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
Can you imagine a gym session that begins with you lying down on the massage table?Well, this is exactly how every training session begins at my new high-tech gym/health club and I want to share with you why I think this model is the future for the ideal muscle and bone strength training program.
What is so special about the futuristic, high-tech gym?
Comprehensive baseline testing is a hallmark of the futuristic gym. No longer do you go to the gym just to “pump iron” and run laps as best you can. Rather, at the futuristic gym, you are given the option of a concierge-type service that employs science-based methods to assess and maximize musculoskeletal strength, oxygen utilization, fat burning capacity, body composition, and posture alignment.
Upon signing up for these specialized training services, my new fitness facility conducts the following baseline tests, which are then monitored over time as I implement my personal fitness program:
1. Bone mineral density testing done on the DEXA machine
Your doctor tests the bone density of your spine and hip using the DEXA machine. Here at my high-tech gym they measure bone density of your entire body(head, arms, legs, spine, trunk, ribs, & pelvis) and watch the changes over time as you build muscle strength.
2. Testing of your muscles
My new high-tech gym uses a proprietary system for detailed muscle testing known as “Bionetics.” This is a type of kinesiology that assesses the muscles, identifying which ones are strong, which ones are weak, and which ones are inactive.
The fitness specialist then bases your program on your muscle activity profile, and knowing which muscles are strong, weak or even inactive guarantees the safety of your strength training program. Assessment of shoulder and trunk rotation is also a key measurement monitored over time as this program has its roots in optimizing performance for golfers and other athletes.
3. Testing of posture and body alignment with 3D imaging
For example, in my case this imaging revealed a misalignment with my right shoulder being lower than my left, it also showed that I had an imbalanced distribution of weight on my feet leading to posture misalignment.
4. An oxygen uptake assessment
This is much like the VO2 max and is used to define the ideal training heart rate for each individual. If the goal is fat burning, one training heart rate is established, if the goal is endurance, another calculation is made.
5. Resting metabolic rate testing
This test determines how many calories are used at rest and activity and helps to define the ideal energy sources for the individual. For example, some individuals are more inclined to use fat for energy, while others are more inclined to use carbohydrates, or many are evenly split on how they process energy. This test helps determine how your metabolic system will function most efficiently.
6. Diet and eating guidelines
Specific guidelines as to the composition of the diet, the amount of protein, the amount of carbohydrates, and total calories is calculated for each individual given their goals.
Why start each session with time on the massage table?
A central component of this futuristic fitness center is muscle testing. The first focus in each session is to detect which muscles are strong, which muscles are weak, and which muscles are inactivated. An inactivated muscle suggests that the brain-muscle messaging system is impaired — and this neural pathway must be reestablished.
In my case, bionetics testing found that my chest pectoral muscles and some upper back muscles were inactive.For movements and strength training that might involve these muscles, I was compensating using my arms and shoulders. This can lead to injury and overuse, and even more, it gave me a tendency to slump my shoulders forward.Now that I know this slumping is a result of weakened upper back muscles and inactive chest pectoral muscles, with proper corrective strength training and careful activation of the inactive pectoral muscles, I have improved my body alignment and posture.
This high tech gym in my hometown is known as the Athletic Apex Health Club, with locations in four cities (Orlando, Florida; Fort Worth, Texas; Syracuse, New York and Rochester, New York). Their approach has a lot in common with the Australian Bone Clinic where older women, under careful supervision, are able to build substantial bone density with strength training.
Looking into my crystal ball, I see these higher tech, science-based fitness programs becoming more popular and available over time.If you already belong to a gym that you love, why not show them this blog and ask if they could consider adding these much-needed biometrics assessment services?
Watch Dr. Brown in her training session at a “high tech gym”!
People frequently ask me if swimming or other water exercise can help build or maintain bone density. I’ve always thought (and so have other researchers) that water exercise wouldn’t be the best possible exercise for bone — after all, swimming is low-impact, and the water supports your body weight. I could see how the full-body muscle movement in water exercise might reduce the “use-it-or-lose-it” peril of sedentary living, but could this form of exercise really stimulate the bones to build new bone?
Well, I have good news for all you swimmers: Studies from all around the world suggest that you not only can maintain bone density with aquatic exercise, you can also build bone.
How water exercise helps after menopause
Several studies over the years that have found that water exercise does indeed offer benefits for bone building in postmenopausal women — but not in terms of bone density increase. Rotstein and colleagues (2008) followed a group of 35 postmenopausal women for seven months as they participated in hour-long water exercise three times a week. They found that the mineral content of the women’s bones improved — meaning, the bones were stronger — but their bone density wasn’t noticeably greater.
This has been a fairly constant theme in research of water exercise and bone health: Swimmers’ bone densities are found to be comparable to sedentary control subjects, but their rate of bone turnover is significantly higher (Gómez-Bruton et al., 2013), meaning their bones became more resistant to fracture and able to repair themselves more effectively.
Personally, I’m happy for women to have stronger bones even if they’re not dense — I’ve long maintained that strong bones are the key to avoid debilitating fractures. Brazilian researchers, however, have been getting great results on both fronts by using a high-intensity interval-training method in their water exercise studies.
In 2014, one study (Moreira et al. 2014) found that high-intensity water exercise for 6 months reduced bone resorption markers even though bone density didn’t change — not that different from what earlier research found. More recently, however, Aboarrage and colleagues (2018) trained study participants in a high-intensity aquatic exercise protocol that included a form of interval training using jumping and hopping performed for 20 minutes in warm water that was about chest deep.
This new study offers a different twist: By using exercise that encouraged jumping in water and fairly high exertion, the water exercisers increased bone density throughout the body, and specifically in the spine and femur. As an added bonus, the exercise group also had greater leg strength and agility after the six-month time frame than the controls.
Swimming builds better bones
For those who prefer water exercise, this is great news! You’re not shortchanging your bones by swimming or doing water aerobics. And if, for one reason or another, you can’t perform other types of exercise due to severe joint pain or poor balance — or perhaps you’re recovering from a fracture to an arm or a leg — exercising in water is one way to keep your muscles strong without overloading your joints or risking a fall. So, I for one am going to let go of the mentality that water exercise isn’t useful for promoting bone health. Jump in, the water’s fine — and it’s good for your bones!
References
Aboarrage, AM Jr, La Escala Teixeira CV, Dos Santos RN, et al. A high-intensity jump-based aquatic exercise program improves bone mineral density and functional fitness in postmenopausal women. Rejuvenation Research 2018;21(6). https://doi.org/10.1089/rej.2018.2069
It’s no secret that exercise helps strengthen thin, weak bones, even in people with osteoporosis. Explaining why it works can be a bit of a challenge — unless you understand the five principles that we at Better Bones use as the basis for our program.
#1 Bones and muscles form interconnected muscle–bone units
The very idea that exercise can help strengthen bones makes no sense at all unless you understand the close relationship between the bones and the muscles. They work together in supporting and moving the body, but can’t do much separately. Remove the bones from an arm or leg, and the muscles have nothing to attach to; eliminate the muscles, and the bones hang uselessly, unable to move or function.
Once you view them as a unit, it makes intuitive sense that lean muscle mass predicts bone mass (rather than total body weight). It also makes sense that chronically strong muscles are associated with strong bones, and by the same token, chronically weak muscles are associated with weaker bones. Both bone mass and muscle mass are lost with aging, but we can do a great deal to limit this loss through modifications of lifestyle (including exercise) and nutrition.
#2 Bone adapts to the load put upon it
In all her wisdom, Mother Nature is economical. Energy and resources are spent to build the amount of bone and muscle that an individual’s activity patterns shows they need. That is, bone acclimates itself to the load put upon it: More activity tells the body that more muscle and bone are required; less causes muscle and bone to decrease.Intermittent spurts of higher-impact loading, in particular, stimulate the strengthening of bone.
#3 The loading of bone has a site-specific effect
You don’t, unfortunately, get a full-body effect for a partial-body workout. The muscles pulling on the tendons that in turn pull on the bone send an important signal to build bone strength, but that signal is localized — meaning, if we exercise in such a way as to work the hip andleg, such as in jumping or hopping, we will build bone strength in the hip and leg, but not necessarily in the arms, wrists, or upper skeleton. Similarly, a right-handed tennis player will have stronger bone in their right arm, which moves more, than in their left arm. So if overall bone strength is your goal, you need to exercise in ways that work all (or most) of the major muscle groups.
#4 Rest is required to build bone (and muscle)
Building bone is not all about working the muscles, though. Rest is very important for both the bone and muscle renewal process. We show the bone and muscle we need them to be stronger by the stress we put upon them during our activities, but it is in the recovery period, when we’re at rest, that bone and muscle renewal take place.
#5 The impact of exercise on bone strength follows a direct dose-response relationship
Even small amounts of exercise benefit bones, but the bone-strengthening benefits of exercise are increased with a higher dose of exercise. The more frequent your exercise sessions are, and greater the intensity per session, the greater the strength you’ll impart to your bones.
#6 Age is no barrier to bone strength
There are plenty of people in their later years who are worried about osteoporosis. They sometimes say, “I wish I’d started exercising when I was still young enough!” But if I were to add a sixth principle to this list, it would be this: It is never too late to build bone strength with exercise. Studies have shown that even wheelchair-bound 90-year-old seniors can build bone with weight bearing exercises, and even a little bit helps a lot.
Hear Dr. Brown talk in her own words about these bone building exercise principles
Since we first published our blog on building bone density with serious weight lifting, we’ve been bombarded with questions. In particular, everyone wants to know how our client Cindi managed to increase her bone density in the neck of the hip by over 20% and the spine by over 5%. I promised I’d give you the details on her story, so here it is.
Point # 1: Cindi’s Background
Cindi was a lifelong exerciser who paid good attention to her diet and lived a very healthy lifestyle.
Even before coming to work with us at the Center for Better Bones she had a serious, long term exercise program.
For decades, she enjoyed a regular exercise program combining muscle conditioning exercises, cardio, and yoga.
Cindi also used low dose hormone replacement therapy since menopause.
When she came to see us in April 2016, she had a low vitamin D level at 29ng/ml. Her weight was 116 lbs.
With this exercise program, lifestyle, and estrogen, her bone density tests showed generalized stability from ages 55 to 62.
Then, between the ages of 62 and 65, she lost a significant amount of bone. She lost 3.2% bone density in the spine, 18% in the neck of the hip, and 14% in the total hip.
Not believing that she could have lost this much bone, Cindi herself paid for a second bone density test two months later, to find out that she indeed had lost that much bone density.
So at 65, she was diagnosed with osteoporosis of the neck of the hip (T-2.9), osteoporosis of the total hip (T-2.6), and osteoporosis of the spine (T-2.6). After doing the complete Better Bones, Better Body program and doing her serious strength training for 1.5 years, she no longer had osteoporosis, her T scores were all in the osteopenic range.
It is also worth mentioning that Cindi had a great deal of support from her family physician who was willing to order all the appropriate tests to look for any hidden causes of this rapid bone loss.
Cindi’s bone density loss between the age of 62 and 65
Spine
Neck of Hip
Total Hip
-3.2%
-18%
-14%
Point #2: Cindi’s decision for building bone density
Cindi had regular bone density test and the bone was quite stable but at age 65, she suddenly found that she lost a significant amount of bone.
Being quite attentive to her health, Cindi was alarmed at this accelerated bone loss. She became further concerned when her endocrinologist told her the solution was, “ to gain 10 pounds and go on a bone drug.” Cindi really didn’t see herself either doing a bone drug or gaining 10lbs, so she set out to learn all she could about how to naturally build back her bone density. One of the first things she did was to make an appointment with D. Brown at the Center for Better Bones.
“I went to the Center for Better Bones because they offered a comprehensive program. They evaluated my diet and prescribed a vitamin and mineral regime. My vitamin D and calcium was tested twice a year to ensure I maintained the correct levels. I learned about and adopted an alkaline diet. Dr. Brown offered a well researched plan, education and a helpful and supportive staff.” — Cindi
Cindi also discussed her rapid bone loss with her son, a professional CrossFit and Olympic weight trainer, who suggested she began serious weight lifting.
While she was intrigued by her son’s suggestion, she was concerned that she might injure herself. Doing online research Cindi discovered the Australian Bone Clinic where older women were gaining significant bone density lifting heavy weights with any injury.
Assured that she could develop a safe weightlifting program, she began her “technical weight lifting program” soliciting the supervision of her son and other trainers at her local gym.
A year and a half after beginning her weight lifting program, Cindi spoke with Lisa Weiss, one of the Australian Bone Clinic’s founders. Lisa told Cindi they recommend people only do the such weight lifting programs under their supervision. Cindi had read in their Women’s LIFTMOR Trial Study that they perform 5-7 different tests to assess safety while training their clients. Lisa Weiss said without such supervision and testing she would wonder about the possible development of horizontal fractures. Cindi thought that was referencing the spine. She did not know what that meant and feels it is important to find out about that and the tests. Cindy did her weight training program without thoroughly understanding this information. She feels it is important to know more about this to feel a “technical weight lifting program” is actually safe for women with compromised bone density.
While not fully understanding the reference to “horizontal fractures”, Cindi took from the conversation an appreciation of the importance of knowing how and what to test for safety as one develops their weight lifting program. Cindi did her weight training program without benefits of specific testing for safety and looking back she sees the importance of such individualized testing so women can be assured their “technical weight lifting program” is safe given their compromised bone density.
Point # 3: Cindi’s whole body approach
First let’s be clear, Cindi did not only do the serious weight lifting, but Cindi carried out every part of the Better Bones Program in a very disciplined fashion.
For example, she followed our nutritional supplement suggestions, alkalized her body chemistry, reduced stress, meditated, and she was committed to maintaining a positive perspective on her challenge.
While undertaking her new technical weight lifting program she also continued her former exercise program.
The characteristics her technical weightlifting program were that it was progressive, meaning she started with low weights and worked up over time to higher weights.
Another characteristic was that she spent a great deal of time and effort learning the proper form of each lift so she would not get injured. All in all, she was very disciplined, and consistent with her program, and she had proper supervision with her weightlifting program.
So what exactly was Cindi’s serious weightlifting program which she did diligently for 1.5 years before the follow up bone density?
Exercise
Frequency
Reps/ Sets
Starting Weight
Weight worked up to
Romanian Deadlift
1x/ week
10 reps, 3 sets
45lbs
110lbs- 5 reps/5 sets
135lbs-1 rep maximum
Conventional Deadlift
1x/week
10 reps, 3 sets- working up in weight each set
45 lbs
110lbs, 5 reps/5 sets
135lbs, 1 rep maximum
Back Squat
1x/week
10 reps, 3 sets
45lbs
95lbs- 5 reps/5 sets
Farmer Carry
2-3x/ week
0.1-0.2 mile
20lbs in each hand
30lbs in each hand
Suitcase Carry
2-3x/week
0.1-0.2 mile
20lbs
30lbs
Back Extension
3x/week
15 reps
0lbs
15lbs/15 reps/1 set
It is important to note that this is Cindi’s weight training program, designed for her particular needs. Each client should develop their own program with a trainer that is specific to them.
What do you think? Interested in adding serious weight lifting to your program for building bone density? The first step is to talk to your health care practitioner to understand what kind of exercise and the amount is right for you. When choosing an exercise program or exercise class, find one the caters to women with bone density issues taught by a qualified trainer.
I want to know how you do so please let me know your progress with weight lifting. Let us know what you are doing to build strong bones in the gym in the comments below!
Combat aging muscle loss through weight and resistance training with Gina in this 50 minute muscle strengthening exercise. Gina focuses on muscle strengthening exercises working large muscle groups that typically experience muscle weakening as we age. Gina uses the Better Bones Exercise Vest, light hand weights (3 and 5 pounds) and resistance bands in this exercise routine. Consider watching this video first to make sure you are exercising in good form when using weights.
How Much Is The Membership?
$12.99/month
Get full access to the premiere bone-building workouts for less than the cost of 1 lunch!
Our time-tested Better Bones, Better Body Program® works! It works because we provide the body with everything it needs to build and maintain bone strength. The Alkaline for Life Diet® giving pH balance, targeted nutritional supplementation, endocrine balancing and stress reduction, and digestion enhancements are all important building blocks of our successful program.
But no part or program is more important than exercise.
The health and strength of our skeleton is directly related to our level and type of physical activity. Each bone grows stronger or weaker depending on the load put upon. Even low-intensity regular physical activity promotes bone strength and reduces fracture risk. At the other end of the scale, intense strength training builds bone density more than any drug therapy ever did. Everyone can enjoy the bone building benefits of exercise and everyone can develop a personal bone-building exercise program suited to their body type, personal needs and desires. With our new Exercise Evolution I have set out to bring you safe bone-building exercises that are accessible, fun, motivating and best of all…able to be done from the luxury of your own home!
Exercise indeed builds better bones and a better body and there is no better time than right now to take charge of your own personal life-supporting exercise.
Dr. Susan Brown, PhDDirector of the Center for Better Bones
What’s Included in Your Exercise Evolution Membership?
Bone-Building Exercise Videos
Gain unlimited access to our growing Exercise Evolution archive of videos available on demand. A new exercise video with Gina Galli RYT is available every Month for you to workout at your convenience.
Exercise & Diet Tracking Portal
You will have access to this desktop and smartphone application which connects with your FitBit to log your exercise. You can also track and monitor your diet and pH readings to ensure you are getting the results you want!
Dr. Susan Brown’s Learning Library
Access to supplemental educational videos on bone health & overall well-being from the Director of the Center for Better Bones, Dr. Susan Brown, PhD.
Community Sharing Page
Get answers to your specific exercise and diet questions and support of our exercise experts as well as other Exercise Evolution members through our community sharing page.
Exercise Evolution Digital Manual
Get instant access to the Exercise Evolution Basics Digital Manual with videos: Your “how-to” series to get you started exercising safely for strong bones.
