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Exercising to Build Strong Bones

Use the LIVE Approach
  -- By Dean Anderson, Fitness & Behavior Expert
You know your heart, lungs, and muscles all need regular exercise to stay healthy and fit. But did you know that’s just as true for your bones, too? Whether you’re already facing bone-density problems like osteoporosis or osteopenia (pre-osteoporosis), or trying to make sure you don’t have these problems later on, regular exercise is one of the most important things you can do for your bones.

But not just any old workout boasts bone benefits. The best exercise for building bone density and strength follows the LIVE approach:

L is for Load-bearing. Weight-bearing exercise that requires your muscles to work against gravity by moving your own weight (or added weight) up and down has the most bone-building benefits.

I is for Intensity. The more weight you move, and the more vigorously you move it, the more that exercise will strengthen your bones.

V is for Variety. Exercises that involve as many different muscles in many different functional movement patterns are best.

E is for Enjoyable. Let’s face it. If you don’t like your exercises, you’re not likely to do them as much as you need to for best results.

While that may sound simple, right now you’re probably asking yourself, "But how do I put these principles into action? How much load, intensity and variety do I really need? What kinds of exercises should I do or not do?" Or for some of you who already have osteoporosis, "How do I know when I’m pushing myself hard enough to do some good without causing further damage?”

In order to pick the exercises that will work best for you and your particular concerns, you need to understand how exercise actually affects your bones.

If you’ve never had the chance to look at bone under a microscope, you might imagine that bones resemble the lumber that holds up the walls and floor of your house. But in reality, your bones are very active biologically (like your muscles and organs), and they respond to exercise pretty much the same way your muscles and cardiovascular system do. The more stress you put on your bones, the stronger they will get—just as your muscles respond to lifting weights by getting stronger, and your heart and lungs respond to cardio by becoming stronger and more efficient.

Like everything else in your body, your bones are made up of cells that are constantly dying and being replaced. Some of these cells, called osteoblasts, are bone-building cells whose job it is to replace lost bone, and make sure your bones are strong enough to meet the regular demands you put on them. Osteoblasts are activated and stimulated when your muscles pull on them to produce movement. To make a long story short, the more stress you put your bones under with load-bearing movement, the more active your osteoblasts are, and the denser and stronger your bones become. If you don’t stimulate your osteoblasts to keep adding new bone material, your bones slowly lose density and eventually may become porous and susceptible to injury from relatively minor stresses.

If you think this sounds a lot like how your muscles get stronger after you “injure” them during your strength training workouts, you’re exactly right. And just like you need to increase the demands you put on your muscles to keep improving your strength, you need to keep challenging your osteoblasts to build new bone. Doing the same old thing over and over again will put them to sleep. That’s why intensity and variety are important aspects of your bone-building program.

How to Exercise for Bone-Building
With all this in mind, let’s take a look at which kinds of exercise are best at stimulating your osteoblasts and building strong bones.

*Note: If you already have been diagnosed with osteoporosis or osteopenia, you should ask your doctor which exercises are safe for you first. Although load-bearing exercise will almost always be an important part of your treatment plan, you may need to avoid certain high impact exercises such as jumping, hopping, or other activities where you “land hard,” as sudden force can cause stress fractures in already weakened bones. Also, it’s very important to include balance training in your routine.

To apply the load-bearing principle most effectively, choose exercises that involve moving your body weight (or added weight) up and down against gravity. Examples of load-bearing aerobic exercises (which will also elevate your heart rate) include: While low-impact exercises such as swimming, walking on flat terrain, and bike riding can be great aerobic exercise, studies indicate that they may not do much for your bone density. Likewise, it’s not clear whether using exercise machines that help you move your weight (like the elliptical machine) help improve bone density as well as the non-assisted exercises listed above. In some cases, especially if you have to avoid high impact activity due to osteoporosis or some other problem, using an exercise bike with added resistance can work well.

Of course, formal strength training is an excellent way to build bone density. The best approach is to use a weight heavy enough that you can only do seven to eight repetitions in good form. When you can handle 12 repetitions with that weight, it’s time to increase the weight. Also, focus on lifting slowly, using a slow count of eight, and with good technique. Lift the weight up for four counts and—this is especially important—lower it down to the start position for four counts without allowing the weight to rest on your body or the machine between repetitions. (If you haven’t been using this approach, you can expect some muscle soreness at first.)

As with any workout program, exercising for bone-building requires lots of variety. Most exercises only work one particular muscle group in one particular way. For bone-building results, try to involve as many muscles, angles and patterns of movement as possible. You don’t have to do this in every exercise session, but you should rotate to a new set of exercises every couple of weeks.

Finally, there are lots of bone-building activities you can include in your daily routine, even though they aren’t formal exercises. Gardening is one good example. Another is making a point of getting up out of your chair without using your hands or arms for assistance. If you can’t do this now, start practicing every day by first sitting on an extra cushion or a phone book, and practicing until you reduce the amount of weight you have to support with your hands. Then remove the cushion, and do the same until you don’t need to use your hands at all. Research shows that people who can get out of a chair without using their hands have a much lower incidence of balance problems and falls, which can be very serious for older people with osteoporosis.

Although osteoporosis is often considered an age-related problem, the foundation for this problem is often set much earlier. Research shows that a person's bone density at the ages of 25-35 plays a large role in determining whether her natural decline in bone density will cause problems associated with osteoporosis and osteopenia. So, don’t wait until you’ve already got problems before you start trying to manage them. What are you waiting for? With your doctor's advice, a bone-building diet, and these exercise suggestions, you're armed and ready to strengthen those bones. So turn off your computer and get out of your chair—without using your hands.