Bone Health: Building stronger bones at any age

About 50% of Americans over the age of 50 are at risk for an osteoporotic fracture. Hip fractures in particular carry a high one-year mortality rate, something many of us have unfortunately seen firsthand.

It’s termed the silent disease, because we don’t feel the symptoms leading up to the fracture.  Bone health matters for all of us, and it starts earlier than most people think.

Understanding Bone Loss

• Peak bone mass is reached in our early 20s.

• After that, both men and women lose about 0.5% of bone mass per year.

• For women, bone loss accelerates significantly during menopause:

  • 2–12% per year during the transition

  • Roughly 10–12% total loss during perimenopause due to declining estrogen

  • The most rapid loss often occurs in the year leading up to menopause

  • Afterward, the rate slows to about 0.5–1.5% annually

While these numbers can feel alarming, there’s an important piece of good news:

Bone is living tissue. It is constantly remodeling. Breaking down and rebuilding - largely in response to the forces placed upon it.

That means we have the ability to influence it.

How to Support Bone Health

Load the Skeleton: Bones respond to mechanical stress. Anything that places load on your body, or creates a pulling force on bone can stimulate bone growth.

1. Strength Training (Especially Heavy Lifting)

This is one of the most effective tools we have.

• Aging is associated with loss of Type II (fast-twitch) muscle fibers, which are critical for power and quick reactions.

• Heavy resistance training helps:

  • Build strength and muscle power

  • Improve reaction time (important for fall prevention)

  • Stimulate bone growth

We’ll talk more about what “lifting heavy” actually means below.

2. Plyometrics (Jump Training)

You don’t need much to see benefits:

• 10 minutes, 3 times per week is enough

Benefits include:

• Improved bone density

• Increased muscle strength and power

• Better balance and coordination

• Enhanced insulin sensitivity

A 2019 systematic review found plyometric training improved:

• Bone health

• Body composition

• Posture

• Physical performance in adults aged 58–79

As you progress, aim to include:

• Multi-directional movement (forward, lateral, rotational)

• Quick, controlled landings

*Unsure where to start? If you haven't been running or jumping, check this out for a progression of impact training:

Phase 1: https://youtube.com/shorts/_9SxcfEaHUM

Phase 2: https://youtube.com/shorts/mqgznjHYs40

Phase 3: https://youtube.com/shorts/0SKWr245Ndw

Phase 4: https://youtube.com/shorts/ZxxDl3dNnEE

If you tolerate these, you are ready to start jumping. This could be hopping in place, progressing to a squat jump, jumping jacks progressing to a lateral hop, or box jumps. At this point, the more impact and the more directions you can incorporate, the better!

3. Weighted Walking

Adding load to everyday movement is simple and effective.

• Walking with a weighted vest or backpack can improve bone density

• Gradually work up to carrying ~10% of your body weight

• A backpack with water works well; a vest distributes weight more evenly

4. Other Power-Based Movements

Explosive or “ballistic” exercises can also help:

• Kettlebell swings

• Medicine ball slams

• Battle ropes

These movements train power and stimulate bone through rapid force production.

5. Target High-Risk Areas

Focus on strengthening:

• Spine

• Hips

• Wrists

These are the most common fracture sites.

Additional Considerations

• Diet and supplements: this is a larger topic, but as a blanket statement:

  • 1200mg Ca+ daily, ideally from food 1st

  • 25 - 30 g of protein/meal (based on body weight)

  • Vit D - usually need more, but not always (based on labs) - critical for absorption

  • Leafy greens daily, dairy, fortified foods

  • Vit K (K2 - helps to activate proteins that help bind Ca+ to the bone)

  • Mg - helps to convert Vit D to it's active form

• Balance training (including head movement) to reduce fall risk

• Home safety:

  • Remove loose rugs and cords

  • Install grab bars and railings

  • Use non-slip mats

• Learn how to fall safely:

  • Aim to distribute impact across your body

  • Avoid landing on an outstretched hand (wrist fractures) or directly on the hip

  • Practice only if safe, ideally with supervision

What Do We Mean by “Lifting Heavy”?

“Lifting heavy” doesn’t mean lifting the heaviest weight possible in every exercise.

It means focusing on compound movement. Exercises that use multiple muscle groups, such as:

• Squats

• Deadlifts

• Overhead presses

And gradually increasing load over time.

If you’re new to strength training:

• Start light

• Progress slowly over months to years, not days or weeks

If you have osteoporosis or osteopenia, it’s essential to work with a knowledgeable provider to ensure safe progression and avoid the risk for fracture.

• Spinal flexion (bending forward), as well as rotation can place you at risk for a fracture.

  • This is confusing, as I just said deadlifts and overhead presses can be great compound lifts, but often get confused with bending forward or compressing the spine. This is why it is so important to work with a skilled provider as you slowly work your way towards this. A physical therapist or knowlegable provider can guide you and train your body to still perform the lifts above, without the risk for fracture.

Can Bone Loss Be Reversed?

For a long time, we didn’t think so. But newer research is changing that.

One landmark study, the LIFTMOR Trial (2018), looked at postmenopausal women with low bone mass.

Participants were divided into two groups:

• A high-intensity resistance and impact training program (HiRIT)

• A low-intensity home exercise program

The HiRIT group:

• Trained 2x per week for 30 minutes

• Performed heavy, supervised lifts (deadlifts, overhead press and squats)

• Included impact exercises (jumping with controlled landings)

The Results:

• Significant improvements in hip and spine bone density

• Increased strength and improved posture

• Better functional performance

The low-intensity group saw no meaningful changes.

Even more important:There were no fractures or serious injuries in the high-intensity group.

Rethinking Fear Around Exercise

Many people with osteoporosis are understandably afraid of lifting weights or doing impact exercise.

But here’s the reality:

• Fragility causes fractures, not appropriate loading

• Avoiding stress on bones can actually increase risk over time

• A properly designed, supervised program has very low risk

Fear often leads to under-loading… which leads to further bone loss.

How Much Is Enough?

Research suggests:

• 40–50 high-impact reps per session

• 2–3 times per week

This is enough to improve bone density in the hips and spine.

More is not always better:

• Benefits plateau beyond ~60 impacts

• Injury risk begins to rise

Final Thoughts

Bone loss is a natural part of aging, but it’s not something you’re powerless against.

With the right combination of:

• Strength training

• Impact exercise

• Progressive loading

…it is possible to slow, and in some cases even improve bone density.

The key is consistency, proper guidance, and a willingness to challenge your body safely.

If you would like to hear more about bone health, come to my FREE workshop Friday, May 15, 2026 from 12-1pm. Sign up via the QR code attached, or this link:

https://l.bttr.to/kwyIs

*I will also be holding a small group training for learning to lift heavy specifically for females with osteoporosis in the fall. Stay tuned for more info!

Now get out there and start working on the bone density!

~Alicia