| Article written on March 24th, 2020 at 12:35pm | Follow Garrett on Facebook and Instagram |
Preserving optimal levels of bone mass is important as we age. Did you know that approximately 52% of American adults over the age of 50 have low bone mass at the femoral neck or lumbar spine?
Part of the difficulty lies in the fact that the majority of peak bone mass is accrued before 18 years of age in females and 20 years of age in males. Therefore, if we don’t take the necessary steps early in life to be active and/or follow a proper nutrition plan, we could potentially set ourselves up for bone related issues later in life.
According to the National Osteoporosis Foundation, approximately 10 million American adults, 8 million of which are women, have osteoporosis. Another 35 million have insufficient bone mass or osteopenia. Adults who do not incorporate regular strength training may experience a 1% to 3% decline in bone mineral density every year. Research studies show that significant increases in bone mineral density can be achieved after 4 to 24 months of resistance training. However, termination of strength training is likely to lead to a reversal in gains.
Need help improving bone mass or recovering from a bone stress injury? Click here to speak with Garrett about individualized strategies that can help you.
Over the years, I have worked with countless people who suffer from osteopenia, osteoporosis, and bone stress injury. Despite being caused by very different factors, all of these can and should be addressed with a structured and progressive strength training program. Strength training and proper loading have been shown to maintain/stimulate bone growth and prevent future decline in bone mineral density. Along with other nutritional and lifestyle factors, a daily dose of exercise can be a worthwhile strategy in promoting overall bone health.
Before we go on, let’s define the terms osteoporosis, osteopenia, and bone stress injury so we are all crystal clear on what this article is describing…
Osteopenia is a mild thinning of the bone mass where formation of new bone is not sufficient to offset normal bone loss. Not as severe as osteoporosis.
Osteoporosis literally means porous bone and is a disease in which density and quality of bones are reduced. Osteoporosis carries a greater risk of fracture.
Bone Stress Injury refers to a phenomenon in which bones cannot tolerate repeated mechanical loads, resulting in structural fatigue, local bone pain, and tenderness.
Since I work predominantly with runners in the Healthy Running Program, I’d like to use this article to speak directly to those who have a bone related disorder, previous history of a bone stress injury, or a combination of both. With the repetitive, sub-maximal nature of running, bone stress injuries are not uncommon and have been shown to comprise approximately 30% of all running-related injuries. This means a proactive approach and understanding of one’s medical history are important to reduce the likelihood of enduring a bone stress injury with the demands of running.
Like I mentioned previously, strength training and progressive loading are proven strategies to prevent the decline of bone mineral density, increase overall bone mass, and rehabilitate from a bone stress injury. Doing so under the supervision of a trained healthcare professional is important. That’s because these programs should be individualized to your needs and progressed at a proper rate over time.
Research shows that a minimum of 6-8 months are needed to see measurable results in bone mass. This is largely in part to one remodeling cycle of bone resorption, formation, and mineralization which takes 3-4 months to complete. Therefore, depending on your need to improve bone health, patience and consistency are necessary factors for success.
Strength training and weight-bearing activities specifically have been shown to provide beneficial effects on bone health. Not only does it increase or prevent the decline of bone mineral density as we age, but it also improves strength, balance, and coordination to reduce to the risk of falls which may contribute to fracture.
In order to achieve maximum benefits with strength training, the program must…
- Include dynamic movements over static
- Achieve adequate strain intensity
- Consist of discrete and intermittent bouts
- Include variable loading patterns
- Be supported by optimal nutrition
- Emphasize adequate intake of calcium and vitamin D
Since strength training is such a vast and complex topic, let’s get more specific and explore two of the most impactful exercises when addressing bone health. These exercises include the squat and deadlift.
The squat and deadlift are staples within the strength training world and for good reason. That’s because they create an axial/compressive load on the musculoskeletal system, can be loaded quite easily with a dumbbell, kettlebell, and/or barbell, and have numerous variations to stress the body in a variety of ways. Like I mentioned above with the requirements to achieve maximum benefit, the squat and deadlift check all of the boxes.
Of course, when suffering from injury or bone related disorder, form and technique become a priority to stimulate the bone in the correct way without creating injury. In the following videos, let’s cover a basic squat and deadlift progression so you understand proper form and how to progress these movements over time to see the best results possible.
Progression #1: Squat
The squat is a foundational knee dominant movement that you’ll commonly see in the gym and also throughout your daily routine. Whether you are lifting weights or getting up and down from a chair, this movement is essential and can be used as an exercise to improve bone density. When using the squat to improve bone mineral density, form and patience should take precedence over load. Once you are proficient with performing the exercise properly, increasing load by adding resistance or progressing to a harder variation will be important and necessary to stress the body enough for a positive change in bone density. This video demonstration will walk you through (3) different variations of the squat to see the best results.
Begin with 2-3 sets of 8-12 repetitions and progress to 4-8 repetitions over time with a heavier resistance. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.
Progression #2: Deadlift
The deadlift is a foundational hip dominant movement that you’ll commonly see in the gym and also throughout your daily routine. Whether you are lifting weights or picking up a box from a floor, this movement is essential and can be used as an exercise to improve bone density. When using the deadlift to improve bone mineral density, form and patience should take precedence over load. Once you are proficient with performing the exercise properly, increasing load by adding resistance or progressing to a harder variation will be important and necessary to stress the body enough for a positive change in bone density. This video demonstration will walk you through (3) different variations of the deadlift to see the best results.
Begin with 2-3 sets of 8-12 repetitions and progress to 4-8 repetitions over time with a heavier resistance. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.
Thank you for taking the time to read this article on ‘How to Utilize Strength Training to Improve Bone Health.’ The key thing to remember is that regardless of your situation there are a multitude of factors that go into improving bone health. In terms of exercise, weight-bearing activities and the strength training exercises shared in this article can be helpful in the rehabilitation and prevention of a bone related disorder and/or bone stress injury. However, your best defense is creating good exercise, nutritional, and lifestyle habits early in life to lay a solid foundation of bone mass for later on in adulthood.
If you or someone you know is struggling with a bone related disorder or bone stress injury, click here to schedule your free consultation. Garrett is an athletic trainer and functional movement expert that can you help you implement an individualized program to improve bone health and reduce your risk of bone stress injury.
By: Garrett McLaughlin, MS, ATC, CSCS, ART
Sources:
- Bone Stress Injuries by Kiuru et al.
- Bone Stress Injuries in Runners: a Review for Raising Interest in Stress Fractures in Korea by Song et al
- Bone Health In Athletes: The Role of Exercise, Nutrition, & Hormones by Goolsby et al
- Resistance Training is Medicine: Effects of Strength Training on Health by Westcott et al
- Physical Activity and Bone Health by Kohrt et al
- Muscle Strength, Bone Mass, and Age-Related Bone Mass by Burr et al
