How Can Physical Activity Promote Good Bone Health?
Of course you know that regular, weight-bearing physical activity (think: brisk walking, golf, jumping rope, dancing, climbing stairs, hiking or racket sports like tennis, squash and paddle tennis) can help to burn stored fat in order to achieve and maintain a healthy body weight. Have you considered, however, that some of those very same activities can also help to prevent — and even reverse — bone loss in adults? Not only does exercise improve your bone health, it also increases muscle strength, coordination and balance. It leads to better overall health in the longer term.
Weightbearing Physical Activity
QUESTION: How will you know whether an activity is weightbearing?
ANSWER: Your heel strikes the ground (or the floor or the treadmill)!
For best results look for an upright physical activity that forces you to work against gravity. Try workouts that that stress your bones and muscles more than you would otherwise do in your everyday life. Jonathan Ross, spokesperson at the American Council on Exercise, encourages such exercise. He adds a reminder that your program does not necessarily require gargantuan, regimented, daily or prolonged, strenuous work. He says that as little as 30-minute physical activity sessions four or five days a week will help you establish an effective routine.
Even if you now have low bone density, do not despair. You can still move that value back into the normal rage for healthy bones with consistent, well-planned exercise. For best results in sustaining the bone-strengthening benefit of weightbearing activity, over time you will probably need to increase the intensity, duration and amount of stress applied to bone. Get started now, and stick with the program. See the progress you can make with consistent effort.
Choosing Appropriate Activities
There are two types of weightbearing exercise: high-impact and low-impact. This differentiation refers mainly to the force that the exercise exerts against your joints, including your spine and connective tissues like ligaments and tendons. These exercises offer different benefits and pose different risks. There is no rule that you must progress to high-impact physical activity as you get fitter; although, many people choose to do so for an increased challenge or greater variety.
Keep in mind, too, that many programs combine high and low impact exercises into a single workout and that sometimes the line between categories is not clearly drawn. Balancing risk v. benefits of high and low impact exercises can be another great reason to cross train.
Some health professionals recommend that you get at least 175 minutes of moderate-intensity, low-impact exercise or else 90 minutes of high-impact, high intensity exercise per week.
High-Impact
This category includes activities where the body is making contact with — or pounding — the ground. In these workouts both feet leave the ground at the same time. Your bones react to the weight on them by building themselves up and getting stronger. High-impact physical activity includes exercise such as:
- Jogging or running/walking at a very fast pace
- Climbing stairs
- Hiking
- Plyometrics, including jumping rope, skipping and clap push-ups
- Step aerobics
- Tennis or other racket sports
- Yard work, like pushing a lawnmower or heavy gardening
High-impact exercises tend to be more intense overall and therefore burn more calories. They may even strengthen bones better than lower impact options. These exercises, however, are best performed by people who already have a baseline of fitness and are at low risk for joint problems. They can pose a higher risk for injury, especially to the ankle, knee and hip joints as well as the spine. High-impact weight-bearing exercises may not be safe for you if you are in a higher-risk category for breaking a bone.
Low-Impact
Low-impact exercises pose less jeopardy to cause fractures, but they are still able to build up your bone density. Such activities typically require that at least one foot stays in contact with the ground at all times. These options include:
- Elliptical training machines
- Aerobics (low-impact)
- Stair-step machines
- Walking at moderate pace (either outside or on a treadmill machine); race walking
- Rollerblading
- Cardio dance workouts
These exercises are most appropriate for beginners as well as for people with arthritis or osteoporosis, older adults, individuals who are obese, pregnant women and people with bone, joint or connective tissue injuries. Low-impact exercise tends to be less jarring on the body and joints and generally less intense overall. According to the American Council on Exercise, keeping at least one foot on the ground at all times also reduces your risk of musculoskeletal injury.
NOTE: Although they are excellent cardiovascular exercise choices, neither swimming nor bicycling can be considered true weightbearing physical activity. Consequently, they are not as effective as other recommended options for adding bone mass. If your musculoskeletal condition does not allow vigorous weightbearing exercise, though, swimming and cycling can be good alternatives nonetheless. They both do have some limited bone-building capacity without the risks of high-impact activities.
Strength Training
You should also consider adding strength training to your workout schedule at least two or three times a week. Working your muscles matters just as much as building up bone. Lifting weights, using the weight machines at your health club or doing calisthenics — these all are effective forms of muscle-strengthening resistance training, which is essential to bolstering bones. Strong muscles protect against falls. Your lower body functions as an anchor; so, focus on moves that work your legs and thighs. Squats and lunges are particularly effective.
Strength training workouts can include basic moves such as standing and rising on your toes or lifting your own body weight with exercises like push-ups or squats. You may choose to use equipment such as:
- Elastic exercise bands
- Free weights
- Weight machines
Functional/Non-impact Exercises
In addition you should consider incorporating non-impact exercises to improve balance, posture and movement in everyday activities. These moves do not directly strengthen your bones. They can, though, improve your coordination, flexibility and muscle strength and thereby lower the chance that you’ll fall and break a bone.
You can — and should — do these exercises every day. To illustrate, if you have trouble getting up from a chair or climbing stairs, you probably should be including additional non-impact activities now as part of your daily exercise program. Such activities fall into three categories:
- balance exercises that strengthen your legs and challenge you to improve your equilibrium (reduce your risk of falls)
- posture exercises that improve your carriage and reduce any rounding or “sloping” of shoulders (decrease the chance of fracture to a bone especially in the spine)
- functional exercises to improve your movement and help with everyday activities (decrease your chances of falling and breaking a bone)
Yoga, tai chi, Pilates and balance-building moves (think: standing on one leg) strengthen your core and help you avoid falls.
CAUTION: some of the moves you do in these programs, especially forward-bending exercises, can make you vulnerable to risk a fracture. If you’re interested in such workouts, talk first with your doctor or ask your physical therapist to distinguish between the moves that are safe and those you should avoid.
Advice from the Trainer
Mark Matozzi, C.P.T., an ISSA Tier 3 personal trainer in Chicago, observes that while such functional/posture/balance exercises are important at any age, they become absolutely essential for most of us at about age 45. That is typically the age when cumulative wear-and-tear, progressive aging and changes in hormonal levels can combine to create a “perfect storm.” At this point a person may become predisposed to injury even from some of the simple activities of daily living.
Matozzi says he typically recommends exercises designed to incorporate task- and context-specific practice in areas individually meaningful to his clients. For example, consider a person whose job requires repeatedly moving bulky or cumbersome objects. The appropriate workout regimen for this person would target towards heavy lifting. If, on the other hand, Matozzi’s client were the parent of young children, then exercise recommendations would differ. Recommended activities would focus more toward moderate lifting and endurance. Finally, if the individual were a marathon runner, Matozzi’s training would aim to build long-distance endurance. Above all this trainer always carefully considers each individual client’s health condition and lifestyle priorities. This way Matozzi can ensure that goals are both realistic and achievable.
Proceed with Caution
If you haven’t exercised regularly for a while, be cautious. Move forward gradually when you undertake a new physical activity program. This advice is especially important if you are currently under treatment for any chronic conditions. Medical problems such as heart disease, diabetes or high blood pressure may need to be accommodated with special activity plans. Also, if you are at high risk for bone fracture or other injury, you probably should strongly consider consulting a personal trainer or a physical therapist to develop a safe, individualized exercise program. This way you can help yourself progress steadily — and safely — toward the goal of optimal bone health.
Do Not Get Impatient
And, finally, please be patient. Even for young adults, the bone-building phase — at its speediest — takes three to four months. It may very well take longer for you if you already have osteoporosis or are older. So, even though you may not be seeing big changes on any bone density tests immediately after your first week of working out, stick with it for the longer term. Bones change slowly, but they DO change.
