May is National Osteoporosis Awareness month! Current research on osteoporosis is focused on how exercise can help prevent and treat this condition.  Osteoporosis – which literally means "porous bones" – is a bone-thinning disease caused by a loss of mineral (primarily calcium) that weakens the bone structure.  The bone becomes vulnerable to fracture.

Resistance is the key factor in both types of exercise that build bone: weight-bearing aerobic exercise and weight lifting. In weight-bearing aerobic exercise, your muscles resist the force of gravity to keep you in an upright position.  In weight lifting, you apply resistance to the muscle to stimulate growth (hypertrophy) of the muscle fibers.  In both cases, the pull of the muscle on the bone causes a parallel hypertrophy to the bone.  

Exercise has a dramatic effect on the growing skeleton, which is why it is essential for children to be physically active. Once the skeleton stops growing, the effect of exercise on the bone is more modest.  If you do not develop adequate bone-mineral density at an early age, your risk of osteoporosis increases in the postmenopausal years.  However, some bone lost through inactivity may be restored and major bone losses can be prevented before ages 30 to 35.

From ages 18-35, the goal is to achieve the highest peak bone mass. Exercise should maximize the load to the bones with a progressive (i.e. gradual intensification) program of:

  • High impact aerobic exercise, defined as activities in which both feet are off the ground at the same time, as in running, jumping rope, and high-impact aerobic dance; also sports like basketball, volleyball and gymnastics.
  • High intensity weight lifting, using the heaviest weights you can lift in good form.  Do exercises for all the major muscle groups (hips and thighs, chest and back, shoulders, and core body). Aim for 8-12 repetitions with the last few reps being challenging.  Do 1-3 sets of each exercise.

From ages 35-50, the goal is to maintain bone mass, offset or reduce bone loss, and improve your coordination and balance.

  • Follow the guidelines above, using common sense.  To protect your joints from injury, use good judgment regarding high-impact exercise and high-intensity weight training.
  • Focus on strengthening the bony sites most vulnerable to fracture:  the thighbone, the spine and the wrist.
  • Add balance training, such as stork stance and "tight rope" walk.
  • To improve your stability and coordination incorporate exercises using the stability ball, BOSU and foam rollers.

From 50-plus and post-menopausal, the goal is to conserve bone and reduce the risk of falls and fractures. 

  • Continue with strength training, balance and stability exercises.
  • If you are doing a walking program, be sure to vary your route to include hills and steps, adding intervals of increased speed or jogging, if appropriate.
  • Focus on stretching exercises to maintain your height and spinal alignment.  Changes in posture become more pronounced at this age and can cause a shift in your center of gravity, increasing your risk of falling.

If you have been diagnosed with osteoporosis, check with your health care professional for exercise guidelines and restrictions. 

Joan Pagano is an authority on the benefits of exercise for women's health issues such as pregnancy, breast cancer, menopause and osteoporosis as well as strength training through the decades. She is the author of a series of fitness training books. For more about Joan and her services, please visit

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