Exercise for Strong Bones

When you provide resistance to muscles through exercise or force, your muscles get stronger and strain the bones that they are attached to. Your bones respond to that strain by remodeling — increasing bone mineral density and collagen flexibility. One goal of exercise and resistance training is to build stronger bones by involving as many muscles in the movement as possible. Compound exercises that involve the contraction of many muscles and the movement of multiple joints are more effective at increasing bone strength.This is what Pilates does. By involving multiple muscle groups and the contraction of many muscles, Pilates delivers an efficient means of exercise to strengthen your bones.

While it is important to strengthen bones throughout your body, the hip, spine and wrist are especially important to keep strong as they are common sites of bone fracture in individuals with bone loss. There are two types of exercises that are important for building and maintaining bone density:  weight-bearing and muscle-strengthening exercises. Additional exercises such as balance and posture exercises reduce fall risks and strengthen spinal muscles.

Weight-bearing Exercises

These exercises include activities that make you move against gravity while staying upright. Weight-bearing exercises can be high-impact or low-impact.

High-impact weight-bearing exercises help build bones and keep them strong. If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises.

Examples of high-impact weight-bearing exercises are:

  • Dancing
  • Doing high-impact aerobics
  • Hiking
  • Jogging/running
  • Jumping rope
  • Stair climbing
  • Tennis

Low-impact weight-bearing exercises can also help keep bones strong and are a safe alternative if you cannot do high-impact exercises. Examples of low-impact weight-bearing exercises are:

  • Using elliptical training machines
  • Doing low-impact aerobics
  • Using stair-step machines
  • Fast walking on a treadmill or outside
  • Standing Pilates work

Muscle-Strengthening Exercises

These exercises include activities where you move your body, a weight or some other resistance against gravity. They are also known as resistance exercises and include:

  • Lifting weights
  • Using elastic exercise bands
  • Using weight machines
  • Lifting your own body weight
  • Functional movements, such as standing and rising up on your toes


Safety First

Certain Pilates and yoga positions may not be safe for people with osteoporosis or those at increased risk of broken bones. For example, exercises that have you bend forward may increase the chance of breaking a bone in the spine. Did you know that exercises involving rounding the spine & bending forward (spinal flexion), twisting the trunk (vertically loaded spinal rotation), and side bending (lateral flexion) can potentially produce a vertebral fracture of the spine in individuals with low bone mass?  Research conducted by Dr. Mehrsheed Sinaki at the Mayo Clinic (see Sinaki under “Articles”) showed 89% of the participants in the study suffered compression fractures after participating in flexion (curl up) exercises and gives the scientific support and rationale for avoiding all spinal flexion exercises in those with low bone density!

This is why it is important to work with an exercise professional who is trained in modifying exercises for individuals with osteopenia or osteoporosis.

Non-Impact Exercises

Non-impact exercises can help you to improve balance, posture and how well you move in everyday activities. These exercises can also help to increase muscle strength and decrease the risk of falls and broken bones. Some of these exercises include:

  • Balance exercises that strengthen your legs, improve your balance, and decrease your risk of falls.
  • Posture exercises that improve your posture and reduce rounded or “sloping” shoulders can help you decrease the chance of breaking a bone, especially in the spine.
  • Functional exercises that improve how well you move can help you with everyday activities and decrease your chance of falling and breaking a bone.

We do all of these and more in Pilates for Strong Bones!

Starting a New Exercise Program

If you haven’t exercised regularly for a while, check with your healthcare provider before beginning a new exercise program—particularly if you have been diagnosed with osteoporosis or other health problems.

Once you have your healthcare provider’s approval, start slowly. If you have already been diagnosed with osteoporosis or if you’ve already broken bones in the spine because of osteoporosis, be very careful to avoid activities that require reaching down, bending forward, rapid twisting motions, heavy lifting and those that increase your chance of a fall.

How Much Exercise Do You Need?

Weight-bearing Exercises – 30 minutes on most days of the week.

Muscle-strengthening Exercises – 2-3 days per week.

Balance, posture and functional exercises – Every day or as often as needed.