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BONE HEALTH & STRENGTH
Osteoporosis: Why Strength Training Is One of the Best Investments You Can Make in Your Bone Health
When we think about staying healthy as we age, we often focus on our heart, muscles or joints. But our bones deserve just as much attention.
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When we think about staying healthy as we age, we often focus on our heart, muscles or joints. But our bones deserve just as much attention.
Osteoporosis is often called the “silent disease” because it can develop gradually without causing symptoms until a fracture occurs. The good news is that there is a lot you can do to improve your bone health. Alongside good nutrition, strength training and impact exercise are some of the most effective ways to maintain bone density and reduce your risk of fractures into older age.
What is Osteoporosis?
Bone is living tissue that is constantly being broken down and rebuilt. Throughout childhood and early adulthood, we build more bone than we lose. Peak bone mass is usually reached by around 30 years of age. After this, bone naturally begins to break down faster than it is replaced, even more so if we are not actively trying to preserve it through our lifestyle habits.
Osteoporosis occurs when this loss of bone becomes significant enough that the bones become weaker, less dense and more fragile. They can become intolerant of the same loading you’ve done for many years and this increases the risk of fractures, particularly in the hip, spine and wrist, even after relatively minor falls or everyday activities.
Many people don’t realise they have osteoporosis until they experience their first fracture, which is why early identification and prevention are so important.
Who is at risk?
While osteoporosis is more common in older adults, it is not simply a normal part of aging, and at PEAK we are trying our best to break down this belief!
Several factors can increase your risk, including:
- Being female, particularly after menopause due to reduced oestrogen levels
- Increasing age
- A family history of osteoporosis or hip fractures
- Previous low-trauma fractures
- Low body weight
- Smoking and excessive alcohol consumption
- Low calcium or vitamin D intake
- Physical inactivity
- Long-term use of corticosteroid medications
- Certain medical conditions, including rheumatoid arthritis, coeliac disease, hyperthyroidism and some hormonal conditions.
Although some of these risk factors cannot be changed, many lifestyle factors are modifiable and can make a significant difference to your long-term bone health.
Osteoporosis and Sarcopenia
Your muscles matter too!
As we age we don’t just lose bone, we also gradually lose muscle mass and strength, even more so if we are not actively trying to keep it through strength training. This age-related loss of muscle is known as sarcopenia.
Osteoporosis
Affects your bones
Osteoporosis causes bones to become weaker and more fragile, increasing the risk of fractures. Staying active and maintaining muscle strength can play an important role in supporting bone health and reducing falls risk.
Sarcopenia
Affects your muscles.
Sarcopenia is the age-related loss of muscle mass, strength and function. It can make everyday activities harder and increase the risk of falls, but regular physical activity—particularly strength training—can help maintain muscle strength and function as we age.
Strong bones and strong muscles work together to support balance, mobility and everyday movement. Maintaining strength and staying active can help reduce the risk of falls and support a healthier, more independent life as we age.
Strong muscles play a vital role in supporting our bones, improving balance, generating power and helping us react quickly if we trip or lose our balance. When muscle strength declines, the risk of falls increases, which in turn increases the risk of fractures in people with osteoporosis.
It’s common for osteoporosis and sarcopenia to occur together. This combination significantly increases the risk of falls, fractures and loss of independence. Fortunately, progressive resistance training is one of the most effective treatments for both conditions, making it an incredibly powerful investment in your long-term health.
How is Osteoporosis diagnosed?
Osteoporosis is typically diagnosed using a bone mineral density scan, known as a DEXA (Dual-Energy X-ray Absorptiometry) scan. This quick, painless scan measures bone density and helps estimate your future fracture risk.
Your doctor may recommend a DEXA scan if you have multiple risk factors, have experienced a low-impact fracture or are over the recommended screening age. At PEAK, we recommend any women over 50 years of age or who believe they may be experiencing perimenopause to have a bone density scan done!
How is osteoporosis treated?
Treatment is usually tailored to the individual and may include a combination of:
- Progressive exercise
- Adequate calcium and vitamin D intake
- Medications that slow bone loss or stimulate new bone formation
- Falls prevention strategies
- Lifestyle modifications such as smoking cessation and reducing excessive alcohol intake.
While medications play an important role for many people, exercise remains one of the few treatments that improves not only bone health but also muscle strength, balance, mobility, confidence and overall quality of life. If you have been diagnosed with Osteoporosis and don’t know how to get started with loading your bones safely, feel free to book an appointment with one of our friendly Physiotherapists who can guide you through this process!
Why strength training and impact exercise matter!
Bones respond best to gradual increase in load over time. Just like muscles become stronger when challenged, bones also adapt when exposed to appropriate mechanical stress. When muscles pull on bones during resistance exercise, this stimulates specialised bone cells to build stronger bone tissue.
However, bones also benefit from impact loading. Activities that involve your feet leaving the ground and landing again such as jumping, hopping, skipping or bounding, these create short bursts of force that stimulate bone growth. This is known as osteogenic loading, meaning exercise that encourages bones to become stronger.
Research consistently shows that combining progressive resistance training with appropriately prescribed impact exercise is one of the most effective non-drug strategies for maintaining or improving bone mineral density, particularly around the hips and spine where osteoporotic fractures are most common. Exercise also improves muscle strength, balance, coordination and reaction time, reducing the likelihood of falls, which is the leading cause of fractures in older adults.
Importantly, everyday activities such as walking are excellent for cardiovascular health but generally do not provide enough mechanical load on their own to significantly improve bone density. To build stronger bones, the skeleton needs to be challenged with heavier resistance and, where appropriate, controlled impact loading. If the gym makes you nervous or you are new to weight training, you would be a perfect fit for our exercise led prevention classes! These classes are designed to be small classes for close guidance from your Physiotherapist, following individualised programs and based in a social group setting for fun and accountability!
What does the research recommend?
Current clinical practice guidelines and recent research recommend a combination of progressive resistance training, weight-bearing impact exercise and balance training for improving bone health and reducing fracture risk.
For most people, this includes:
- Resistance training 2–3 times per week, targeting all major muscle groups.
- Exercising at a moderate to vigorous intensity, with resistance progressively increased over time.
- Performing 5–10 resistance exercises for the major muscle groups, completing 5–12 repetitions using loads of approximately 50–85% of your one repetition maximum (1RM).
- Weight-bearing impact activities on most days where appropriate. This may include jumping, hopping, skipping, bounding, stair climbing or low-level jumping exercises depending on your age, fitness level and bone health.
- Balance exercises performed regularly to reduce the risk of falls
The goal isn’t simply to exercise more, it’s to provide enough stimulus for your bones to adapt and become stronger. It’s important to note that higher-impact exercises such as jumping are not appropriate for everyone. People with severe osteoporosis, previous vertebral fractures or certain medical conditions may require modified impact activities or may initially focus on resistance training and balance exercises under the guidance of a Physiotherapist. An individualised program ensures the exercises are both safe and effective while still providing enough stimulus to promote bone health.
It's never too late to start!
One of the biggest misconceptions is that if you’ve already been diagnosed with osteoporosis, there’s nothing you can do. In reality, research shows that people with osteoporosis can still improve their strength, maintain or increase bone density and significantly reduce their risk of future fractures through appropriately prescribed exercise. Combined with medical management where indicated, exercise is one of the most powerful tools available to help maintain independence, confidence and quality of life.
Whether you’re in your 30s looking to build strong bones for the future, navigating menopause, or wanting to stay active later in life, it’s never too early (or too late) to invest in your bone health.
How a physiotherapist can help
Starting an exercise program can feel overwhelming, particularly if you’ve recently been diagnosed with osteoporosis or have concerns about fractures. A physiotherapist can assess your strength, balance, mobility and fracture risk before developing an individualised program that matches your goals and level of bone health. This ensures you are performing the right exercises with good technique while progressively increasing the load safely over time.
Build Stronger Bones
At PEAK Sports & Spine Centre, we believe movement is medicine. Whether your goal is preventing osteoporosis, improving your bone health after a diagnosis or maintaining your independence as you age, a tailored strength and impact-loading program can help you continue doing the things you love with confidence.
Invest in Your Bone Health Today