A Practical Guide to Strengthening Bones Through Exercise
Taking Control of Your Bone Health as You Age
Aging often feels like an inevitable march toward losing control over our bodies. For many, the idea of frailty—deteriorating muscles, weak bones, and an increased risk of falls—seems unavoidable. But what if it wasn’t? While some changes are natural and unavoidable, you have more influence over the aging process than you might think.
One area where this is particularly true is bone density. It might not sound glamorous, but focusing on bone health can have a profound impact on your overall quality of life as you age.
Why Bone Density Matters
As early as age 30, our bodies start losing bone density at a faster rate than we can replace it unless we’re actively working to counteract this process. This decline is part of the natural aging process, but it carries serious consequences. Reduced bone density increases your risk of developing osteoporosis, a condition where bones become brittle and fragile.
Why does this matter? Osteoporosis significantly raises the risk of fractures, particularly in high-risk areas like the hips and spine. For older adults, a fractured hip can lead to decreased mobility, prolonged recovery times, and even increased mortality risk. A study examining the relationship between hip fractures in women and mortality risk found women to have a nearly 3-fold risk of mortality within a year following a hip fracture. Falling, which becomes more common as we age, compounds the risk of fracture, and in turn increases mortality risk.
The good news is that bone density isn’t entirely out of your control. In fact, your lifestyle choices can significantly influence how strong your bones remain over time.
Wolff’s Law: A Brief Science Behind Improving Bone Density
As we mentioned above, you actually have the ability to take matters into your own hands and improve your bone density. This is because your bones aren’t just static structures that remain unchanged over time. Your bones are dynamic structures that directly respond and adapt to the stress and load placed on them. Wolff’s Law in a nutshell, is the concept that bones remodel and structure themselves over time in response to the mechanical forces they experience.
Think of it this way: if you’re new to lifting weights and don’t do any work with your hands, you won’t have any callouses built up. The first time you come into the gym and grip a barbell, you’ll initially experience small stresses to the skin of your hand. These small stresses will heal in a few days and the skin will grow back slightly thicker. After several months of incurring small stresses to the skin on your hands, you’ve develop thickened calluses on your hands that will have developed and adapted in response to the stress you’ve subjected your hands to.
Helen’s 100lb Deadlift will certainly help build those “bone calluses”!
We can think of improvements in bone density very similarly. As you subject your bones to bearing heavier and heavier loads, your bones will gradually respond to the stress placed upon them, resulting in an increase in bone density that corresponds with the increasing stress that your bones are able to tolerate.
Building Bone Density: Think of It as a Pyramid
When it comes to improving bone density, it helps to think of your efforts as building a pyramid. At the base of the pyramid is weight-bearing exercise, which serves as a strong foundation to build off, and helps you maintain your current level of bone density. Resistance training is the next tier on our pyramid, helping you to improve your bone density in a way that’s harder to recover from than weight-bearing exercise, but still very accessible for most people. Last but not least, at the top of the pyramid is high impact exercise. Here, you stand to reap the most reward, but you’ll need to carefully manage recovery and ensure that the risk of high impact exercise doesn’t outweigh the reward. Let’s dive a little deeper into each of the bone-building levels, and how you can incorporate them into your routine.
1. Foundation: Weight-Bearing Exercise
Weight-bearing exercises are simple, accessible, and form the base of your pyramid. These include activities like:
Walking
Dancing
Jogging
These exercises use gravity to apply stress to your bones, helping maintain the density you already have. While weight-bearing exercise alone won’t drastically increase bone density, it’s a critical starting point for laying a solid foundation. These activities are gentle on the body, making them ideal for beginners or those with joint issues. They’re also the easiest to recover from compared to the other recommended forms of exercise that we’ll talk about today.
2. Core: Resistance Training
Resistance training takes your bone-strengthening efforts to the next level. It involves working against a force—whether that’s your body weight, resistance bands, or free weights—to stimulate bone growth. Examples include:
Bodyweight exercises: Pushups, squats, pull-ups.
Machine-based exercises: Cable rows, leg presses.
Free weights: Dumbbells, kettlebells, and barbells.
Not only does resistance training improve bone density, but it also strengthens the muscles around your bones, which helps with balance and reduces fall risk. It’s suitable for almost everyone as long as exercises are properly scaled and adapted to individual needs. It’s a little harder for your body to recover from resistance training than weight-bearing exercise, so we’ll need to be mindful of how often resistance training takes place, and the program design.
3. Top Tier: High-Impact Exercise
The pinnacle of bone health is high-impact exercise. These activities include movements like:
Jumping (e.g., jump squats, box jumps)
Plyometrics
Stomping exercises (a gentler introduction to high-impact work)
High-impact exercises deliver the most significant improvements in bone density, but they also carry the highest recovery demands. For those new to exercise or at risk of fractures, these should be approached with caution and under supervision.
Tailoring a Bone-Building Program: Two Examples
Okay, so in an ideal world, anyone who wants to improve their bone density should include those 3 components in their workout routine: 1) weight bearing exercise, 2) resistance training, and 3) high impact exercise.
But here’s the thing: the individuals who are at the highest risk for osteoporosis or already have it are likely already pretty sedentary, and asking them to do anything beyond stomping for a high impact exercise will likely be unsafe. Improving bone density for someone like this is going to look a lot different than improving bone density someone who is more active and isn’t already experiencing osteoporosis. So let’s takes a look two different example individuals, and how we might help them improve their bone density.
Person #1: Hazel (72, Sedentary, Joint Pain, Borderline Osteoporosis)
Hazel, 72 y/o, does not currently take part in any form of exercise. She is prone to joint pain and is bordering levels for osteoporosis. She finds that she gets winded with exertion.
Weight-bearing exercise: since Hazel is not currently participating in any form of weight-bearing exercise, we’d recommend she start with a 10-15 minute walk 3-4 days a week. She gets winded easily, so we’ll need to take that into consideration when implementing her walking. As she builds up endurance and is able to walk for longer, we’d progress her to walking 6-7 days/week, with the end goal being 30 minutes of brisk walking. She could also try starting a yoga class that would double as a way for her to improve balance and maintain bone density.
Resistance training: Given’s Hazel’s sedentary lifestyle, age, and lack of resistance training experience, we’ll consider her pretty novice. We’ll also want to keep in mind that she has a history of joint pain. Because of this, we’ll be ready to make adjustments to exercises if needed to make her more comfortable. When selecting her exercises, we chose ones that aren’t highly technical given her lack of exercise experience. We’d start her with a strength-training program 2x a week, with a beginner friendly program such as the one below:
A Day:
-High box squats
- Seated cable row
-elevated pushups
-glute bridge
-paloff press
B Day:
-elevated kettlebell deadlift
-cable lat pulldown
-standing landmine press
-step ups
-deadbug
High impact exercise: Given the fact that Hazel is so sedentary and is already toeing the line of an osteoporosis diagnosis, we want to be really carful with how we bridge her into high-impact exercise. We’ll need to consider risk vs reward here. In this case, while we might see better improvements in bone density with higher-impact exercises such as box jumps, we certainly aren’t going to put Hazel at increased risk for fracture or injury. This doesn’t mean that Hazel can’t do any type of high-impact exercise though. We’d likely recommend Hazel start with marching a few minutes a couple times a week.
With all that being said, the amount of exercise and the type of exercise that an individual will be able to tolerate is dependent on several different personal factors that we can’t even begin to factor in here. We would make sure that we continued to re-evaluate Hazel’s recovery and how she was feeling over the course of her program to ensure that she was on the right track.
Now let’s change it up a bit and look at how we’d approach programming for another sample client will a little more exercise experience and capacity:
Person #2: Karen (55, Active, Regular Gym-Goer)
Karen, 55 y/o, has been resistance training on her own at a gym for several years 2-3 times a week. She plays pickleball with her friends once a week and goes for short, 15 minute walks with her dog once a day. She has elbow pain that flares up occasionally, but otherwise doesn’t have any joint issues or orthopedic concerns.
Weight-bearing exercise: Karen is already in the habit of walking everyday with her dog, which is an awesome place to start. However, in order for her to maximally benefit from her walks, we’d recommend she aim for a 30+ minute brisk walk every day. She could also challenge herself on weekends and incorporate a short hike, or a dance class to really maximize her progress.
Resistance training: since Karen already has a pretty extensive history of resistance training, we can expect her to be stronger and able to do more technical lifts than someone her same age who was more novice. She may need help progressing her exercises and challenging herself to accomplish higher weights. Since she’s already working out 2-3 times a week, we’d keep her on that schedule and progress her exercises.
A Day:
-trapbar deadlift
-dumbbell bench press
-3 point row
-split squat
-dumbbell overhead press
B Day:
-barbell back squat
-pushups
-band-assisted pull ups
-kickstand RDL
-incline dumbbell press
High-impact exercise: given Karen’s exercise proficiency and active lifestyle, we’ll have to be less careful when programming high-impact exercise compared to Hazel. We also know that Karen is playing pickleball once a week, so she is able to tolerate low-level high-impact exercise well and recover from it. We’ll need to take her pickleball into consideration when adding high-impact exercise, and try incorporate a second day of high impact exercise a few days after her pickleball day.
We might start her off with TRX squat jumps for 3x8 (24 impacts) and then progress her to 4x7 (28 impacts) and 5x6 (30 impacts). Once she became proficient at those and we had sufficiently increased her volume and intensity, we might move to another more advanced exercise such as the box jump.
Just like it was for Hazel’s case, it would be important for us to continually evaluate how Karen was recovering from the increased exercise volume and intensity.
Now that we’ve taken a look at the sample program for Karen and Hazel, it should be evident that two women with the same goal of increasing bone density may have very different programs to accomplish that. With that being said, if you’re looking to improve your bone density but you’re not quite sure where to start, it can be really helpful to work with a personal trainer who can help you find a good entry point.
A Real Life Success Story: Lisa
We want to take a moment here to highlight a real life example client that has been a part of our NOVA Strong family for several years now. Lisa came to us way back in 2018 with several health goals, one of which being to improve her bone density. She had been getting regular DEXA scans that indicated that she needed to improve her bone density to avoid osteoporosis. We created a resistance training program for her and encouraged her to find ways to incorporate weight-bearing activities into her day-to-day life, and slowly but surely her DEXA scans reflected an increase in bone density. Flash forward to today, Lisa is still training with us twice a week, in addition to her very busy pickle ball schedule. Her bone density has improved to such an extent that she no longer has to go in for DEXA scans so often, and instead just gets a check once a year. We’re happy to be a part of Lisa’s success story, but at the end of the day it was her decision to take her health into her own hands and seek out a professional who could help her achieve her goals. If you’re interested in hearing more about how Lisa turned her life around, you can check out her success story here.
Measuring Your Progress
When setting goals for improving bone density, it’s important to note that improving bone density is a long game. There’s also several factors that impact how quickly and to what extent you should expect to increase your bone density, such as age, genetics, baseline bone density, and adherence to the exercise program. A safe bet is to reassess bone density once a year.
Note here that because improving bone density is a long game, your consistency matters more than your intensity, meaning that you’ll see more improvements if you can make it to the gym twice a week all year than if you go every day for a month and then burn out. Remember that although improvements might seem small, even small increases in bone density play a large role in reducing your risk for fracture.
As we’ve already alluded to, the most definitive way to measure bone density is through DEXA (dual-energy X-ray absorptiometry) scans. However, you can also track your progress by monitoring your strength and muscle gains once beginning a resistance training program. Studies have found a positive association between strength, muscle mass, and bone density, making it safe to assume that when you make a 50 pound jump in your deadlift, you’ve also made a positive improvement in your bone density.
Advice for Taking Action
By the time you’ve made it to the end of this blog, you’ve hopefully concluded that improving your bone density is worth your while regardless of your age or exercise experience.
It’s worth noting that most goals in exercise, including improving bone density, are dose dependent, meaning that if you can only manage to get yourself to do resistance training once a week, and walk twice a week, that’s still better than doing nothing at all. Similarly, if you don’t feel comfortable trying high-impact exercise, you can still benefit from doing resistance training and weight bearing exercise.
With that being said, it’s important that whatever you choose to start with is done consistently. Adherence is 50% of the battle for most people who are new to exercise, so it’s crucial that you plan ahead for how you’re going to stay consistent on days that you don’t feel motivated. This might mean working out with a friend who will keep you accountable, enlisting the help of a trainer who can keep you on schedule, or even just keeping a workout calendar where you can schedule and plan your workouts.
As always, whether you’re local to NOVA or reading this blog from afar, the trainers here at NOVA Strong can guide you and help you accomplish your goals in-person or virtually.
