The Bone Health & Osteoporosis Foundation estimates that approximately 54 million Americans have low bone mass, which puts them at increased risk for osteoporosis. Genetics, hormone levels, and lifestyle all play a role in the development and progression of osteoporosis, and if you want to reduce your own risk, diet and the right kind of physical activity are the keys. best starting points. But what is the right type?
Bones respond to the stress we put on them, and we need enough stress from physical activity to promote bone growth – but not too much stress, as can happen with excessive exercise. This is why the American College of Sports Medicine and other organizations recommend “weight-bearing” activity, but unfortunately these recommendations have not been linked to clear examples. If you’ve always assumed that walking and resistance training (weightlifting) count as “weight-bearing” activity, which I learned when I attended a skeletal health session at the annual meeting of the Academy of Nutrition and Dietetics last fall might surprise you. . It surprised me too.
Turns out walking is technically carrying weight – you’re carrying your own weight, after all – but while it’s good for your muscles, heart, lungs and sanity, it probably doesn’t tax your bones enough to count. Consider This: Walking Is Good For Your Joints because it’s low impact.
Ah… here’s the rub. Our bones need impact. That leaves out swimming (the water supports your weight), cycling (unless you’re mountain biking over rough, bumpy terrain), and walking (there’s always one foot on the ground, so impact n is equal only to your body weight, which is not enough).
A 2017 position statement from Exercise & Sports Science Australia on physical activity to prevent and manage osteoporosis provided the clear guidance that was long lacking. Specifically, the activity must provide rapid impacts of at least twice your body weight, and it must become progressively more difficult as your physical condition improves and your bones adapt.
What does this mean for you?
ESSA’s “exercise prescription” for bone health includes impact, resistance and balance training, with some modification depending on whether or not someone already has osteoporosis.
Impact training. Running matters, and racquet sports are even better. Jumping rope ups the ante again, but not as much as volleyball and aerobics. The overall impact winner? Gymnastic. Visualize yourself sticking a takedown or handspring on the floor, and you’ll see why.
If you have stairs in your house, you can jump from the bottom step, first holding on to the handrails if necessary, then progress by jumping from higher objects. Think 10 to 150 impacts a day, at least three days a week. It’s also important to mix up your impact activity so your bones don’t get used to what you’re doing and stop improving. This includes jumping or bouncing in different directions, such as when playing pickleball or tennis.
Resistance training. Lifting weights is great for your muscles and can also be good for your bones if the weights are heavy and you’re working hard. ESSA advice recommends doing two sessions per week of eight exercises that target large muscle groups. The goal is two to three sets of each exercise, lifting enough weight that you can only manage eight reps. Results from the LIFTMOR (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) study demonstrated that supervised high-intensity progressive resistance training—using deadlifts, squats, and overhead presses—can improve bone density in postmenopausal women and middle-aged and older men with low bone mass.
Many female runners are shocked to get a DEXA scan and find that their bone density is excellent in their hip and spine, but not in their wrists. Push-ups — starting with your hands against the wall if necessary — help build strong wrists, but once they feel easier, you’ll need to increase the challenge. You can move from the wall to a chair, knees to toes, then try lifting your hands off the floor at the top of the push-up.
Although some discomfort can be a sign that you are getting the positive bone stress you are looking for, it is important not to injure yourself. If you already have low bone mass, are deconditioned, or are new to impact or resistance-based exercises, a physical therapist can help you learn how to do these movements with proper technique so you don’t injure yourself. as you get stronger. .
Balance training. Walking heel to toe forward for 10 steps, then backward for 10 steps, is one idea. When it becomes easy, walking on a foam mat or closing your eyes increases the difficulty, as does adding a cognitive element like counting down by sevens while doing the physical exercise. Always be safe, whether it’s having someone to supervise you or something sturdy to hang on to if needed.
No time like the present
The best time to build our bones is from childhood to early adulthood. But later is better than never. If you know your bone density is already declining (you’re a postmenopausal woman or have been diagnosed with osteopenia or osteoporosis), anything you can do to slow bone loss is a win.
My sister did gymnastics as a kid, played volleyball and basketball and ran track in middle school and high school, then continued to run recreationally, so she probably built some better bones than me. However, I started heavy weightlifting in high school and did a lot of aerobics in my teens and twenties, so I feel good with the foundation I laid. But I don’t take anything for granted. I added pushups and heavier weights to my resistance workouts and dusted off my jump rope. Although I don’t feel ready to jump off my 15-inch plyometric box just yet – I’m working from a lower step for now – I will get there.