Features February 2012 Issue

Best (and Worst) Exercises You Can Do to Boost Bone Health

Weight-bearing and strengthening moves will make bones stronger, but some of them may be risky.

Regardless of age, the condition of our bones is always changing — for better or for worse. Until about the age of 25 the news is generally good. Our bodies manufacture new bone tissue faster than old bone breaks down. After 30, we begin to lose more bone tissue than we gain.

Brisk walking is a great weight-bearing exercise, particularly when done on a hilly path.

What can you do about it? Exercise to increase bone mass and strengthen it, but do so with physical activities that don’t cause further damage. “In order to strengthen bones, you need to put more load or impact on them than usual,” says Maribeth Gibbon, PT, a physical therapist in the Department of Physical Medicine and Rehabilitation at Cleveland Clinic. “Two categories of exercise are important— weight-bearing and muscle-strengthening.”

Weight Bearing vs. Muscle Strengthening
Weight-bearing exercises make you move against the force of gravity while standing and/or moving in an upright position. “If your feet impact the ground,” explains Gibbon, “that’s weight-bearing.” 

Muscle-strengthening exercises involve activities where the muscles exert a pulling action on bones, but they don’t necessarily have to be done while standing (the foot doesn’t strike the ground). Moving your body (modified push-ups and wall-squats), lifting a weight (dumbbell or barbell), and exercising against the resistance of an elastic band are examples.

Which one can build and strengthen bone without risking injury or further damage caused by arthritis or osteoporosis?

“Both can be beneficial, but how you execute weight-bearing and strengthening exercises depends on your level of fitness,” says Gibbon. “For some people it’s as simple as varying their walking routine. Inside, increase treadmill speed or its incline. Outside, choose a sidewalk or walking path that has hills.”

Moves That Can Make Things Worse
Some exercises present risks for both osteoarthritis and osteoporosis patients. The spine and lower extremities are particularly vulnerable to high-impact movements, and the spine is at risk in exercises that involve bending forward (trunk flexion) and/or twisting at the waist.    Avoid jumping, running/jogging, high-impact aerobics, sit-ups, toe touches, bowling, some yoga and Pilates poses, and rowing machines. 

Trunk Extensor

Whatever exercises you choose, be especially careful about movements or conditions that increase the risk of falling. Exercising on a slippery floor or performing step aerobics are invitations to injury. 

To protect yourself, start your program with a trained fitness instructor or physical therapist.

Special Situations
If you’d like to walk but have a balance problem, walking sticks, a cane, or a walker might be an option. 

If you have a relatively high level of fitness, jogging or running is an option. However, running puts an extra load on leg joints (seven times your body weight on the knee; five times body weight on the hip). Though jogging or running is great for building bone, it may not be recommended for people with arthritis.

“Strengthening exercises have the most benefit for bone health when a sufficient load is placed on the bone,” says Gibbon. “Again, the specific activity depends on your  level of fitness. If you’re able to lift weights, you could lift higher weights with fewer repetitions. If you’re not used to exercising, resistance bands or performing exercises on a mat would work.”

“Strength training is site-specific,” adds Gibbon. “The main goal of strengthening bone is to prevent fractures, and the areas where fractures occur most often are the spine, hips, and wrists.”

Extension vs. Flexion
“Research supports the value of increasing trunk extensor strength, which can decrease pain, improve posture, and lessen the risk of fractures,” says Gibbon.

An example of a trunk extensor is lying face-down, holding your arms behind your back and lifting your upper body.
Trunk flexion (sit-ups, knees to chest while lying down) should be avoided if you’ve had an osteoporosis-related fracture, and it should be done with caution if you suffer from osteoporosis but have not had a fracture.

Finally, when considering an exercise program to improve your bone health, keep one thing in mind:  A little exercise done on a regular basis is better than no exercise at all.