Exercise and Bone Density

Adapted from Osteoporosis Australia's Medical and Scientific Advisory Committee 2016

Exercise throughout life

Regular physical activity and exercise plays an important role in maintaining or improving bone density. Exercise also increases the size, strength and capacity of our muscles. However exercise must be regular and ongoing to have a proper benefit. Our bones become stronger when a certain amount of impact or extra strain is placed on them. This means there are specific types of exercises that are better for bone.

Click to download Exercise and Osteoporosis fact sheet 

The specific goals of exercising for bone health change throughout life from building maximum bone strength in childhood and adolescence, to optimising and maintaining muscle and bone strength in young and mid-adulthood, and reducing bone loss in older age.

For the elderly the focus of exercise is to increase or maintain muscle mass and strength, and address risk factors for falls, particularly any difficultly in balance and walking ability.

Read about the effect of exercise at different stages of life

The right kind of exercise

Specific types of exercise are important for improving bone strength.

  • Weight bearing exercise (exercise done while on your feet so you bear your own weight). For example: brisk walking, jogging, skipping, basketball / netball, tennis, dancing, impact aerobics, stair walking
  • Progressive resistance training (becomes more challenging over time). For example: lifting weights - hand / ankle weights or gym equipment

The ability of an exercise to build bone (osteogenic capacity) depends on the specific way that stress is applied to the bone during the exercise.

Exercise and Osteoporosis

Osteoporosis*

A combination of weight-bearing exercise with supervised progressive resistance training and challenging balance and mobility exercises, at least 3 times per week. AVOID forward flexion (bending over holding an object, sit ups with straight legs) and twisting of the spine, as this may increase risk of a spinal fracture. 

Osteoporosis – after a fracture has occurred
 

Exercise is an important part of rehabilitation and a program will normally be planned and supervised by a physiotherapist. Exercises will be determined by the type of fracture and the patient’s age and level of physical function. Resistance training has been shown to be effective following hip fracture.

Read the recommended exercises for osteoporosis, and for different life stages

Get the most out of exercise

Exercise must be regular (at least 3 times per week)

  • Exercise should progress over time (amount of weight used, degree of exercise difficulty, height of jumps...must increase or vary over time to challenge bones and muscles)
  • Exercise routines should be varied (variety in routines is better than repetition)
  • Exercise should be performed in short, intensive bursts

Exercise regularly

Regular physical activity and exercise plays an important role in maintaining or improving bone density. Exercise also increases the size, strength and capacity of our muscles. However exercise must be regular and ongoing to have a proper benefit. Our bones become stronger when a certain amount of impact or extra strain is placed on them. This means there are specific types of exercises that are better for bone.

View the following table for recommended exercises at different stages of life

Balance exercises and preventing falls

Balance and mobility exercises do not improve bone or muscle strength but can help reduce falls. Exercises that assist with balance include standing on one leg (increasing to standing on one leg with eyes closed), heel-to-toe walking and tai chi.

Falls are a common cause of fracture. For people with osteoporosis, even a minor fall can cause a fracture. Half of all falls occur around the home and approximately one third of people over 65 fall each year. It is estimated around 6% of falls result in a fracture so preventing falls has become an important part of managing bone health. Falls are most commonly caused by:

  • Poor muscle strength
  • Problems with balance (weak muscles, low blood pressure, inner ear problems, some medicines, poor nutrition)
  • Poor vision
  • Home hazards that cause tripping

*Moderate to high impact activities are only recommended for people with osteoporosis who do not have a previous fracture(s) or lower limb arthritis. Consult your doctor and physiotherapist for advice. Weight-bearing activities may either be moderate impact (for example, jogging, hill walking), moderate to high impact (for example, jumping, skipping, step ups) and/or various sports that involve moderate to high impact (for example, basketball, tennis). Resistance training requires muscles to contract when lifting weights, placing stress on the muscle and related bones. The bones strengthen as they adapt to this extra strain. It is best to target specifi c muscle groups around areas that are most vulnerable to osteoporotic fractures – usually the hip and the spine. It is also wise to strengthen leg muscles to improve balance.