Supporting your bone health with exercise – there’s more to it than you think!
Exercise is important to incorporate into our lifestyle for many health reasons. It is one important link in maintaining bone health and strong muscles throughout the lifespan. Bone health and exercise is especially important for women across the menopause years, as the drop in oestrogen disrupts the bone remodelling cycle, resulting in bone loss occurring at a faster rate than bone building up. Exercise is one way, in combination with diet strategies, that slows bone loss and helps to maintain and strengthen bones to prevent falls and fractures later in life.
Exercise and bone development throughout life
Exercise for bone health is important when we are young, during our growth and development. Sports that involve running, jumping and jolting actions are the key to promoting strong bones when we are younger, as bone building occurs at a faster rate than bone loss. The bone remodelling cycle continues to add more bone than lose it, up until the age of about 30 years. Between the ages of 30-50 years (approximately) your bone density stays pretty stable, where the ratio of bone loss to building bone is pretty much equal. However, for women going through perimenopause, bone loss starts to outweigh bone building due to fluctuations and the fall in oestrogen. It is at this time in life where the start of osteopenia or osteoporosis could be silently happening. In fact, in Australia, around a half of all women over the age of 60 years have osteoporosis.
Now you may be thinking, I am in my forties or I am too young, so I don’t need to think about this, but in actual fact now is the time to start thinking about it and taking action.
Not all exercise is created equal
Exercise done consistently, for the rest of your life will prevent bone loss and strengthen bones and muscles. However, not all exercises are created equal when talking about supporting bone health. Specific types of exercises promote bone health and slow loss more than others.
Weight bearing exercises
Weight bearing exercises are those that force you to work against gravity and usually involve you standing on your feet and bearing down on your weight, jolting and jarring bones, which initiates the bone cells involved in the bone remodelling cycle to start doing their work to strengthen the bone.
Weight bearing exercises include:
Jumping, aerobics, running, skipping, hopping, hiking, climbing stairs, dancing, housework, gardening, basketball, netball, tennis
Walking is a weight bearing exercise, but it only improves bone health, muscle strength, fitness and balance if it is high intensity, such as brisk walking with a back pack or holding weights, faster paced over longer distance such as bushwalking and walking in terrain where there are hills and exertion is needed. Walking can also be broken up with intermittent bouts of faster walking or running. Wearing a pocketed vest to add weights to, or wearing ankle or wrist weights while walking are also beneficial. This is an excellent way to build strong bones and strengthen the ankles, knees and hips. It is important to point out that walking is a really good starting point for someone who hasn’t exercised for some time and when starting out, any level of exercise is better than none. Swimming and cycling build strong muscles, but are not considered as weight bearing exercises, as they do not contribute to building strong bones.
Resistance exercises
Resistance exercise causes muscles to contract against an external force resulting in increased strength and stability. This allows the muscles to grow and become stronger, as the muscle fibres tear microscopically, then repair and recover. Because of this process, known as catabolism (break down or tearing of the muscle) and anabolism (building up or repair of the muscle), it is important to have at least one rest day in between the days that you do resistance exercises. Resistance training strengthens the muscles and in turn strengthens the bones, reducing the risk of falls and fractures, by also improving balance and stability.
Resistance exercises include:
Using free weights, weight machines, resistance bands, barbells, lifting weights, using hand and ankle weights and training with increasing intensity over time.
Balancing exercises
Balancing exercises help with preventing falls, strengthen bones and muscles, improve stability and prevent fractures. Falls are commonly caused by a sedentary lifestyle, poor posture, balance and muscle strength. Simple balancing exercises like standing on one leg or some balancing yoga poses can help with improving balance. Yoga, pilates and tai chi are all beneficial in improving balance as they strengthen the muscles and improve posture. There is some controversy around yoga and spinal twisting poses, as they may be risky for women with osteoporosis.
How often and when should I do exercise for bone health?
The Australian Physical Activity guidelines recommend being active most days, preferably every day of the week. Adults should do either:
- 2.5 – 5 hours of moderate intensity physical activity each week
OR
- 1.25 – 2.5 hours of vigorous physical activity each week
This is a minimum of 30 minutes of physical activity each day of the week. It is recommended to add to that at least 2 days of the week for strengthening exercises.
An example of an exercise plan for bone health could be:
Day 1 Weight bearing
Day 2 Resistance/weight bearing
Day 3 Weight bearing
Day 4 Balance
Day 5 Resistance
Day 6 Weight bearing/Balance
Day 7 Weight bearing
This ensures that you are getting the rest days in between resistance days, doing some balance work as well as weight bearing most days of the week. Examples of weight bearing, resistance and balancing exercises can be found on the Healthy Bones Australia website. Always consult with your GP before embarking on an exercise program and only do exercises that are within your limits. Most importantly, always choose any exercise that you enjoy doing, so that it is something that you look forward to time and time again.
References:
1. Australian Government, Department of Health, Physical Activity and exercise guidelines for all Australiana, Adults aged 18-64 years. https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years
2. Better Health Channel, Osteoporosis and exercise. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis-and-exercise
3. eMedicineHealth, Resistance Training. https://www.emedicinehealth.com/strength_training/article_em.htm
4. Harvard Health Publishing, Strength Training Builds More Than Bones. https://www.health.harvard.edu/staying-healthy/strength-training-builds-more-than-muscles
5. Healthy Bones Australia, Exercise and Bone Health. https://healthybonesaustralia.org.au/your-bone-health/exercise-bone-health/
6. The American Orthopaedic Society for Sports Medicine, Sports Tip, Exercising and Bone Health. https://www.sportsmed.org/aossmimis/STOP/Downloads/SportsTips/ExerciseBoneHealth.pdf
7. The North American Menopause Society, Bone Health: Exercise is a key component. https://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/bone-health-exercise-is-a-key-component
8. Troy Kl et al, Exercise Early and Often: Effects of Physical Activity and Exercise on Women’s Bone Health. Int J Environ Res Public Health, 2018. May;15(5):878. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981917/
