This section contains physical activities for increasing bone strength that you can include in your daily life, both inside and outside of the home. They are weight-bearing activities, which means that you are on your legs and your skeleton is supporting the weight of your body. While these exercises are beneficial for your hips and spine, they won’t benefit your wrist bones. Weight-bearing is not the same as weight-training, which is about lifting weights to increase muscle and bone strength.
The exercises here are arranged in order of increasing intensity. If you have not been exercising regularly before now, start by introducing some gentle activities into your life. If you are young, healthy and already lead an active life, the higher-impact exercises will further improve your bone strength.
If you are not in the habit of taking any exercise at all, then a brief daily walk outside the home is a good start. Most people achieve this every day, without thinking of it as exercise at all, but if you are a person who drives everywhere in the car, it is worth adding up how much walking you have done in the last few days.
Women who walk more than 1.5 km a week, have a significantly higher BMD than those who walk less than that. Walking for longer periods makes no further difference to BMD, although it has many other health benefits. Other research has shown that women who habitually walk briskly have better BMD than those who tend to walk at a slower rate. It is better, therefore, to take regular short walks than long ones, and to concentrate on walking faster.
Hiking in the countryside is great exercise and is likely to be good for your BMD and balance. The changing gradients and surfaces give a variety of stimulation for bones. As yet, however, there have been no formal studies on the benefits. .
Go for a brisk walk – at least five minutes long -every day.
Once you are warmed up, introduce some short spurts of a faster pace for a few seconds, reverting to your chosen speed in between. You should be breathing more than normal, but not breathless.
Walking for more than 10 minutes every day does not improve bone health any further, but walk-jog does, so if you can, follow the walk-jog programme instead.
Walking for half an hour once a week is not the same as five minutes daily. Little and often is the way to better bones.
If you have osteoarthritis in your joints or problems with your knees or hips, then stair climbing is not the best exercise for you. Other forms of physical activity such as swimming would be better.
If you live in a house with stairs you will be giving your leg muscles and skeleton a good daily workout without even realising it. Climbing stairs is an easy way to increase your daily activity level, and seems to be associated with good BMD and a low risk of fracture. Whenever possible, take the stairs instead of the escalator in a department store or public building, and instead of the lift in your work place or block of flats. If you live or work in a high-rise block, get out of the lift a storey earlier and walk the rest of the way.
You should aim to climb ten flights of ten stairs per day. If you live in a home with stairs, you will meet this target without even thinking about it. But if you live in a bungalow or flat, then try to take the stairs whenever you are out and about.
Exercise classes that take place in water, such as aquaerobics, use the resistance of the water to develop endurance, muscle strength, flexibility and balance. Any exercise that improves balance is important for reducing the risk of falls; it is especially helpful for people who have suffered a fall already and are fearful of falling again. You can work your body hard in the pool without risk, because you are cushioned by the water.
T’ai Chi Ch’uan
Also known as ‘T’ai Chi’, this ancient practice is an excellent way to develop good balance and strong legs. It also instils a feeling of calmness, peace of mind and stability. It can be practised by people of all ages and is a confidence-booster for those who have suffered a fall.
T’ai Chi originated in China nearly 2000 years BC. It embraces a whole philosophy of life which has its roots in martial arts. It is also a meditative form of weight-bearing exercise which has been adapted to meet the demands and pace of modern life in the West. Balance, power and energy are the fundamental principles behind T’ai Chi.
It takes a long time to learn T’ai Chi properly and you need to join a class to do so. Once learned, however, it can be practised independently.
Do not jog if the ground is icy, nor if the weather is extremely cold or hot.
If you have asthma or are at risk from heart disease or falls, start with a regular walking programme for 12 weeks. Make sure you do not get breathless.
This is brisk walking interspersed with a bit of jogging. Jogging is a much gentler activity than running, with a wide range of energy options. It used to be called ‘Scout’s pace’ and it is a very efficient way of getting somewhere quickly without getting too hot, tired or breathless. Walk-jog can start as a bouncy walk and get more energetic as you improve.
This walk-jog programme has been proven to increase BMD in the spine and hips. It needs to be done three times a week in order to be effective, unless you already do other exercise. It should be done on non-consecutive days. Each session should last for about 20 minutes. It doesn’t matter where you exercise; it could be in the park, while walking to the post box or to work. Wear sensible shoes and comfortable clothes.
If you have arthritis, any leg or back pain, or a diagnosis of osteoporosis, then do not jog. Stick to a daily brisk short walk.
If you experience pain of any sort, slow down or stop.
This is widely practised in gyms, sports clubs and health clubs. In these settings weight-training is done using free weights as in the home exercises and also using special weight-training machines. These machines contain stacks of weights that you raise and lower with your arms or legs using pulleys. Women of all ages do weight-training; you do not have to be strong.
An advantage of using weight-training machines in a gym environment is that there are different machines that allow you to exercise all the major muscle groups in the body. The machines are safe because your back is supported, the start position can be adjusted to suit you and the weights are within a cage so they cannot do any damage if you let them go.
Weight-training is often confused with weight-lifting which is a competitive sport in which very heavy weights are lifted, and bulging muscles are developed. It has nothing to do with the particular kind of training recommended here; muscles can get much stronger without becoming bulky.
Weight-training can be practised using small weights and many lifts; this is good for endurance but it does not improve BMD. To improve BMD you need to lift heavier weights quite slowly, a few times. It is important to work up to the heavier weights over several months so you do not injure yourself. Injuries, if they occur, are usually the result of too much, too soon or poor technique.
If you have never done any weight-training, seek advice from a qualified instructor about technique and about how the machines work. Most gyms have free introductory sessions, so you can look until you find a gym that suits you. For improvements, train three times a week.
Every woman is different, so it is important that you use a weight that is right for you. Follow the 1RM rule. If in doubt about the most suitable weight to use, seek advice from a qualified instructor.
When you have practiced correct lifting using a weight-training machine at least three times a week for one month, measure your ‘one repetition maximum’. Lift a succession of weights once each, resting in between lifts. Increase the weight until you can no longer lift it once with acceptable form. This means smoothty and steadily through the movement, without any wobbles. The heaviest weight you can lift once is your IRM. To train effectively for improving BMD, choose weights which are at least 70 per cent of your IRM and do up to eight repetitions. If you can do more, then you need to use a heavier weight. As }^ou improve and can complete eight repetitions easily, use a heavier weight. You should feel that the last lift of the last set is as much as you can manage.
It is essential to start with light weights that you can lift easily until you have mastered the technique.
Make sure that your position is comfortable. Your back should be supported and your posture should be correct throughout.
Lift and lower the weight slowly. Count to three as you lift, and to three as you lower. Rest briefly before the next lift.
Breathe evenly throughout while counting out loud. You should not get breathless at any time.
Aim for eight lifts, resting for a second between each. r Aim to repeat your set of eight lifts twice more, resting for a minute between each set.
Remember to warm up first and stretch afterwards.
The exercises here improve your BMD because of the impacts involved when your feet hit the ground but they cany a far higher risk of injury than the exercises contained in the main programme. Provided they are not practised to excess, they are recommended for healthy, premenopausal women.
Jumping is an energetic form of exercise, but it only takes a few minutes and you do not have to do many jumps to benefit your bones. It improves BMD in the hips in premenopausal women, but unfortunately has no effect in postmenopausal women, even if they are taking HRT. Jumping also increases the power in your thighs and calves and improves your balance.
Jumping is not recommended for women who have poor balance, a history of falls or osteoarthritis in the back, legs or hips, or a history of joint pain.
You will need to wear supportive shoes with cushioned, flexible shoes to avoid joint injury. You will get warm, so wear comfortable, cotton clothes and drink water before and afterwards.
Warm up. It is very important that you feel warm, loose and relaxed before you start this exercise.
If you prefer, try skipping. This activity is also good for shoulder flexibility and balance. 1
Find a well-ventilated space with a firm floor. Stand tall with your feet a hip-width apart. Adjust your pelvic tilt and let your ankles, knees, and hips give slightly. Bend your knees and swing your arms back to start.
Swing your arms forward, and jump into the air with both feet. Aim to jump about 8 cm high – no more. The jump should be done in one smooth, quick movement.
Bend your knees as you land. Repeat according to the programme opposite.
Day 1 Start with a few experimental jumps
Day 2 5 jumps
Day 3 10 jumps
Day 4 20 jumps
Day 5 30 jumps
Day 6 50 jumps
Day 7 Rest
NOTE: When doing 20 or more jumps, rest between each block of 10 by doing gentle stepping movements.
Check your local community for exercise to music classes. They come in many forms and contain a variety of exercises. This variety is useful for bones as it loads the skeleton in lots of different ways. Aerobics classes and circuit-training include weight-bearing exercises and the best of these include both high- and low-impact work.
It is important to go to the class regularly, three times a week, unless you plan to include other forms of bone-loading activities in your weekly routine.
High-impact exercises carry a relatively high risk of injury. They are recommended only for premenopausal women.
Since jumping and jogging are both good bone-loaders, it is likely that any dance that involves ground impact will have the same effect. Tap, Scottish and Irish dancing should all be effective.
Gentler forms of dance such as line dancing or ballroom dancing are very good for maintaining or improving balance, but they are unlikely to stimulate your bones.
Any sport that involves impact is likely to benefit your bones. Racquet sports such as tennis or squash should be effective, as will any sport that involves running and jumping, such as basketball.
Swimming and cycling, although very good for your health in other ways, are not effective for improving BMD.
There is good evidence from studies in the USA that running stimulates BMD at both the spine and the hip in young women aged 20 years.
The usual recommendation is to run for 20-30 minutes, three times a week. This works well for reducing the risk of coronary heart disease and related problems. But there is evidence that shorter periods of running might do your skeleton just as much good.
In 20 minutes of running or jogging, your leading foot hits the ground at least 2000 times. However, fewer impacts are known to be effective for bone, so you may prefer to opt for intermittent jogging instead.
Asphalt or grass are better running surfaces for your joints than tarmac. Wear light-coloured clothes if you go running in traffic, for safety.
Jogging or running for long periods on hard surfaces increases the risk of osteoarthritis and should be avoided if you are vulnerable to this disease.
You will need to wear supportive shoes with cushioned, flexible shoes to avoid joint injury. You will get warm, so wear comfortable, cotton clothes, and drink water before and afterwards.