30-minute yoga
- Sunday: 30-minute gardening
Weight-bearing exercises for osteopenia vs. osteoporosis
The diagnoses of osteopenia and osteoporosis differ only in bone mineral density. This means that those with osteopenia have a higher bone density than those with osteoporosis. Therefore, it is important to consider which type of exercise you perform depending on your diagnosis.
Those with osteopenia may have some high-impact exercises in their exercise routine since their bones may be able to handle more force. This may include tennis, running, and jumping rope.
Those with lower bone density and a diagnosis of osteoporosis may include more low-impact exercises in their routine since they are at a higher risk of compression fractures or other bone fractures. For example, walking, and low-impact aerobics classes might be safer for these individuals.
Please note that these are general recommendations and may not apply to all. The best exercise routine for you is the one you discuss with your doctor and/or physical therapist. These professionals know your bone density, fitness level, and nutritional status and can work with your goals to find the workouts you will enjoy.
Things to keep in mind
You should always seek medical advice from your healthcare provider about what physical activities are most appropriate for you. For example, if you have more risk factors for fractures, your doctor might suggest low-impact exercise. However, it is also important to note that building muscle strength through resistance exercises is crucial for reducing your risk of fracture.
Exercise can only do so much without the fuel of vitamins and minerals needed to build and maintain strong bones. Your doctor will also assess your need for calcium and vitamin D. In some cases, supplementation is necessary.