Can low impact exercise build bone?

How much exercise is “enough” for bone health?

When I talk to some of my clients about exercise, I know a lot of them aren’t enthusiastic, thinking I’m going to tell them they need to spend hours lifting heavy weights and sweating in a gym. After all, everyone knows it’s weight-bearing exercise — and lots of it — that builds bone and lowers the risk of fractures, right?

Surprise! Not necessarily. Two new studies show that even small amounts of low-impact exercise have a positive effect on fracture risk.

Twenty minutes of walking does the trick

The first study (Stattin et al., 2017) followed over 65,000 Swedish men and women for 17 years and found that participants who walked or bicycled daily for even short periods of time had a lower fracture rate compared with those who did not. Regardless of sex or age, even relatively sedentary people could lower their fracture risk by exercising just a little bit every day. As long as they got at least an hour of exercise per week, these otherwise inactive people had a 13% lower rate of hip fractures and a 6% lower rate of any fracture compared to people who did none at all.

It’s worth emphasizing that the findings held true whether you looked at any fracture (including common, relatively mild fractures like vertebral or wrist fractures) or the more serious and life-changing hip fractures that everyone fears.

Of course, the more exercise they got, the better the results: those with 20 minutes of walking or cycling every day, which translates to about 2 hours per week — had a 23% lower rate of hip fracture and a 13% lower rate of any fracture. That’s a pretty good return for not a lot of effort — just imagine what you get when you do even more!

Light loads do more than you think

The second study (Hamaguchi et al., 2017) had a small group of 7 postmenopausal women undergo six weeks of training wearing a weighted vest with 380-760 g (roughly from 1.75 pounds) of added weight. With just two workout sessions per week, the participants saw improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%) — which is helpful in maintaining balance and preventing falls. Workouts consisted of squats, front lunges, side lunges, calf raises and toe raises (eight sets of three repetitions with a 15-second rest between each set).

A little bit goes a long way

I know that it can be hard to start exercising if you’re not accustomed to it, and especially if you’re recovering from a muscle strain or a fracture, the get-up-and-go impulse just isn’t there. But you don’t have to do a lot to get benefit from it! Both of these studies show that a little goes a long way. 

 

 

References

Hamaguchi K, Kurihara T, Fujimoto M, et al. The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: a pilot study. BMC Geriatrics 2017;17:102. doi:10.1186/s12877-017-0490-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414134/

Stattin K., Michaëlsson K., Larsson S.C., Wolk A., & Byberg L. Leisure-Time Physical Activity and Risk of Fracture: A Cohort Study of 66,940 Men and Women. Journal of Bone and Mineral Research 2017;32(8):1599-1606. doi: 10.1002/jbmr.3161.

Strength training class

New research: Low-weight, high-repetition strength training builds bone

Here’s good news for those of us who avoid rigorous high load strength training – either due to risk of injury or personal preference. New research shows powerful bone-building benefits can also be obtained with low-load, high-repetition strength training.

To determine this, researchers compared the results of a 24 week strength training program for two groups – one using the Body Pump Program,™ a full body, low-load, high-repetition resistance training program using weights with the other group using a combination of Pilates and yoga exercises without weights.

At the end of the 24 weeks period those doing the low-load, high-repetition strength training increased their bone density (BMD) significantly, while those doing the core strengthening program didn’t increase bone density.

Gains in bone density in the low-load, high-repetition group

  • 4% gain in arm BMD
  • 8% gain in leg BMD
  • 6% gain in pelvis BMD
  • 4% gain in spinal BMD

As for gains in muscle strength, both groups experienced improvements in body mass composition and muscular strength, but the gains were greater in the low-load, high-repetition strength training group.

My take on the study results

Personally, I find a low-load, high-repetition system works well for me. And this approach fit right into the strength training program I was already doing at my local Y.

This well-designed study clearly shows that you can build bone density with a gentler form of strength training, but you must commit yourself to do 3 hours strength training per week and find time for 3 hours of aerobic exercise each week also. I know that this may sound like a lot, but remember, if you don’t change things up to keep challenging your bones and muscles, you won’t get results! Here are some of my favorite ideas to help you get started.

More details about the study’s strength training program

  • All sessions were one hour
  • First, participants did a three-week preparation program learning the proper form of each exercise.
  • During the first 12 weeks of the full study participants did 2 strength training sessions per week and 3 bicycling aerobic sessions per week.
  • During the second 12 weeks period there were 3 strength training sessions and 3 by bicycling sessions per week.
  • Each session consisted of 8 loading exercises done with a load of only 20% of the individual’s 1 repetition maximum. (Traditional high-load strength training uses weights of 70-85% an individual’s 1 repetition maximum with only 6-12reps per set).
  • Each of the low load exercises was done for 100 reps, thus the entire class involved some 800 repetitions with a low-weight load.
  • Participants were asked to increase the weights in any particular exercise if the exercise did not feel hard enough by the end of the 4 to 5 minutes of repetitions.
  • 8 exercises were done each session including squats, dead lifts, chest press, triceps variation, bicep curl, lunges, pushups and clean and press.

For further specifics on this type of low-load, high-repetition strength training program see the BODYPUMP Program™ info.

 

 

 

Can Wearing a Weight Vest Build Bone?

Top questions about a weight vest for Better Bones

weight vest better bones

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 less 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 demonstrate how the 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 to their bones when they walk.

As you use the vest over time, you’ll note you are building muscle strength. Remember, studies show you 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 time 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 1-2 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. 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 this is 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: Where can I get additional weights?

A: Extra flex-weights are available here.

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 that date of delivery. If in that time you decide it is not for you we will refund you for the cost of the vest.

Q: Do I need my doctor’s permission to use this vest?

A: The vest is very safe because you totally control the amount of weight you put in it. By itself, or with say 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.

You can learn more about my weight vest here.

References:

Jessup, J et al., 2003, Effects of exercise on bone density, balance, and self-efficacy in older women, Biol Res Nurs 2003, 4:171-180.

Snow, C et al., “Long Term Exercise Using Weighted Vests Prevents Hip Bone Loss in Postmenopausal Women”, Jr of Gerontology: Medical Sciences 2000, Vol. 55A, No. 9, M489-M491.

Snow, C, Marcus, R et al., 1991. “Exercise, Bone Mineral Density, and Osteoporosis”, Jr of Exercise and Sport Sciences 1991, Vol. 19:351-388.

3 Ideas to get moving

How to reduce the risks of too much sitting

If you’re looking for extra motivation to get up and get moving, there’s a powerful new study documenting how sitting 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.

If you want to learn more about the risks of sitting, check out my blog Is sitting the new smoking?

So let’s make 2017 our year to get out and moving — I’d love to hear about your exercise plan for 2017!

 

References:

Ding, Ding, et. al. 2016. The economic burden of physical inactivity: A global analysis of major non-communicable diseases.  The Lancet, 388(10051):1311–1324.  http://dx.doi.org/10.1016/S0140-6736(16)30383-X

Ekelund, U., et al. 2016. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet,  388(10051):1302–1310. http://dx.doi.org/10.1016/S0140-6736(16)30370-1

2 hours of strength training a week improves bone density

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.
  • Studies now document that the regular practice of yoga could halt bone loss and begin to build new bone.
  • 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.

References:
Kemmler, Wolfgang et al., The Erlangen fitness osteoporosis prevention study: a controlled exercise trial in early postmenopausal women with low bone density—first-year results. Archives of Physical Medicine and Rehabilitation , Volume 84 , Issue 5 , 673 – 682,2003

Kemmler, Wolfgang et al. Exercise frequency and bone mineral density development in exercising postmenopausal osteopenic women. Is there a critical dose of exercise for affecting bone? Results of the Erlangen Fitness and Osteoporosis Prevention Study. Bone , Volume 89 , 1 – 6 (https://secure.jbs.elsevierhealth.com/action/showCitFormats?pii=S8756-3282%2816%2930106-5&doi=10.1016%2Fj.bone.2016.04.019&code=bon-site)

How to increase spinal bone density with exercise

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 Better Bones tips for strengthening lower back muscles

  1. Do regular exercise to build the back extensor muscles. My favorite exercise is the one developed by the Mayo Clinic, which they used even with women who had previous spinal fractures.
  2. Practice good posture, which is an exercise in itself. Stand tall, shoulders back but relaxed and imagine showing off a lovely necklace.
  3. Train with weights. A simple routine of upper arm exercises with light hand weights is a good way for many to start (bicep curls or arm lifts, etc.) Working with a trainer who adjusts and monitors your progress is also very helpful. For those of you who like to walk, using a weighted vest is a simple and time efficient way to build muscle and bone.
  4. Mindful exercises like yoga and Pilates also offer postures and moves that strengthen the back.
  5. Seeking the advice of a physical therapist is always an excellent idea, especially if you have a fracture or a special health concern.

 

References:

Dae-Young Lee et al., Relationship between bone mineral density and spinal muscle area in magnetic resonance imaging.  J Bone Metab. 2015 Nov. 22(4):197-204.

Sinaki, M et al., Stronger Back Muscles Reduce the Incidence of Vertebral Fractures: A Prospective 10 Year Follow-up of Postmenopausal Women. Bone, Vol. 30, No 6, June 2002:836-841.

 

Exercise and bone health — use them or lose them

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 a YouTube video on-line. 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.

exercise

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 the OsteoBall, Bosu Ball, or rubber flex bands (e.g., Thera-Band).
  • 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.

exercisedontExercises 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.

Groundbreaking study shows yoga can build bones

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 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.

Interested in getting started with yoga?

If you decide to take up yoga for its bone benefits, you’ll see the best results with a practice of at least 4 times a week. Consider training with a knowledgeable yoga teacher who can help you determine the most appropriate poses based on your fitness level.

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.

Yoga poses from the clinical trial

Standing poses
standing prayer pose
mountain pose
triangle pose

Sitting
half spinal twist
seated forward bend
lotus pose

Supine
bridge
reclined thunderbolt
corpse pose

Prone
cat pose
boat pose
crocodile pose

Pranayama: 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.

 

References:

Fishman, L. M. 2009. Yoga for osteoporosis: A pilot study. Topics in Geriatric Rehabilitation 25(3):244–250.

Fishman, L. M., and E. Saltonstall. 2010. Yoga for osteoporosis: The complete guide. New York: Norton.

Motorwala, Z. S., S. Kolke, P. Y. Panchal, N. S. Bedekar, P. K. Sancheti, and A. Shyam. 2016. Effects of yogasanas on osteoporosis in postmenopausal women. International Journal of Yoga 9(1):44–48. [http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2016;volume=9;issue=1;spage=44;epage=48;aulast=Motorwala]

Lu, Y. H., B. Rosner, G. Chang, and L. M. Fishman. 2015. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Topics in Geriatric Rehabilitation, epub ahead of print. DOI: 10.1097/TGR.0000000000000085.

Is exercise enough for bone health?

Who else has spring fever and is ready to spend more time outdoors walking, gardening and just moving? Spring definitely reminds me to brush off my exercise plan.

A big motivating factor is the explosion of recent research emphasizing the profound benefits of exercise. One 2015 long-term European study showed a 50% reduction of all low trauma fracture overall with a multipurpose exercise program mixing  endurance, jumping, strength training and stretching done 4 days a week.

Another study shows improving fitness may counteract brain atrophy in older adults, including those already diagnosed with mild cognitive impairment.

With all the clear benefits, it’s hard not to think that exercise is everything you need for healthy bones, body and mind. But in reality, if you’re getting the exercise you need for better bones, you’ll need more nutrients too. Here’s why:

Nutrient needs increase with exercise

If you’re already exercising, keep moving!  The average woman will lose 45% of her bone and muscle as she ages from 35 to 85. Exercise is an important piece of the puzzle to limit bone loss — but it’s not enough alone. What might surprise you is that exercise creates nutrient needs in your body that need to be considered in your overall bone-building program.

  • Exercise uses vital minerals, vitamins, amino acids and other nutrients needed to build and maintain bone strength. This is especially true with exercise that makes you sweat a lot!  For example, during a basketball season University of Memphis college players lost an average of 247 mg calcium in their sweat alone. Even more, there was an overall decrease of 6.1% in total bone mineral content and a 10.5% decrease in mineral content in their legs, and the average player lost 3.8% of his bone density in 3 months while playing. Calcium supplementation during exercise and with meals reversed these decreases in bone mineral content. (Klesges et al. 1996)
  • Exercise also creates oxidative damage. The more strenuous the exercise the more free radicals produced and the more oxidative damage to cells. For this reason, exercise substantially increases our need for a wide range of protective anti-oxidants such as vitamins C and E, N-acetylcysteine, CoQ10, flavonoids, beta carotene, etc. (Finaud et al. 2006; Ji 1999)
  • Exercise can disrupt acid-alkaline balance. Strenuous exercise acidifies by creating excess lactic acid, oxidative damage and other metabolic by-products. In fact, elite athletes given alkalizing mineral compounds to combat exercise-induced acidosis performed significantly better than non-supplemented athletes (Heil et al. 2012).

Increase your nutrient intake

Again, I encourage you to keep up with your personal exercise plan!  But as you do, it pays to compensate for any losses by getting enough of the key nutrients your body requires.  Vigorous exercise helps strengthen bone, but the exercise-induced changes should be counterbalanced with extra nutrients and the alkaline mineral reserve compounds found in an alkaline diet and the Better Bones products.

If you participate in tai chi, Qi Gong and yoga, these mindful gentle exercises do not create oxidative stress and they help alkalize the body. Nonetheless, research shows that even these mindful exercises should be accompanied by intake of all the essential 20+ key bone-building nutrients (Shen et al. 2007).

 

References:

Kemmler, W. (2015, October 15) Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study. Osteoporosis International Volume 26, Issue 10, pp 2491-2499.  (Retrieved February 26, 2016:  http://link.springer.com/article/10.1007/s00198-015-3165-3)

University of Maryland. (2015, November 19). Improving fitness may counteract brain atrophy in older adults, study shows: Exercise may help to reverse neurodegeneration in those with mild cognitive impairment, an early stage of Alzheimer’s disease. ScienceDaily. Retrieved February 26, 2016: www.sciencedaily.com/releases/2015/11/151119113458.htm

Finaud, J., G. Lac, and E. Filaire. (2006) Oxidative stress: Relationship with exercise and training. Sports Medicine 36(4):327–358.

Heil, D. P., E. A. Jacobson, and S. M. Howe. 2012. Influence of an alkalizing supplement on markers of endurance performance using a double-blind placebo-controlled design. Journal of the International Society of Sports Nutrition 9:8.

Ji, L. L. (1999) Antioxidants and oxidative stress in exercise. Experimental Biology and Medicine 222(3):283–292.

Klesges, R. C., K. D. Ward, M. L. Shelton, W. B. Applegate, E. D. Cantler, G. M. Palmieri, K. Harmon, and J. Davis. (1996) Changes in bone mineral content in male athletes: Mechanisms of action and intervention effects. Journal of the American Medical Association 276(3):226–230.

Shen, C. L., J. S. Williams, M. C. Chyu, R. L. Paige, A. L. Stephens, K. B. Chauncey, F. R. Prabhu, L. T. Ferris, and J. K. Yeh. (2007) Comparison of the effects of tai chi and resistance training on bone metabolism in the elderly: A feasibility study. The American Journal of Chinese Medicine 35(3):369–381.