Strong Bones For Life: The Key to Staying Active and Independent as You Age

Author: Ruben Salinas, PT, DPT, OCS, CSCS

Author: Ruben Salinas, PT, DPT, OCS, CSCS

Ruben Salinas is the founder and president of Salinas PT.

The Facts About Bone Health

Aging, along with certain diseases and medications, can cause bones to become fragile over time. The condition known as osteoporosis often occurs in women after menopause and also in men over 50. This bone-thinning disease puts people at greater risk for fractures and broken bones, leading to limited mobility and independence. Another common condition among older adults is sarcopenia. During the natural aging process, our bodies lose muscle mass over time. People who develop osteoporosis or sarcopenia are considered frail by most physicians and more likely to suffer from long-term injuries. Nearly 10.2 million Americans 50 years and older are estimated to suffer from osteoporosis.  In addition, 43.4 million Americans suffer from low bone mass, clinically known as osteopenia. The risk for osteoporosis increases with age, with the data showing that women have a higher fracture risk than men. The lifetime risk of osteoporotic fracture for women is approximately 50% and 20% for men. Learning how to counteract the natural decline of bone mineral density (BMD) can play a crucial role in reducing your risk for fracture or injury during your golden years.

Tips for managing osteoporosis

Why is Exercise Important?

Since bone is a living tissue, it changes over time and reacts to our lifestyle. Our body builds bone through “remodeling” every 10 years. Specialized cells in our body called osteoblasts and osteoclasts constantly build and break down bone mass. Like our muscles, bones respond to weight-bearing exercise by becoming stronger. Both resistive and weight-bearing exercise has been shown to positively affect our bone health. Exposing our bones to more significant stresses than those we encounter during our daily routines is essential. Although regular walking can positively affect our bone health, the amount of walking also makes a difference. In a study of over 200 hundred postmenopausal women, the authors found that women who walked 1 mile each day had higher whole-body bone density than women who walk shorter distances. Not only can exercise help you maintain a stronger musculoskeletal system, but it can also help your balance, coordination, and lead to better overall health.

Improving Bone Health 

Nearly all exercises that improve your bone health have one or more of the following in common. They provide resistance, are typically weight-bearing, and provide impact. When you jump or run, you multiply the effects of gravity. That’s why higher-impact activities have a more pronounced effect on your BMD than lower-impact exercises. However, people who are frail or have already been diagnosed with osteoporosis should talk to a healthcare professional about the types of physical activity best suited for their condition. Activities like hiking, running, dancing, or playing tennis are all examples of weight-bearing exercise. Lifting weights is also an effective way to stress and strengthen your bones. Other exercises, such as swimming and cycling, can be an excellent way to improve your cardiovascular health. But, these forms of exercise are not weight-bearing enough to build BMD effectively.  

Bone-building Exercises

Improving your bone health does not require costly equipment. Simple bodyweight exercises are enough to stress your bones and stimulate remodeling. The following are simple examples of weight-bearing and resistive exercises that can safely enhance your bone health.

1. Squatting

Squatting is one of the simplest compound movements that exposes your body to weight-bearing exercise. A good way to start is by using a chair and simply moving from seated to standing. As the exercise becomes easier, you can add load in the form of dumbbells or kettlebells. Once you are able to safely complete standing from a seated position, you can consider removing the chair to perform a Goblet Squat, as seen below.         

2. Pulling

Pulling is another compound movement that can be performed using elastic resistance or a cable machine. Performing this exercise standing will challenge your balance and force the body to use its core muscles to stabilize against the load.        

3. Pushing 

This exercise is also considered a compound movement but is unique because it can be weight-bearing in the right position. By using a countertop, chair, or even a wall, one can perform a pushup to provide weight-bearing force that builds BMD.      

4. Lunging

The act of lunging has several benefits aside from it being a weight-bearing exercise. Performing a stationary lunge is an excellent way to build balance and coordination. Lunging forward and returning to the starting position requires your muscles to contract differently. As you lunge forward, your muscles act like brakes controlling the movement and shorten when returning to the starting position.       Exercise images provided by HEP2go.


*Exercise Tips* 

  1. Resistive exercises must be performed at least 2 times per week to be effective.
  2. Besides resistive exercise, it is beneficial to incorporate weight-bearing exercises such as hiking, dancing, walking, pickleball, or tennis. 
  3. Alternate days to allow your body to recover and remodel. 

In Conclusion

Remember, exercise is only one part of the osteoporosis prevention or treatment program. A diet that is rich in calcium and vitamin D, along with exercise, helps strengthen bones at any age. However, more than just exercise and diet may be required to counteract the effects of low BMD. Lifestyle choices such as smoking and excessive alcohol consumption should also be addressed. It is important to speak to your doctor about your bone health during your regular exams.  If you are diagnosed with low BMD, we recommend seeking a referral for physical therapy. Our team will design safe and effective exercise programs specific to your needs. While keeping your needs in mind, we can teach you how to perform the exercises properly to minimize the risks of injury.  In good health, Ruben Salinas, PT, DPT, OCS, CSCS