For many years now, we here at the Center for Better Bones — as well as our clients! — have been singing the praises of weighted exercise vests and belts. And how can we not? Not only does weighted exercise equipment allow us to do less and accomplish more, but numerous studies have shown that weighted vests and belts can improve strength, balance, and muscle mass, halt bone loss, and even build bone! You can see all of these studies in our blog, Weighing In on Wearing Weights: How Weighted Vests and Weighted Belts Can Help You. So why are we talking about weighted exercise equipment yet again? Because the research in support of weighted vests and belts keeps coming to our attention!
The use of weighted vests in a Norwegian clinical trial
Another fascinating study on the impact of weighted exercise vests on fracture risk factors comes from Norway. (1) This study followed 42 postmenopausal women over the age of 50 with osteopenia and a healed wrist fracture. These participants completed a 6-month exercise program called OsteoACTIVE that consisted of 60-minute sessions held 3 times a week. The exercises performed were designed for strength, balance, coordination, and core stabilization. For more specifics about the exercises performed and to see images, please refer to the original research article.
Weighted vests were used during exercise. Each participant started with two 1.1 kg weights (approximately 2.43 pounds) and all but 3 participants worked up to nine weights (about 21.9 pounds) by the end of the program.
At the end of the 6-month program, a significant improvement in both hip bone density and quad strength was observed. At the 1-year follow-up, it was discovered that there was a significant improvement in dynamic balance compared to the baseline measurements. Here is yet another study (2) that affirms these groundbreaking findings on weight-bearing exercises from 1998!
Why we love weighted vests beyond their bone benefits
With all of the research supporting their positive impact on bone, it’s no wonder why we stand behind weighted vests. However, the benefits don’t stop there! While incredibly important for your health, we understand that voluntary exercise is no easy feat. With limited time and resources, it’s important to make the most of your workouts — something that can be easily done with a weighted vest! A few more reasons why we love weighted vests are:
They’re convenient — weighted vests can be worn to add extra weight while doing pretty much anything, including household chores, dancing, walking, etc.
Weighted vests include a progressive program — you can (and should) start off slowly and add weight as you go.
Weighted vests are relatively safe — there is less risk of injury because of the gradual buildup of weight.
Weighted vests allow you to do less and accomplish more!
We’d also like to note that while there is not as much research on weighted belts, they are still a great option for many. You can read more about weighted belts in our blog, The Weighted Belt: A New Exercise Tool to Build Bone.
Preventing bone loss during weight loss
Weight loss among overweight adults improves the prognosis of health outcomes; however, such weight loss comes at a cost to bone. When older adults lose weight, they also lose bone. Currently, U.S. scientists are conducting a study combining weight loss programs with resistance exercises incorporating the weighted vest. They propose that using weight vests along with resistance exercise will be more effective for preventing weight-loss-induced bone loss than resistance exercise alone. (3)
These researchers propose that weighted vests are likely to be very helpful for several reasons:
They’re feasible — older adults are more likely to use a weighted vest than get a gym membership, learn about resistance training, or seek proper resistance training supervision.
Resistance training alone may not be enough to prevent weight-loss-related bone loss.
Weighted vests during exercise can increase BMD and bone turnover, and may impact muscle power.
Therefore, the weighted vest could be a solution to preventing unnecessary bone loss while losing weight!
Better Bones Exercise Resources
Weighted Vest and Belt
Interested in weighted exercise equipment? You can check out our weighted exercise vest and belt here!
Webinar with Dr. Belinda Beck of the Australian Bone Clinic
Have you ever been told that as an older person, it’s great to exercise, but that you can’t build substantial bone with exercise? Dr. Brown sits down with Dr. Belinda Beck, the Australian scientist whose groundbreaking clinical trials clearly document that older individuals can rebuild bone mass with high intensity, high resistance, strength training. We like to call her the bone-building mythbuster. Click here to watch Dr. Brown and Dr. Beck discuss exercise and bone health!
Exercise Evolution with Gina Galli, RYT
Exercise Evolution is our exciting new affordable subscription program that we offer on Patreon.com. This program will include monthly videos, Dr. Brown’s learning library, a community sharing page, monthly exercise plans to build bone, access to the Better Bones diet, an exercise tracking portal, and more! This program is not only accessible, but safe. Our goal is to create a community full of like-minded individuals that support one another and are ready to get out there and get healthy!
References:
Hakestad, K. A., et al. 2015. Exercises including weight vests and a patient education program for women with osteopenia: A feasibility study of the OsteoACTIVE rehabilitation program. Journal of Orthopaedic & Sports Physical Therapy 45(2): 57-147.
Shaw, J. M., and C. M. Snow. 1998. Weighted vest exercise improves indices of fall risk in older women. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 53(1):M53-M58.
Miller, R. M., et al. 2021. Incorporating nutrition, vests, education, and strength training (INVEST) in bone health: Trial design and methods. Contemporary Clinical Trials 104:106326.
The many benefits of using a weighted vest or belt
How much weight should you put in a weighted vest or belt?
MAKING THE MOST OF YOUR EXERCISE SESSION
Most of us realize that physical exercise is essential for building and maintaining muscular/skeletal strength. For most of us, however, modern life involves low levels of physical activity or often no physical labor. Given this reality we turn to voluntary exercise. However, because we are pressed for time, we most likely ask, “How can I maximize the benefits of my exercise time?” Many may also ask, “How can I do less exercise and benefit more?” One solution is to make the body work a bit harder in each and every exercise session by adding weights to stimulate the muscular/skeletal system. As research shows, using a weighted vest or weighted belt is a low-cost, safe, and effective way to increase the productivity of your exercise session. Furthermore, while these exercise enhancements are useful for the exercise enthusiast, they also help those with limited mobility and/or frailty.
THE MANY BENEFITS OF USING A WEIGHTED VEST OR BELT
Weighted-vest exercise reduces fall risk
A landmark study by Shaw and Snow (1) utilized weighted vests to enhance lower body resistance training in postmenopausal women with the goal of building lower body strength. In this population of women, most fractures are due to falls and better lower body strength is correlated with reduced fall incidence.
The group was divided into an exercise group and a control group. Women in the exercise group did a series of lower body exercises including squats, stepping, chair raises, forward lunges, jumping, and toe rises. These exercises were done 3 times a week with 35 minutes of strength training each session for a duration of 9 months. The women wore weighted vests while exercising, except when doing the jumping exercises, which were added four months into the training. The vests were initially loaded with little weight; more weights were then added over the months as the women grew stronger, with a maximum load of 40 lb.
Results showed that participants using the vests gained 16 to 33% in lower extremity strength, 13% in muscle power, and 3.5% in leg lean mass after 9 months compared to the control group. Extending over only 9 months, this trial was not long enough to detect any changes in hip bone density.
Weighted vests enhance the impact of simple lower body exercises
A recent study among older adults (2) showed again the strength-building effects of a weighted vest.
In this study, the impact of simple hip-strengthening exercises done with a weighted vest (loaded with 10% of body weight) was compared to those same exercises done without using the weighted vest. Both exercise programs included a 30-minute walking session done 3 times a week. A full 100% of those using the weighted vest while exercising saw significant improvements in strength, sit-to-stand performance, and aerobic capacity, while only 42% of those doing just exercise alone saw such benefits.
Weighted-vest use amplifies the bone-building effect of moderate strength training exercises
In a unique long-term study with older women (3) researchers found that the use of a weighted vest combined with lower-body resistance exercise and jump training increased hip bone mineral density 3.2 to 4.4% over a period of 5 years. This study is remarkable given that women of this age generally lose 0.5 to 1% of bone.
Strength training incorporating a weighted vest is capable of halting early menopausal bone loss
A very interesting 14-month German study with osteopenic women in early menopause (4) showed that strength training 4 times a week with the incorporation of weighted vests was capable of halting the accelerated rate of bone loss that occurs in the few years after menopause. Training was done twice a week in supervised sessions and twice a week at home.
In this two-year study, women gained spinal bone density (1.3%) while the control group lost bone mass. Hip density was stable in the exercise group, but was reduced in the control group. Maximum strength was improved dramatically in the exercise group, but decreased in controls.
A weighted vest enhances the bone-building benefits of treadmill exercise
In an Iranian study (5), postmenopausal women wore a weighted vest loaded with only 4 to 8% of their body weight while doing moderate treadmill walking. This was done 3 times a day for 30 minutes a session. This simple exercise stimulated bone synthesis, decreased bone breakdown, and also improved balance.
Moderate intensity resistance training using weighted belts may improve hip bone density in women on hormone therapy
In a two-year study (6), women on hormone therapy who previously were continuing to lose bone mass, gained 1.5 to 2.4% hip bone density with moderate resistance training.
One group of women did lower body exercises using weighted belts in which the mean belt load was 17 lb. A second group did upper body exercises using elastic bands and dumbbells. Both exercise programs produced similar hip bone density gains.
Simple walking yields greater benefits when done with a weighted vest
Walking while using a weighted vest at 10% of body weight for 30 minutes three times a week provided statistically significant improvements in strength performance and aerobic capacity greater than just walking alone. (2)
Using a weighted vest can help prevent bone and muscle loss associated with intentional weight loss
When older individuals lose weight, they also lose bone and muscle. Researchers have suggested that using a weighted vest of 10% of one’s body weight substantially reduces the bone weakening induced by weight loss. (7, 8, 9)
Aging muscle loss and frailties are reduced using a weighted belt
Weighted belts can be powerful exercise tools not only for the athletic and vigorous, but also for the elderly population, who may not have access to or instruction in using other types of exercise equipment.
A Swedish study (10) worked with frail older women following a hip fracture, combining functional training with a weighted belt. They documented that use of a weighted belt over 10 weeks sped up recovery after hip fracture, improved balance 36 to 76% and improved gait speed 16 to 38%. The weighted belt was initially set at 6% of body weight and increased gradually.
Weighted vests with a modest load can help those with moderate to severe mobility limitations
Women aged 70 and over with mobility limitations were given progressive resistance exercises 3 times a week for 12 weeks. Women using a modestly loaded weight vest during the exercise period gained significant improvements in leg power measurements in comparison with controls not using a weighted vest. (11)
Other studies with mobility-limited seniors tested home-based stair climbing exercises using a weighted vested and had good results. (12)
Using the weighted vest while climbing stairs produced a 17% improvement in double leg press peak power and significant improvement in stair climbing power, compared to a walking-only control group.
HOW MUCH WEIGHT SHOULD YOU PUT IN A WEIGHTED VEST OR BELT?
Overall, studies suggest that a vest or belt loaded with 10% of one’s body weight is manageable and effective, while loads of 3 to 5% of body weight have been shown to provide insufficient stimulus to increase strength and functional performance. At the other extreme, loads of 20% of one’s body weight are often seen as difficult for older adults to manage. (13, 14, 15)
Anyone trying out a weighted vest or a weighted belt for the first time should begin with a very low weight, perhaps just a few pounds, and slowly add more weight as they gain strength. For both the vest and the belt, be sure to balance the weights in the front and the back. And it is preferable to use a vest without weights in the breast area, like the Better Bones Exercise Vest with Zipper Front.
References:
Shaw, J. M., and C. M. Snow. 1998. Weighted vest exercise improves indices of fall risk in older women. The Journals of Gerontology: Series A 53A(1):M53-M58.
Mierzwicki, J. T. 2019. Weighted vest training in community-dwelling older adults: A randomized, controlled pilot study. Physical Activity and Health 3(1):108-116.
Snow, C. M., et al. 2000. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. The Journals of Gerontology: Series A 55(9):M489-M491.
Kemmler, W., et al. 2004. Benefits of 2 years of intense exercise on bone density, physical fitness, and blood lipids in early postmenopausal osteopenic women: Results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS). Archives of Internal Medicine 164(10):1084-1091.
Roghani, T., et al. 2013. Effects of short-term aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis. Rheumatology International 33(2):291-298.
Judge, J. O., et al. 2005. Home-based resistance training improves femoral bone mineral density in women on hormone therapy. Osteoporosis International 16:1096-1108.
Miller, R. M., et al. 2021. Incorporating nutrition, vests, education, and strength training (INVEST) in bone health: Trial design and methods. Contemporary Clinical Trials 104:106326.
Nicklas, B. J., et al. 2017. Weighted vest use for preserving muscle mass during weight loss in older adults. Innovation in Aging 1(Suppl 1):549.
Normandin, E., et al. 2018. Feasibility of weighted vest use during a dietary weight loss intervention and effects on body composition and physical function in older adults. The Journal of Frailty & Aging 7:198-203.
Lindelöf, N., et al. 2002. Weighted belt exercise for frail older women following hip fracture: A single subject design. Advances in Physiotherapy 4(2):54-64.
Bean, J. F., et al. 2004. Increased velocity exercise specific to task (InVEST) training: A pilot study exploring effects on leg power, balance, and mobility in community-dwelling older women. Journal of the American Geriatrics Society 52(5):799-804.
Bean, J. F., et al. 2002. Weighted stair climbing in mobility-limited older people: A pilot study. Journal of the American Geriatrics Society 50(4):663-670.
Puthoff, M. L., et al. 2006. The effect of weighted vest walking on metabolic responses and ground reaction forces. Medicine & Science in Sports & Exercise 38(4):746-752.
Salem, G. J., et al. 2004. Lower-extremity kinetic response to weighted-vest resistance during stepping exercise in older adults. Journal of Applied Biomechanics 20(3):260-274.
Greendale, G. A., et al. 2000. A randomized trial of weighted vest use in ambulatory older adults: Strength, performance, and quality of life outcomes. Journal of the American Geriatrics Society 48(3):305-311.
Using a weighted vest long term is just as effective as drug therapy in building bone mass, according to research reports. And based on my personal experience I can tell you that with regular use you will enjoy better balance, experience fewer falls and build both full body strength and bone strength.
With these amazing results, a lot of you have more questions about how the vest works, what you need to do, and if it is safe for you to try. Here are answers to the top questions I receive about wearing a weighted vest:
Q: Will a weight vest really help me build bone?
A: Several clinical studies (see references below) have demonstrated how regular use of the weight vest helps to build bone density by adding extra weight and a greater impact to your steps. This is especially critical for thin women, who have less of a weight-bearing effect on their bones when they walk.
As you use the vest over time, you’ll note that you are building muscle strength. Remember, studies show that as you build muscle, you also build bone.
Q: How often should I use the vest?
A: It’s best to use the vest daily or at least every other day. The most bone-strengthening benefits are seen with regular, long-term use over the years.
Personally, I’ve worked up to putting 19 pounds in my vest — and I really like to wear the vest when I walk my dog. Each time the dog stops to smell a mail box, I do a few small hops giving additional impact to the hip.
Q: How much time should I wear the vest?
For most healthy individuals the answer is the longer you have it on the better. Various studies used the vest for at least 1 hour, 3 times a week. Remember, it is important to build up strength and work up slowly on the weights. And, take the vest off when you find yourself getting fatigued.
Q: How much weight do I start with?
A: You should start with 1 to 2 pounds of weight. The vest itself weighs 1 pound, so a gentle start is to add 1 extra pound (which equals 2 of the flexible weight packets) to get started. You’re working toward a goal of loading the vest with 10% of your body weight. For example, a woman who weighs 100 pounds would work up to 10 pounds in the vest.
Q: What is the maximum amount of weight I can use in the vest?
A: The vest has pockets to hold 18 pounds of flex-weights, plus the vest itself which weighs 1 pound.
Q: How do I put the weights in the vest?
A: The unique soft flex metal weights are very easy to manipulate in and out of the pockets on the vest. They are even easy to use for anyone with arthritis.
Q: What activities can I do in this vest?
A: Most all activities! It is great to wear the vest while doing a wide range of activities — from walking to housework to strength training, Pilates, and yoga. Wearing the vest is a great way to accomplish more during your exercise time.
Q: Can I jog while wearing this vest?
A: Yes, if you like to jog and jogging with the vest is comfortable for you, this would be a great way to get extra bone-building impact with each step. This particularly strengthens the hip.
Q: Does the vest adjust to fit my size?
A: This vest is fully adjustable and fits most everyone from very petite women to larger-boned women. It adjusts on the shoulder for women who are short in the torso or for those who are tall (from under 24 inches to over 50 inches). In addition this vest adjusts around the waist for a snug fit. This high quality Women’s Zipper Front Vest™ can quickly be adjusted to fit women from below 5 feet to over 6 feet tall.
Q: What is the vest made of?
A: The outer shell is nylon with a knitted nylon stretch neoprene chest. The vest has soft double stitched bound edges with Lycra and neoprene stretch pockets for the weights. There is comfortable padding in shoulders with the back and waist shoulder adjustments.
Q: Is the vest washable?
A: The Women’s Zipper Front Vest™ can be hand washed with the weights inside or machine washed with the weights removed.
Q: Will the extra flex-metal weights from my existing vest also work with this vest?
A: Yes, you can add other weights you have as long as they fit into the pockets.
Q: I have pain issues. Can I use this vest?
A: This really depends on the sort of pain you have. You should always check with your physician or physical therapist before beginning any exercise regimen if you have pain. Take special care to seek professional advice before using the vest if you have any sort of back pain.
Q: What if I don’t like, or can’t use, this vest after I buy it?
A: You can try the vest for two weeks from the date of delivery. If in that time you decide it is not for you, we will refund you the cost of the vest minus the shipping.
Q: Do I need my doctor’s permission to use this vest?
A: The vest is very safe because you are in total control of the amount of weight you put in it. By itself, or say, with one weight in it, it is like wearing a jacket. If course, if you have a special health concern, or a back issue, it is wise to discuss the use of this vest with your doctor.
It has been known since the 1800s that putting an unusual load on bone sends a signal for bone to grow stronger. It is as if upon noting high impact, the body says to the bone, “You need to be stronger because heavy loads are coming.” We see this signaling through the impact of exercises which are site specific. Right-armed tennis players have stronger right arms; if you hop on one leg you will build strength in that leg; wearing a weighted vest distributes loads on the hips equally, thus strengthening both hips, and so on. The ground-breaking study I detail here is about building bone strength by hopping, and for premenopausal and postmenopausal women interested in strengthening bone it’s hopping good news!
As early as 1994, British researchers documented that premenopausal women could build bone density with a jumping program. Specifically, women gained more than 4% in hip trochanteric bone density by doing 50 jumps per day over a 6-month period. Then again in 2010, premenopausal women were shown to gain hip bone density with a similar jumping program.
Buoyed by these successes, researchers went on to see if postmenopausal women could build bone density by jumping. Unfortunately, the answer was no. The same researchers who found success with jumping exercise in premenopausal women reported that jumping did not build bone density in postmenopausal women. Fortunately, future research proved otherwise.
After the failed postmenopausal jumping research, it was assumed that older folks could not build bone with a jumping exercise. This was accepted until 2013, when another set of British researchers tested if older men could build bone density with single leg hopping. It was found to be successful. Seventy-year-old men built impressive bone strength doing 50 one-legged hops a day. As you read my blog on this hopping study of older men (includes video) , you will note that I speculated that older women would obtain the same benefit with this hopping protocol. In fact, this hypothesis has already been tested. Seven years following the hopping study of older men, British researchers have proven for the first time that indeed older women can also safely build strength with one legged hopping.
Here are the details of this ground-breaking study on women ages 55 to 70:
The clinical trial tested for changes in the bone mineral density and bone mineral content, bone bending strength, and cartilage health markers.
Before hopping, there was a 5-minute stretching warm-up.
Study subjects began with very few single-leg vertical hops per day and over time worked up to 50 hops per day for a total hopping time of 3-4 minutes.
Hops were progressively increased to reach 5 sets of 10 hops.
15-second rests were taken between each set of hops.
By week 6, the women were hopping in all four directions; front, back, and both sides. The rotational hopping stimulated different parts of the hip.
After 6 months, changes in the hopping leg were compared to those in the control leg (no hopping on this leg).
Research findings:
The postmenopausal women achieved gains in bone strength, bone density, and bone mineral content in the hopping leg (the leg that was “loaded”).
Bone strength increased 3.18% in the hopping leg, while bone strength decreased in the control leg.
Hip-neck bone density increased in the exercised leg while it decreased in the control leg.
The bone mineral content also increased in the hopping leg, but decreased in the control leg.
This high-impact hopping exercise was safe on the knee joint
This high-impact bone building exercise resulted in no detrimental effects to the cartilage, nor was there progression of osteoarthritis in these older women. In fact, some spontaneous resolution of cartilage issues was found in the exercise leg and in the control leg.
My own experience
I was on an airplane flight in 2013 when I first read about the successful hopping study in men. Instinctively knowing that this should also work for women, I immediately began to do 50 vigorous one-legged hops after I exited the plane. I did these without warming up or working up to this number hops. While not dangerous, doing 50 hops without working up to it or warming up did irritate the muscles in my leg, forcing me to rest the leg before doing more hopping. Later, I did the suggested warm-up stretching and worked up to the full 50 hops, although I never did do adequate rest between sets of hops. However, based on my own positive experience with one-legged hopping, I suggest you try hopping (but the way the study describes!).
Who should not practice hopping?
High-impact hopping exercise is not for everyone as seen by the various groups of women excluded from the study. Those not allowed in the study included “women being eligible for pharmacological treatment for osteoporosis according to national guidance,” women who have had medical conditions restricting this sort of exercise, those with hip or back injuries, women taking bone medications, and a few others.
If you are thinking of trying a hopping program, please contact your physician, health consultant, or physical therapist to see if it suits you. Should you not be interested in hopping, there are many ways to safely load your bones. I suggest you look at our Exercise Evolution Channel for more ideas and guidelines.
We need a strong back as we age — to maintain good posture, stay more functional, be able to lift more (be it furniture, groceries, firewood, babies) and be pain free and more playful with kids or grandkids. In short, to stay active life-long and have more fun.
Now we can add spinal bone strengthening to our list of reasons for building stronger back muscles. In new research from Korea, women aged 60 to 75 underwent both magnetic resonance imaging of the paraspinal muscles (the muscles that run up the back along either side the spine) and bone mineral density testing. Those women with well-developed lower back spinal muscles enjoyed higher bone density as compared to those with less back muscle mass.
The average woman without a regular exercise program to strengthen the lower back muscles loses 50% of her back muscle strength between the ages of 50 and 80.
5 favorite exercises for strengthening the back muscles and spine
1. Build your back extensor muscles. My number one favorite exercise for strengthening the back was developed by the Mayo Clinic to help women who had previous spinal fractures. To perform, lay belly down on a flat surface (floor or even your bed to start) and raise your chest for a count of 10 before lowering your chest to your starting position. (See Gina from the Better Bones Exercise Evolution demonstrate this pose!) Practice this back extensor chest lift daily to help reduce new spinal fractures. Start with one rep per day and work up to 20 reps per day for five days a week. For extra strength, you can add a weighted backpack as illustrated below or wear a weighted vest.
2. Practice good posture, which is an exercise in itself. When your back, neck and head are in alignment, it’s a natural workout for the muscles of your spine. Stand tall, shoulders back but relaxed — imagine that you are showing off a lovely necklace. Another way to practice good posture is to stand against a wall and adjust your body until your buttocks, shoulders and head all touch the wall. Hold this position for a few minutes and notice the way your lower back muscles. They are getting a workout! This simple exercise can be done every day. Try to recreate this posture position as you go about your daily routine.
3. Train with weights. If you remember the Australian weight lifting study I talked about last year you will recall the amazing benefits that many are finding with weight training for bone health, especially for strengthening the spine. Working with a trainer who adjusts and monitors your progress is very helpful for anyone wanting to use weight. For specific exercise, check out what my client Cindi did — photos and exercise schedule included — to gain an amazing 5.6% of bone density in her spine! Watch Dr. Brown interview Belinda Beck from the Australian Bone Clinic.
4. Mindful exercises like yoga help tostrengthen the spine. Several recent scientific studies document the positive effects of yoga on bone health in women of all ages. Results showed increased bone density in the spine and hips as measured by DEXA scans, as well as reduced markers of bone turnover. You want to seek out classes (online or in person) that are safe for women with bone health issues. Ask your instructor or look for classes specifically for women with osteoporosis. Poses that can be beneficial for bone health include the Vrksasana (tree pose), Utthita Trikonasana (extended triangle pose) and Virabhadrasana II (warrior pose II). This Yoga Journal article has helpful step-by-step pictures and directions of these poses.
5. Water aerobics. In a recent study, participants took part in a 20-minute aquatic exercise program for a period of six months. The exercise program featured jumping and hopping in chest-high water, along with arm movements for an overall high-intensity workout. At the end of the study, participants experienced increased bone density throughout the body, and specifically in the spine and femur, compared to a control group. As an added bonus, the exercise group also had greater leg strength and agility! We are just beginning to understand the benefits of swimming and other aquatic exercise for bone building and I encourage to learn more.
A groundbreaking clinical trial shows postmenopausal women with osteoporosis gained bone density after only 6 months of regular yoga practice.
This is the first clinical study to show the benefits of yoga and osteoporosis — and the benefits are significant! Yoga can not only halt menopausal bone loss, but a systematic yoga exercise program can increase bone density after menopause when women normally lose bone.
Here’s what the study included
The 30 women who participated all had osteoporosis and practiced yoga for one hour, 4 days a week for 6 months:
The 1-hour session included: warm up, the sun salute movement and various yoga postures done in standing, sitting, supine and prone positions.
Each position included 3 different yoga postures, one of which provided relaxation before going into the next pose.
Each pose was repeated 5 times with holds of 15 to 30 seconds.
Sessions were concluded with a traditional Indian deep breathing relaxation exercise (pranayama) and chanting of the “ohm” sound.
One important note is that all the women in the study had osteoporosis by bone density (T score of -2.5 or more), but women were excluded from participating in the study if they had experienced a fracture associated with osteoporosis or an illness that deemed them unfit for yoga exercise.
Many of the postures used in yoga involve forward bends and are not appropriate for those with spinal fractures or severe vertebral body weakness. Depending on your back strength, you may need to work on some adaptations to these postures with your yoga instructor.
The authors of the clinical trial report that the yoga exercises they used were similar to those used by Dr. Loren Fishman in his promising yoga exercise study.
Poses from the yoga and osteoporosis clinical trial
Standing poses
Standing prayer pose
Mountain pose
Triangle pose
Sitting poses
Half spinal twist
Seated forward bend
Lotus pose
Supine poses
Bridge pose
Reclined thunderbolt
Corpse pose
Prone poses
Cat pose
Boat pose
Crocodile pose
The closing breathing exercises (pranayama) were:
Sheetali — cooling breath
Sadant — another cooling breath
Bhastrika pranayama 1 & 2 — bellows breath
Ujjayi pranayama — ocean sounding breath
The closing chant was: The OM mantra
If yoga is in your future, relax and enjoy the stretches and I suggest you end your sessions with several deep breaths and a prayer of appreciation.
We’ve heard over and over that one of the best ways to build bone is exercise. I can’t tell you how many studies I’ve seen to confirm that. But the question a lot of people ask is, “How much do I need to do?”
And there’s great news for people with limited time: New research from the German scientist Wolfgang Kemmler shows that 2 hours per week of high-impact strength-training exercises done over the years on a regular basis is enough to favorably impact bone density, significantly reducing the rate of aging bone loss.
What a powerful argument for the importance of getting regular exercise – especially when you consider that I have seen research suggesting that, without taking any preventive measures, the average women will lose 45% of her bone and muscle mass as she moves from 35 to 85.
Latest study cuts exercise time needed for bone benefits
I first became aware of Dr. Kemmler’s studies in 2003 when his group published research showing that early postmenopausal women with osteopenia could get actually gain bone mass doing 4 hour-long strength training sessions per week. In this 14 month study the exercise program involved a variety of strength-building activities, including included warm-up/endurance, jumping, strength and flexibility training.
Remember, early postmenopause is a time when women lose 5% or even 10% of their bone mass. These exercising women actually gained bone density as a result of their serious strength training done 4 times a week.
Since I don’t think I could add 4 hour-long workouts into my week at that point without a lot of juggling, I was excited to see Dr. Kemmler’s latest report that bone benefits could be seen with a minimum of 2 hours per week of high-impact strength-training exercises.
Mindful exercise options for building bone
If strength training isn’t your thing when it comes to exercise, remember what we’ve seen about the effect on bone from different types of exercise at different exercise frequencies:
My friend, Miranda Esmonde-White, also reports that her Classical Stretch exercise program done on a regular basis has also led to increase in bone density. The same thing has been suggested for tai chi and other more mindful exercise modalities.
For those who love to walk, using a weighted vest is one of my favorite muscle and bone-building exercise options.
For me, it boils down to this: your exercise program will be good for bones if it’s sufficiently strenuous to maintain and even build body strength, and if you do it on a regular basis over the years.
I recently read a great quote by the Founding Director of the National Institute on Aging, Robert Butler, MD. He wrote, “If doctors could prescribe exercise in a pill form, it would be the single most widely prescribed drug in the world.”
Almost all of us who are invested in our health already know that exercise is one of the most important factors in living a long and healthy life, but many of us are too busy to make time for it.
If you’re serious about maintaining strong and healthy bones throughout your life — and despite the wide prevalence of osteoporosis and osteopenia, it is entirely possible — exercise should move up on your list of priorities. But what type of exercise is best for bones? You may have heard that high intensity forms of exercise are good for bone-building. But it comes as a surprise to many women that mindful exercises like yoga or tai chi are also very helpful.
If your bones could talk…
If your bones could talk, they would say, “Show me you really need me!” Though it feels and looks solid, living bone is dynamic tissue that is constantly altered in response to motion and movement. The more your bones are called upon to carry weight, the more your body puts its resources into building them to support that weight. Bone and muscle are part of the same unit, and as you build muscle, you build bone by default. Here’s why: muscles are attached to bones by tendons. When muscles contract, the tendons tug on your bones, stimulating them to grow. The stronger the muscle, the more powerful the stimulation on the bone.
The best news is that everyone, from a young athlete to an elderly person confined to a wheelchair, can build bone mass with a combination of exercise, an alkaline diet, and bone-healthy nutritional supplements. And there are many options out there for you to explore (see the box above). From hopping on one or both legs during the commercial breaks of your favorite TV show to biking back and forth to work, there’s a way for you to make exercise a part of your life, and once your bones are called upon, their mass will increase.
What and how much exercise helps build bone?
As I have written in my book, Better Bones, Better Body, regular lifelong exercise is best for bone, but it’s never too late to begin building bone density with exercise. Your age, gender, current bone mass, and training history are all factors that will influence your choice of exercise for bone health. (Curious about your bones? Take our Bone health profile.)
The optimal exercise routines for men’s and women’s bone health is unknown and subject to much debate. But we do know that different forms of exercise benefit bone mineralization and the mechanical properties of bone in different ways for men and women of different age groups.
Mix it up!
Your bones respond best to unusual, unexpected bursts and varying combinations of forces, rather than routine workouts. Here are some ideas to help you achieve this:
Jump, skip or break into a jog when you wouldn’t normally.
Vary your weight-lifting repetitions, mixing heavier weights than you’re used to with lighter ones.
Include several bursts in your workout, where you increase your heart rate for a minute or so.
If you always use the treadmill, try dancing or yoga exercises every other work-out.
Try a whole body vibration platform if there’s one in your area
The standard party line is that exercise that requires high forces or generates high impact on the body (such as gymnastics, dance, or weight-lifting) is necessary to improve bone density. Generally speaking, the greater the force or impact, the more bone-growth stimulation. Scientific evidence does suggest we most efficiently build bone mass with a combination of high-impact exercise (such as jumping) and weight-lifting (which can include push-ups, yogic arm balances, using a weighted vest, etc.).
But other properties of bone besides mass make it resilient, such as its water content and cross-sectional geometry. That’s why non-weight-bearing or resistance exercise such as swimming, biking, and isometric exercise (like using the OsteoBall®) also have value, in that they can increase your bones’ flexibility and compression strength. Resistance exercise also decreases your risk of falling and fractures by enhancing balance, coordination, and muscle strength.
East meets West — osteoporosis and yoga, t’ai chi, qi gong, and Pilates
One way to increase the forces of resistance on your bones is with Eastern forms of exercise such as yoga, t’ai chi, or qi gong, and other alternative systems such as Pilates. We’re just now beginning to understand that the benefits we gain from such mind–body disciplines extend much further than simply strength and flexibility.
Practices like yoga and t’ai chi can improve balance, coordination, and focus — not to mention providing a boost in confidence! As we age, many of us become less confident when moving about, and while it’s good to be careful, hesitancy can make us more likely to fall and possibly fracture. And whether you’ve been diagnosed with osteoporosis or osteopenia or not, falling puts you at risk of fracture.
Several recent scientific studies document the positive effects of yoga on bone health in women of all ages. Results showed increased bone density in the spine and hips as measured by DEXA scans, as well as reduced markers of bone turnover.
In addition to the physical effects, there’s often a psychological benefit to Eastern practices. This can help enhance our natural mind-body connection and calm the autonomic nervous system, lowering adrenaline and cortisol, our primary stress hormones. These actions ultimately help bone and whole-body health. As Dr. Paul Lam notes on his Tai Chi for Osteoporosis DVD, “Practicing Tai Chi strengthens from the inside out.” When beginning from our hearts and minds, we are capable of great things in the whole body.
If it seems overwhelming to join a class to learn exercises, you might try familiarizing yourself first with the concepts with a DVD like the ones we offer on our website or take a look at our online exercise channel. You may find you prefer practicing in the comfort of your own home, or that you’re ready to find a local class. What I like about attending a class is that most instructors lead the class to move in different ways each session, rather than sticking with the same routine. And variety is great for bone.
Caption: Even gentle, low-impact exercises like those shown here can help build muscle and bone. Consult your physician before starting any new exercise program, and work with a physical therapist if there is concern about your risk of fracture.
Top row, left, leg lifts are performed lying flat on your back on a firm surface (a floor with a mat, for example). Top row, center, leg lifts on hands and knees – keep your back parallel to the ground and lift your leg only as high as is comfortable. Top row, right, arm squeeze in which you bring your elbows together in front of your face and return to a position perpendicular to the spine (do not twist at waist or turn or bend the spine.) Middle row, left, sit upright in a chair and squeeze your shoulder blades together. Do this holding weights if you can. Middle row, center, lift arms straight from your sides up above your head, with weights if you can. Middle row, right, raise yourself up on your toes, hold for as long as you can, then slowly lower yourself down again. Bottom: Start in a seated position with a chair in front of you for balance, raise yourself to your feet while maintaining upright posture. Lift your body using the muscles in your legs, buttocks, and lower back, not the muscles in your arms or upper back (extend your arms to the front chair for balance, but do not press upon the chair back).
Exercising for your bones — simple ideas to get you started
Go dancing with a friend or partner.
Take a walk each night after dinner or try wearing a pedometer during the day to track how much you walk.
Ride your bike to friends’ houses, stores, and work.
Run up and down your stairs a few times a day.
Purchase or borrow a Nintendo Wii Fit program (includes dance parties, yoga, tennis games, boxing, and more).
Jump rope or simply hop on one leg, then the other — or on both.
Try my Exercising for Bone Health DVD to sample Pilates, yoga, isometric training, weight-bearing exercises and strength training.
Try bursting several times during your regular exercise routine.
Use an X-iser step machine for a few minutes a day. Use steppers, free weights, and other strength training devices at your local gym, or wear a weight vest or belt during your workout.
Exercise: one way to stem menopausal bone loss
While both men and women can develop osteoporosis, women are far more likely than men to experience bone loss, and the critical time in their lives for bone health is the menopause transition. For years we’ve been told that women can lose up to one-fifth of their bone mass during the menopause transition, and that estrogen is the crucial player. But there is actually much more to the story — waning estrogen doesn’t make it impossible to build bone in perimenopause and menopause. Women’s bodies maintain bone best when our hormones are balanced, not just when they’re present at certain premenopausal levels. It also helps to exercise, eat an alkalizing diet, and take a quality multivitamin designed for bone building, like the ones we offer in our Better Bones Package.
I always tell women, the bone you’ve got is good. Let’s keep it! Exercise is an excellent way to maintain the bone you already have during this crucial transition time, and more rigorous strength training can make a big difference to bone mineral density during the early postmenopausal years.
If you want to build bone during the menopause transition, it may take a more intensive exercise plan. In the case of early post menopausal women with osteopenia, some research indicates that the isolated effect of simply increasing habitual physical activity does little to increase muscle strength. But don’t be discouraged by that — it just tells us that women with a diagnosis of osteopenia or who are otherwise at higher risk need a more deliberate exercise program than simply increasing habitual physical activity.
Exercise “dont’s” for those with osteoporosis or osteopenia
Some exercises aren’t recommended for those who have fractured or who have severe osteoporosis. Flexion exercises where you bend your spine significantly forward can increase the risk of vertebral fractures by putting excessive pressure on the vertebral bodies. Such exercises may include crunches where you round your back, touching your toes from a standing position, pulling your knees into your chest and lifting your chin and neck while on your back, or rounding your back over and downward while in a seated position. Extension exercises where you stretch up and flex backwards are generally safe for everyone.
Exercises that curve or bend the spine increase your chances of vertebral fracture.
It’s common for people diagnosed with osteoporosis or osteopenia to be a little afraid of exercise, because they are worried their bones might fracture with any unusual activity. Such caution is warranted in some situations, such as if your bone density is very low compared to other women your age, or if your body is in a very deconditioned state. But in the vast majority, this is not the case. Almost everyone can start with a program of walking, and most can safely undertake a significant bone-building exercise program with great success. But it’s important to work with your healthcare practitioner and take care not to put excessive stress on weakened bones.
Take a look at our Better Bones Exercise Plan to begin your process, and make sure you discuss your goals with your practitioner.
How to get results — a Better Bones approach
For most of us, almost any exercise — as long it’s regular and not so intensive it causes damage — is good bone exercise. Your bones are designed to naturally break down and rebuild themselves to support the demands you place on them. But truly amazing changes come about when all the body’s systems are working synergistically. Here are the three core elements of our integrative bone health approach:
Create an exercise plan. Because everyone is starting from a different place, we put together a guide to help you design Your Better Bones Exercise Plan in a way that fits your unique needs and lifestyle.
Eat a plant-based, alkalizing diet. Just by living and breathing, we create an internal acid load, and because our bones are the body’s great buffers, an overly acidifying diet leaches buffering minerals from the bones to alkalize the blood. In contrast, fruits and vegetables provide alkalizing mineral reserves to counterbalance acid-forming metabolic processes. (See our articles on acid-alkaline balance).
Boost your bone-building vitamins, minerals, essential fatty acids, and amino acids. Because even the healthiest diet doesn’t necessarily supply all that you need, I recommend taking high-quality nutritional supplements to ensure that you’re getting all 20 essential bone-building nutrients, such as vitamin D, vitamin K, calcium, potassium, and magnesium.
Combining these three elements — regular exercise, an alkalizing diet, and high-quality supplements — will make it much more likely for you to get the results you’re looking for. Adopting this approach can also give you a surprising bonus: improved energy and whole-body wellness, well into old age.
Tips for safe exercise
Exercise within your comfort zone.
Avoid movements that cause pain.
Maintain good posture and avoid rounding your back.
Be sure to warm up and stretch your muscles.
Work with a physical therapist if you have experienced an osteoporotic fracture.
As a mother and busy practitioner myself, I know how tough it can be to find the time and inspiration to exercise regularly. But it’s so important for your bones, and I promise, when you find something you love doing, it will become second nature.
Be creative, explore, and be willing to try something new or combine different forms of exercise. Avoid anything that feels like one more chore. When you exercise in a way that replenishes you it triggers the reward cascade in your brain — you’ll know it when you experience it!
There is so much out there. Fully embracing your exercise routine will not only help you to maintain and build new bone, but will enhance your outlook, longevity, and whole-body health.
With about 26% of the adult population sitting for more than eight hours a day the risks of physical inactivity taking a toll on your body are real.
If you’re looking for extra motivation to get up and get moving, there’s a powerful study documenting how physical inactivity for 8 hours a day can take years off your life.
The increased risk of early death adds to what we know about the harm of inactivity — which also includes increased risk of diabetes, cancer, heart disease, and obesity.
What’s your risk?
Researchers analyzed data from 16 different studies world-wide involving more than 1,000,000 people, most of whom were over 45. Study subjects were classified into activity levels of less than 5 minutes a day for the least active to 60 to 75 minutes for the most active.
The greatest risk was for people who both sat for long periods of time and were physically inactive. One interesting point was that people who sat for 4 hours and got no exercise each day were worse off than people who sat for 8 hours but got an hour or more of exercise daily.
And watching TV makes it worse. Sitting watching TV for more than 3 hours per day was associated with increased risk of death in all activity groups except the most active. And at more than 5 hours per day of TV, it didn’t matter how much you exercised, risk of death was increased.
What can you do to reduce your risk?
Here are more ideas to get moving
Determine your daily sitting time and set your daily exercise requirement.
Establish a routine for getting in those necessary minutes of physical activity: take a 15-minute walk before work, or park your car 10 minutes’ walk from your office. Then take a 20-minute brisk walk at lunchtime and another after work — and just like that, you’ll have negated most of the day’s sitting.
Consider using an activity monitor like a Fitbit that can be set to track your minutes of active exercise. I set mine for 60 minutes a day to ensure I get up and out daily.
The loading of bones through exercise and the use of external weights is well recognized to enhance bone strength. While everyone benefits from osteogenic loading, small, slender individuals, in particular, should exercise with additional weights to help maintain and build bone density. As Swedish researchers suggested, the advantage of using a weight belt for osteoporosis instead of a vest or backpack is that “there is load only on the lower extremities and no unwanted load on the back, shoulders and chest, which may be especially important where frail older people are concerned.”
Here at the Center for Better Bones, we have long recommend the use of women’s weighted vests and now are pleased to find scientists using a weighted belt as another safe and easy-to-use bone-building tool.
Three studies have shown positive results using a weighted belt to safely build bone strength among specific populations at high risk for osteoporosis:
Study #1: Using a weighted belt to reduce the bone loss associated with breast cancer treatment.
In 2008, researchers at Yale University asked an interesting question: Could postmenopausal women undergoing treatment for breast cancer safely reduce their bone loss by exercising with a weighted belt? The results of this innovative study were both informative and positive. The 16- to 24-week study looked at women diagnosed with Stage I or II breast cancer, most of whom (65%) had completed adjuvant chemotherapy and/or radiation therapy within the past 3 years. All of the women were within 2 years of menopause, itself a period of accelerated bone loss, and some of the study subjects were being treated with estrogen suppressing drugs, which exacerbates the normal menopause bone loss.
These women were at especially high risk of excessive bone loss for two main reasons. First, breast cancer treatment itself is associated with accelerated bone loss. Second, they were in early menopause, which is a time of accelerated bone loss (with the average woman losing 10% of her bone mass between the first year before her last period and five years after).
Participants underwent supervised, progressive treadmill walking exercises performed 3 times per week with a weighted belt and a backpack. The waist belt provided loading of the hip and the backpack provided further loading of the upper body. The walking exercise was increased each week, as were the weights carried in the belt and backpack.
The training program looked like this: – Each session, the women did a 5-minute warm up and a 5-minute cool-down along with the walking exercise using the weighted belt. – Week #1, the women did three 10- to 20-minute walking sessions on a treadmill with 1 lb weight in the waist pack and 1 lb in a backpack. – Weights in the weighted belt and backpack began at 1 lb, increasing in 1-lb increments to 5 lb in both the waist belt and backpack by week 5. – By week 16, participants walked 45 minutes each day with a 5-lb belt and 5 lb backpack weights.
Over these first five weeks, the maximum heart rate was gradually increased to 75%. The results of this remarkable, innovative Yale University study were clearly positive: This weight-loading exercise program protected their bones and allowed them to maintain stable bone density despite their high risk of bone loss.
Study #2: Exercising with a weighted belt for women on long-term hormone replacement therapy with persistent low bone density.
Studies suggest that even on long-term hormone replacement therapy (HRT), women with low bone density still lose bone at a rate of about 0.3 % a year. In fact, 42–59% of women on hormone therapy have been reported to have osteoporosis or osteopenia.
This particular study tested the use of a weight-bearing exercise program to help maintain bone density in women on long-term HRT. The objective was to determine the bone density impact of a long-term exercise program using a weighted belt to load the lower body and compare this to the effect using resistance training to strengthen the upper body.
This was a large exercise trial with 189 participants ages 59 to 78. The women were divided into two groups, one underwent lower extremity training using weighted belts and the other loading the upper body with elastic band exercises and dumbbells. Both groups exercised three times a week with 35 minutes of resistance training and 5 minutes of warm-up and cool-down.
The result was that both upper- and lower-body exercise regimes significantly enhanced hip, spinal, and total bone density over this two-year study.
Details of the lower-body strength training program: – Initial loading of the weight belt was 6% of the woman’s body mass (7.5 lbs for 125lb woman). Weights were added based on fatigue and ability to maintain correct form. – The exercises using the weighted belt included chair rises (16.7-inch rises) and step ups (progressing from a 6-inch to a 8.6-inch step up). The speed at which these exercises were done increased over the trial. – Heel drops were completed with 10 repetitions using both feet, followed by 3 sets of 10 drops on each side. – Ankle weights were used one leg at a time to flex the hip from standing position with the support of the chair. The range of motion was from 0° to 90° flexion with three sets of 10 repetitions at slow speed. Over the trial the resistance in the ankle weights increased from 2.2 lbs to 7.9 lbs.
Details of upper body training program: – Seven exercises were performed at each session, with two sets of 10 to 14 repetitions for each exercise (total of 140–196 repetitions among all the exercises). – Every session included 4 elastic band exercises. These were horizontal chest press with external shoulder rotations, shoulder external rotation, shoulder abduction, and overhead press. – In addition, 3 of 9 possible dumbbell and body mass exercises were done by all women.
Nine of the 13 exercises were performed in a seated position. Two dumbbell exercises (triceps kick back and one-arm rows) were performed standing with one hand on chair. One dumbbell exercise, the upright row, was done from standing position without support. Modified pushes up from one’s knees were also included.
All dumbbell exercises were introduced at 6 months, and the weight was progressively increased based on ability to complete 12 to 14 repetitions with good form.
Study #3: Weighted belt exercises to enhance function after hip fracture
A novel Swedish pilot study looked at the possibility that exercise with a weighted belt might speed recovery after a hip fracture in frail older women. These women (ages 78–82) had experienced a hip fracture at least 6 months before and were experiencing mobility problems, including impaired lower limb strength balance, instability and gait problems. In this pilot study, three elderly, frail women underwent a 10-week exercise program wearing a weighted belt. Again, the study was successful in that the women gained greater balance and improvement in their gait over the 10 weeks.
The exercise program looked like this: – The women did 19 exercise sessions of 40 minutes each while wearing a weighed belt. The belt was worn while the women completed the following exercises which are designed to stress the major muscle groups in the legs and also to challenge the balance: – Squats – Sit and stand – Stair climbing – Step-ups with varying heights – Toe raises – Moving center of gravity side to side and forward/lateral lunges – Two sets of 6–10 repetitions were completed for each exercise. Initially, the weighted belt was loaded with about 6% of the subject’s own body weight and weights were added or removed as necessary. Exercises were performed at approximately 80% of maximum capacity.
The strength-enhancing effects of this weighted belt exercise were impressive after only 10 weeks: – Gait speed improved by 16–38%. – Step performance improved 36–76%. – Dynamic leg assessment showed increases for the leg press but not for the overall isometric leg strength. – The effects of dynamic muscle strength in accounts balance and gait speed were reflected in increased activity levels and lesser dependence on walking aids. – The subject’s experience of the training was positive in subjects also reported a reduction in pain.
What the studies show
In all of these studies, we see women with significant risk of bone loss and fracture — including, in one study (#3), women who had already had a major fracture event — using weighed belts and backpacks as a way of producing added load on the bones and obtaining important improvements to bone strength, balance, and overall health.
The third study, while small, is particularly encouraging because it highlights the ability of bone to restore itself even after a catastrophic injury in very old and frail persons. It supports what I have always maintained: It’s never too late to improve your bone health!
See the Better Bones Weighted Belt and Exercise Vest Options. Use separate or together for even more bone loading opportunities! Weighted Belt Weighted Vest
Exercises that curve or bend the spine increase your chances of vertebral fracture.
