Exercise and Bone Health: Strong bones are built with movement—exercise now to stand tall for life
Many people think of bones as static and unchanging, but bones are actually dynamic, living tissues. They constantly undergo a process called remodeling, where old bone tissue is broken down (resorption) and new bone is built (formation). This process is especially rapid during childhood and adolescence, slows in adulthood, and becomes imbalanced with aging—leading to bone loss.
Peak bone mass—maximum bone strength and density—is typically reached by the late 20s. After this peak, the goal shifts from building to maintaining bone mass. Physical activity plays a crucial role in both stages.
How Exercise Strengthens Bones
Bones respond to physical stress by becoming stronger. When you exercise, your muscles pull on bones, and the impact of movement stimulates osteoblasts—cells responsible for forming new bone. This response is known as mechanical loading.
The more stress you place on your bones (within healthy limits), the more they adapt by increasing in density and strength. This is why astronauts, who experience weightlessness in space, often suffer bone loss due to the absence of mechanical load.
Here’s how exercise helps bone health:
Increases bone density: Particularly during adolescence and early adulthood, weight-bearing activity can maximize peak bone mass.
Reduces bone loss: In older adults, regular exercise helps slow the natural process of bone loss.
Improves balance and coordination: Reducing the risk of falls and fractures, especially in the elderly.
Enhances muscle strength: Stronger muscles support joints and bones, improving posture and movement efficiency.
Types of Exercise for Bone Health
Not all exercises are equally beneficial for bone health. The most effective exercises are those that apply force to the bone through weight-bearing and resistance activities.
- Weight-Bearing Exercises
These are activities that make you work against gravity while staying upright. They include:
High-impact activities: Jumping rope, Running, Hiking, Dancing, Tennis
Low-impact alternatives (for people with joint issues or older adults): Brisk walking, Low-impact aerobics, Stair climbing
High-impact exercises are more effective for bone growth, particularly in the hips, spine, and legs. However, low-impact options still offer benefits and are safer for individuals with osteoporosis or arthritis.
- Resistance Training (Strength Training)
Lifting weights or using resistance bands improves muscle mass and also stimulates bone growth, especially in areas like the arms, shoulders, and spine.
Examples:
Free weights
Weight machines
Resistance bands
Bodyweight exercises (push-ups, squats, lunges)
Engaging in resistance training 2–3 times per week can maintain or even increase bone density in adults and seniors.
- Balance and Flexibility Exercises
These may not directly increase bone density but are critical for fall prevention, especially in older adults. Improving balance helps reduce the likelihood of fractures caused by falls, which are a major health risk in people with fragile bones.
Age and Bone Health
Children and Adolescents
The earlier you start exercising, the better. Childhood and adolescence are the most critical times for bone development. Activities like jumping, running, and team sports during these years can lead to a higher peak bone mass.
Adults (20s–50s)
After reaching peak bone mass, the goal is to maintain it. Adults benefit from combining cardio, resistance training, and flexibility exercises to support bone strength and overall health.
Older Adults and Seniors
As bone density naturally declines with age, older adults should focus on maintaining bone mass, preventing falls, and preserving mobility. Low-impact weight-bearing exercises, strength training, and balance activities are essential.
For those with osteoporosis, high-impact or high-resistance activities may not be safe. Always consult a healthcare provider or physical therapist for tailored guidance.
Exercise and Osteoporosis
Osteoporosis is a condition where bones become brittle and porous, increasing the risk of fractures. While exercise cannot reverse osteoporosis, it can help manage and slow its progression. Key benefits include:
Improved balance and coordination to prevent falls
Enhanced muscle strength for better posture and stability
Slowed bone loss, especially in weight-bearing areas
Exercises should be low-impact, with an emphasis on:
Weight-bearing aerobic activity
Resistance training using light weights
Flexibility and balance exercises
It’s important to avoid high-impact or jarring activities that can cause fractures in people with advanced osteoporosis.
Nutrition
Exercise and nutrition go hand in hand. Without the proper building blocks, physical activity alone cannot optimize bone strength.
Key nutrients:
Calcium: Essential for bone formation. Found in dairy, leafy greens, almonds, tofu, and fortified foods.
Vitamin D: Helps the body absorb calcium. Obtained from sunlight, fatty fish, fortified foods, or supplements.
Protein: Supports muscle and bone repair.
Magnesium, phosphorus, vitamin K: Also contribute to bone health.
Hydration is also important, especially during exercise, as it maintains joint function and nutrient transport.
Tips for Safe and Effective Bone-Building Exercise
Start slowly and build gradually, especially if new to exercise.
Use proper form to avoid injury—consider working with a trainer or physical therapist.
Stay consistent: Aim for at least 150 minutes of moderate activity per week, with 2–3 days of strength training.
Include a variety of exercises to target different bones and muscle groups.
Listen to your body: Sharp pain or joint discomfort means you should stop and seek guidance.
Exercise is a cornerstone of lifelong bone health. From childhood to old age, physical activity plays a critical role in building, maintaining, and protecting your skeletal system. By incorporating weight-bearing, resistance, and balance exercises into your routine—and combining them with proper nutrition—you lay the foundation for strong, resilient bones that support an active and independent life.
Whether you’re a teenager building peak bone mass or a senior aiming to prevent fractures, it’s never too early or too late to make bone health a priority.
Author is Physical Therapist and Educator
