How to strengthen your bones with exercise

NEW YORK – When Ms Barbara Hannah Grufferman was in her early 50s, a bone density scan showed she was on a path to developing osteoporosis. If she did not change her lifestyle, her bones would become increasingly brittle, putting her at high risk of spine, hip and other life-altering fractures.

Ms Grufferman had always been active, chasing after her two daughters and walking her dog around Manhattan. But she had not done much formal exercise since her 20s, she said.

Once she learnt about her low bone density, she began training to run-walk the New York City Marathon and started doing daily planks and squats. She practised standing on one foot whenever she could, to improve her balance.

Today, more than 15 years later, her bone density has held steady, and she is training for her 18th marathon.

“I’m a walking, talking, breathing example that it’s never too late to take action,” Ms Grufferman, 67, said.

But you do not have to run marathons to protect your bones. Simply adding a few strategic exercises to your routine can support them – now and in the future.

“People think of bone as this static thing,” said Dr Andrea Singer, chief medical officer of the Bone Health & Osteoporosis Foundation. But “it’s a living, dynamic organ that is constantly remodelling”.

As with your muscles, the more you strategically stress your bones with exercise, the stronger they become, she added.

Everyone’s bones weaken with age, but 80 per cent of Americans with osteoporosis are women, and half of women older than 50 will break a bone because of the disease.

Women reach their peak bone density in their early 20s. The biggest decline happens in the five to seven years following menopause, when levels of oestrogen, which help to keep bones robust, plummet.

The earlier in your life you start building bone strength, the better. But it is also never too late, experts said. If you have been diagnosed with low bone density, if you have fractured bones in the past, or if you have osteoporosis, speak to your doctor about the best workout plan before starting anything new.

For cardio, gravity is your friend

While most exercise is good for your bones, workouts that require your body to support its own weight are especially effective for bone strength, experts said.

“Bone is very, very adaptive,” said Ms Rebekah Rotstein, a Pilates instructor and creator of Buff Bones, a fitness programme to help women build bone strength, who has worked with hospitals across the country. “It responds to external forces by getting stronger, and the lack of force will weaken it.”

If you are new to aerobic exercise, getting back into the swing of it – or have been diagnosed with low bone density – start by walking, said Dr Mary O’Connor, emerita professor of orthopaedics at the Mayo Clinic. She is also chief medical officer for the telehealth company Vori Health.

Carrying hand weights can help to strengthen the bones in your upper body as well.

If you work out regularly and have not been diagnosed with low bone density, cardio that puts more force on your body is ideal for preserving or strengthening bone. Running and jumping exercises are good options. Workouts that involve moving in multiple directions – think dance, tennis and pickleball – are even better.

“Surprising your body with new movements, in different directions, has a better, more efficient effect in building bone than doing hours and hours of repetitive activity,” said Dr Kathryn Ackerman, an associate professor of medicine at Harvard Medical School who studies bone health.

Regularity is also key, since bones must be stressed constantly to stay strong. Rather than stacking workouts on the weekends, do roughly 30 minutes of daily weight-bearing cardio to support bone health.

Build muscle to build bone strength

Resistance training strengthens your bones as well as your muscles – which, in turn, strengthen your bones more by putting extra force on them, experts said.

“We used to be really nervous about older women, in particular, and having them do too much” or lift too much, Dr Ackerman said. “We did them a little disservice because they got nervous to move, because they thought they would break.”

As part of her Buff Bones programme, Ms Rotstein recommends squats, hip hinges, lunges, calf raises, planks and push-ups. These exercises strengthen the muscles that are essential for daily activities, including sitting and standing, bending to pick up objects and reaching for items on a shelf.

Consider free weights or machines as well, Dr Ackerman said, but start slow. As you age, these daily activities can lead to fractures if your bones and muscles are not strong yet.

Boost your balance

A well-rounded bone health workout should also include exercises designed to keep you stable on your feet. This can help to prevent falls, which can be particularly devastating to your bones as you age, Dr Ackerman said.

Single-leg balances, weight shifts, Pilates and yoga are all helpful for cultivating balance, experts said. And research suggests taiji may be particularly effective.

If you have weak bones, avoid bending and twisting.

Finally, if you have been diagnosed with osteoporosis, avoid movements that involve bending all the way forward from the waist and quick twists.

“Most hip fractures in older, osteoporotic women – what we would call fragility hip fractures – happen before the fall,” Dr O’Connor said. “So someone stands, they turn, their hip breaks, and they fall.” NYTIMES