The bone building workout

July 17th, 2008  |  Published in Uncategorized  |  8 Comments

As the population ages, osteoporosis, or brittle bone disease, is a growing concern. Though osteoporosis is not just a condition that affects older women, they are one of the groups most at risk for it. Predisposing factors for osteoporosis, and the related condition of osteopenia (essentially a lesser degree of osteoporosis) include:

  • genetics: if mom has osteoporosis, you are also at risk
  • age: risk increases with age
  • menopausal status: menopause initiates changes in hormone levels which eventually can decrease bone density (by the way, improving bone density post-menopause is one useful application of testosterone supplementation)
  • smoking: you all know you shouldn’t smoke, so I don’t have to tell you
  • history of drastic dieting: this takes its toll on your bones
  • high caffeine intake
  • corticosteroid use (e.g. Prednisone)
  • thyroid disorders
  • body composition: if you are too thin, especially if you have been amenorrheic (your periods have stopped) for lengths of time, this increases your risk

Osteoporosis and osteopenia are distinguished by the degree of bone density present. Healthy bone looks like havarti cheese: mostly solid with a few little pores here and there. Bone that has lost its density resembles Swiss cheese that’s been left in the sun: giant holes predominate and it seems that only a few strands of solid matter are holding it all together.

A close-up of a healthy bone’s structure. It’s porous but strong.

A close-up of a bone decayed by osteoporosis. Note that the structure is composed of only a few strands.

We tend to think of bone as inert, sort of like a Tinkertoy construction that holds our bodies together. In fact, bone is a responsive tissue that reacts constantly to the demands imposed on it. It is always breaking down and remodelling itself. Astronauts exposed to zero-G rapidly lose muscle tone and bone density, while weight training improves bone density. Much of the bone loss associated with “normal” aging is simply a result of poor nutrition, inappropriate lifestyle choices, and lack of proper activity.

A fitness/diet strategy aimed at bone density health and osteoporosis must incorporate the following things:

  • Weight bearing exercise (to improve functional strength and bone density)
  • Balance and stability training (to prevent falls)
  • Adequate vitamins and minerals, particularly calcium, but also magnesium and vitamin D (to provide the building materials for bone, and to help calcium be absorbed)
  • A diet that is not hypocaloric (taking in fewer calories than the body needs) for long periods of time, and a bodyweight that is healthy, not underweight

The rest of this article will deal with the first and second components, and discuss how to put together a fitness program that will give you bones of titanium!

weight bearing exercise

Well, duh, we should know by now that that’s weight training. But what kind of weight training is best? Ideally, your workout should include movements that load the bone along its length. That means a squat is better than a leg extension, for example. The weight in a squat is transmitted down along the spine, through the hip, and down along the bones of the leg. The weight in a leg extension is transmitted across the shinbone, and mostly just puts pressure on the knee joint. Most types of presses, such as bench presses, pushups, and overhead presses, are another good choice for bone loading.

A second type of weight bearing exercise is impact exercise. This can be walking, running, jumping, skipping rope, hitting a heavy bag, or any other type of plyometric exercise like clapping pushups. This is also good to incorporate into a workout.

One study found that even a single bout of high-impact exercise can increase bone turnover. Study participants jumped up and down until they were exhausted. Afterwards, markers of bone formation (procollagen type I amino terminal propeptide [P1NP] and bone resorption (carboxyterminal crosslinked telopeptide [CTx]) were both elevated, signifying that the body was busily fixing the damage and rebuilding the bones to be stronger.

Rantalainen, Timo, et al. Short-term bone biochemical response to a single bout of high-impact exercise. Journal of Sports Science and Medicine (2009) 8, 553 – 559.

While other forms of exercise like swimming, yoga, and tai chi are also good for you in general, fun to do, and can help train balance (see below), they don’t provide the same kind of loading that weight training and impact activities do. Indeed, a recent study found that cyclists had surprisingly reduced bone density despite plenty of exercise, because cycling doesn’t really load the bones along their length — the combo of training plus lack of bone loading led to significant problems. So, feel free to do these types of activities, but just make sure to do the bone-loading stuff at least twice a week.

what’s right for me?

Your existing level of fitness and bone density will determine your exercise choice. If you’re a bit older, a bit less fit, and/or already showing signs of degeneration, don’t start right off with two-metre plyometric depth jumps or pounding a cement wall. Start with lighter versions of the recommended types of exercises. Avoid excessive rounding of the spine, especially under load.

Level 3 would be done by someone who is already fit, and interested in prevention. You may find that you can’t progress past Level 1, or Level 2, but that’s okay. The main thing is that you do at least something. I’ve suggested some ideas below. These aren’t the only exercises you should do, of course, but you should include at least a few of them.

There are many ways to integrate these into a workout. You can do a conditioning-type workout where you do them all at once, in a circuit (e.g. jump rope 1 min, 10 pushups, jump rope 1 min, 10 squat jumps, jump rope 1 min, 10 walking lunges, repeat). Or you can just make sure to put one or more movements into your workouts, 2-4 times weekly.

Level 1

Level 2

Level 3

  • Unweighted squatting
  • Unweighted step-ups on to a low step
  • Unweighted walking lunges
  • Squatting with a hip belt from Ironmind
  • Squat jumps
  • Squatting with a bar on your back
  • Plank or modified plank
  • Counter pushups
  • Light overhead press and/or bench press
  • Pushups
  • Moderate overhead press and/or bench press
  • Clapping pushups
  • Heavy overhead press and/or bench press, other presses, jerks
  • Hitting a heavy bag at low to moderate intensity, wearing padded boxing gloves
  • Hitting a heavy bag with open palm style, or wearing less padded bag gloves or hand wraps only, or hitting with all the power you can muster
  • Sledgehammer GPP: swinging a sledgehammer into a mat, sandbox, rubber tire, or some other shock absorbing material
  • Walking
  • Brisk walking
  • Running
  • Short sets of low jumps
  • Jumping rope, intervals of up to 1 min
  • Squat jumps with rebound
  • Jumping rope, intervals up to 2 min, jumping in patterns, jumping on one leg
  • Depth jump from a box with rebound

balance training

As we age, if we do not train it, we lose our balance. Falls are one of the chief dangers for people with osteoporosis, and loss of bone density combined with loss of balance presents a very risky situation. However, balance, like other physical qualities, can be trained. Regular free weight exercises such as squats, deadlifts, Olympic lifts and their variations, and performing exercises standing (e.g. standing press) are all a big help. But there are lots of other ways to train for balance. One of the best ways I know is martial arts. If you are a Level 1 – Level 2 person, something like tai chi, yoga, or even dancing might be better. Below I’ve listed some ideas for training your balance, again sorted into levels of difficulty.

There are exercises here called “perturbation stimulus”. This means putting yourself into a position which is a bit unbalanced, then having someone else supply further instability by pushing you. You are then forced to respond. Make sure your partner is gentle initially and doesn’t shove you. Gentle pushing and pulling will be fine. All you need the partner to do is unbalance you enough so that you have to respond.

Level 1

Level 2

Level 3

  • Walking along an imaginary straight line
  • Walking lunges
  • Walking a path with obstacles in it
  • Overhead squat
  • Single-leg squat with one leg held straight out in front
  • Standing with eyes closed
  • Mountain pose
  • Powerful pose
  • Standing on one leg
  • Warrior pose 1 and Warrior pose 2
  • Standing on one leg with eyes closed
  • Tree pose
  • Half moon pose
  • Perturbation stimulus administered to person sitting on swiss ball
  • Perturbation stimulus administered to person standing with eyes closed
  • Perturbation stimulus administered to person standing with light barbell held overhead

Responses

  1. Marcia says:

    March 16th, 2009at 11:58 am(#)

    Hey Krista,

    Could you provide more specifics regarding “perturbation stimulus”? For example, I am holding a light barbell overhead, and what, my partner pokes me in the ribs?

    Cheers,
    Marcia

  2. Mistress Krista says:

    March 17th, 2009at 4:46 am(#)

    Yes, somehow you need a stimulus that puts you off balance a bit, so that you have to correct. This could be a very light push or something even stronger (within safe limits of course).

  3. bob says:

    October 21st, 2009at 6:36 pm(#)

    Please dont get someone to poke you in your ribs while holding a barbell over your head. thats just not smart duhh

  4. Mistress Krista says:

    October 22nd, 2009at 3:25 am(#)

    Don’t walk down stairs on your hands. That’s just dumb. Oh wait, no, I meant fun.

    “Perturbation stimulus” is not done with 200 lbs. It’s done with something like a medicine ball or a light barbell.

  5. Sarah says:

    February 9th, 2011at 8:43 am(#)

    Hi, Krista,

    At 33 years old, an orthopedic surgeon told me that my hip is showing signs of degenerative osteoarthritis and to stop the squats, because the heavy weight will accelerate the degeneration. I loved doing squats so this was disappointing. I can’t for the life of me figure out what to do for leg exercise now, everything I did used heavy weight, I thought I was doing myself a favor!
    He told me to get on the stationary bike and the Stairmaster, which I have, but still feel like while I might be preventing my hip joint from dissolving away (which has happened to my father), I’m not fending off osteoporosis, which I am at high risk for. Any suggestions for low-weight bearing lower body exercise that will help my legs from becoming brittle while my hip stays happy? I am having a tough time finding help.

    Thanks!
    Sarah

  6. Mistress Krista says:

    February 21st, 2011at 12:55 pm(#)

    @Sarah: It’s not all-or-nothing. You can still move the joint, you just have to load it less. In fact, arguably keeping it moving will keep it from locking up and ossifying. What about lightly loaded squats and DLs? Sumo DLs in particular will keep the hip mobile and open. Try a 20- or even 50-rep sumo DL set — gets a good schvitz going while keeping the loading relatively lower.

    You can also jump rope (or jump in general), run, water jog, etc. You can use other forms of bopping and running besides the standard jogging, e.g. lateral shuffles, skips, side-to-side hops, etc.

  7. Heber says:

    March 30th, 2011at 4:48 pm(#)

    What about using a rebounder or trampoline for balance training? They can be fun and quite an aerobic workout too.

  8. Banksy says:

    April 10th, 2011at 6:16 am(#)

    Bone health is something i just don’t take into account when i’m training so this was a great read for me.


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