Following a diagnosis of low bone density, it’s common to feel unsure about how much exercise or what type of exercise is safe. Some people cut back their activity or avoid strength training altogether out of concern. However, research shows that the right kind of exercise is not only safe but it’s essential for maintaining and improving bone health. Rather than avoiding load, the key is to apply it in a safe and gradual manner.

How Exercise Influences Bone

Bone responds to the load placed through it and follows the “use it or lose it” principle. When you do activities that place enough stress on your bones such as strength training or impact-based exercise, it sends a signal to your body that the bone needs to be stronger. This stimulates bone-forming cells to become more active. As a result, bones gradually become stronger and better able to handle load.

It’s important to note that not all exercise provides the same level of stimulus. Low-impact activities such as walking, cycling or swimming are excellent for cardiovascular fitness and general health but generally do not place enough load on the bones to significantly improve bone strength.

This doesn’t mean these activities should be avoided but they are best combined with other forms of exercise that specifically target bone health.

Why Strength Training Is Effective

Strength training is one of the most effective ways to improve bone health. When muscles contract against resistance, they pull on the bones. This mechanical stress stimulates bone formation and encourages the body to maintain or increase bone density.

Additional benefits include increased muscle mass and reduced risk of falls and fractures. Strength training also supports functional movements. This means everyday tasks like lifting, carrying, climbing stairs and getting up from a chair become easier and more efficient.

What does the research say?

Research continues to support the role of strength training in improving bone health. One well-known study (The LIFTMOR trial) investigated high intensity resistance training in post-menopausal women with low bone density.

The participants completed a supervised program (2 x/week over months) which included:
• Deadlifts
• Squats
• Overhead press
• Impact based movements

The results showed:
• Improvements in bone density at the spine and hip
• Increased muscle strength
• Safe outcomes when exercises were performed with proper technique and supervision

These findings challenged the previous belief that people with osteoporosis should avoid heavy lifting. Instead, they highlight that appropriately prescribed, progressive strength training is both safe and beneficial.

How to approach exercise safely?

To get the most benefit from strength training while reducing risk, it’s important to approach exercise in a structured and progressive way.

A few key principles can help guide your training:

• Start gradually: if you are new to strength training, begin with lighter loads and focus on learning proper technique
• Use resistance: use a weight that fatigues and challenges you within about 8-12 repetitions.
• Progress over time: bones adapt to increasing levels of load, so gradual progression is important
• Allow recovery: give your body time to recover between sessions to allow the bones to adapt
• Be consistent: regular training over time is key to achieving long-term benefits

Moving forward

There’s no single exercise or quick fix when it comes to bone health, it’s about consistency with the right type of training.

If you would like support putting this into practice, at JBS Physio, we offer Bone Strong classes that focus on progressive, evidence-based training in a supervised environment. Feel free to get in touch to learn more.