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Just what are the best exercises for healthy bones?

An article just came out last month in the NY Times on The Best Exercises for Healthy Bones.  It was interesting to say the least. The writer suggested that hopping was the best exercise to build bone but gave no context or guidelines to incorporate hopping or jumping safely into an exercise program! I decided to pull together the best information from the top researchers in the field of bone and exercise. I like to look at the groups who have been doing this kind of research for a long time.

I was at a bone symposium last week and was able to ask Beth Lambright, the Oregon State University exercise teacher of all the main studies during the past 15 years if jumping rope or mini-trampolines build bone. The answer was, “No, you need 4-8x body weight impact to stimulate bone. For children this means jumping off a 24″ box and for adults this means jumping off an 8″ step. They progress from 4″ to 6″ to 8” very slowly and prepare the knees and hips with step-ups, heel raises, squats, lunges and faux jumps before jumping off the steps.” So what else will give us healthy bones?

1. Walking does not build bone and should not be considered an osteoporosis exercise. (However, walking is great for your heart if you keep up a good pace.) Palombaro KM. “Effects of walking-only interventions on bone mineral density at various skeletal sites: a metaanalysis.” J Geriatr Phys Ther. 2005;28(3):102-7.

2. Weighted vests with lunges, squats, step ups, side lunges and small jumps 3 x per week builds bone in the hip according to Christine Snow’s bone research lab at Oregon State University. (Long-term Exercise Using Weighted Vests Prevents Hip Bone Loss in Postmenopausal Women by Christine M. Snow, Janet M. Shaw, Kerri M. Winters, and Kara A. Witzke Journal of Gerontology: 2000, Vol. 55A, No. 9, M489- M491) They are continuing their long-term studies and the latest one should be published next month!

3. Sinaki has the best long-term research on exercise for building bone and fracture prevention in the spine (vertebral bodies). (Sinaki, M., et al. 1986.”Relationship between bone mineral density of spine and strength of back extensors in healthy postmenopausal women.” Mayo Clinic Proceedings, 61 (2), 116-22.) (Sinaki, M., et al. 1996. “Can strong back extensors prevent vertebral fractures in women with osteoporosis?” Mayo Clinic Proceedings, 71 (10), 951-56.) (Sinaki, M, et al. 2002. “Stronger back muscles reduce the incidence of vertebral fractures: A prospective 10 year follow-up of postmenopausal women.” Bone, 30 (6), 836-41.) (Sinaki, M”The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture.” Phys Med Rehabil Clin N Am. 2007 Aug;18(3):593- 608)

4. Loren Fishman has some ongoing research on Yoga for osteoporosis and is getting some increases in BMD with
his program. (Yoga for Osteoporosis: A Pilot Study by Loren M. Fishman, MD. Topics in Geriatric Rehabilitation. Vol. 25, No. 3, pp. 244-250: 2009)

Main Points for Exercising Your Bones:

  • Hip Bone Building: Jumping is best. (If your T- score is below a -3.0 do not jump!) Prepare for jumping by doing forward and side lunges, squats, step ups, heel raises and standing balance exercises. Consider using a weighted vest up to 10% of your body weight. Mini-trampolines are a good warm-up or for cardiovascular work but they do not build bone.
  • Spine Bone Building: Prone (face down) Back Extension Exercises are best.
  • Walking briskly on uneven terrain up and down hills is great for your heart but should not be considered a bone building exercise.
  • Yoga and Pilates in general are not considered bone building exercises YET! They may be effective programs to increase variety and pleasure with exercise and are a good body awareness fracture prevention and preparation for the bone loading exercises necessary to stimulate bone formation!

Reprinted with permission from Sherri Betz. Originally published on her blog, TheraPilates

Sherri Betz is a physical therapist and director of TheraPilates® Physical Therapy, in Santa Cruz, CA, specializing in geriatrics and osteoporosis. Ms. Betz is a graduate of LSU Medical Center’s Physical Therapy program and is board certified in geriatrics.

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