Updated 29 May 2013

Exercise your bones, it’s never too late

One way to build stronger bones, and maintain your skeleton, is physical exercise.


Bone and movement are inextricably linked. Bones help convert muscle power into directional motion. Think of the great speed a cheetah can achieve whilst the poor snail or worm, without a skeleton, can barely achieve a rapid crawl. Teréza Hough, CEO of the National Osteoporosis Foundation of South Africa (NOFSA) explains.

As we grow, our muscles get bigger, and so do our bones. Improving the strength of our muscles will put more muscle strain on bones, which invariably leads to stronger bones. Therefore, the stronger your muscles are, the stronger your bones will be. 

Although the exact mechanism is still a bit of a mystery to us, we know that adequate exercise is important for normal bone formation as it is the only physiological means of stimulating new bone formation. Being immobile for lengthy periods of time has the opposite effect on bone and immobilisation, and so it causes rapid bone loss which in turn can lead to osteoporosis.

Osteoporosis is a condition that causes a reduction in bone mass and a deterioration of bone structure. Osteoporosis weakens bones, and weak bones can easily fracture. In turn, fractures cause pain and can put severe limitations on our daily life because they reduce mobility.

Use it or lose it

Less mobility, because of an osteoporosis-related fracture or simply by doing no exercise, means muscles are not being used as much. This lack of movement results in a cutback in the production of new, healthy bone tissue. Thus, weaker muscles result in weaker bones.

All of us are acquainted with the old adage: “If you don’t use it, you lose it!” What this means is that as muscles are used less and less, the control our nervous system exerts over those muscles begins to decline. This means that reflexes are not as good as they should be and the risk of stumbling or falling increases.

If we don’t exercise our muscles, we run the risk of falling, and the more often you fall, the better your chances are of suffering an osteoporotic fracture. Falls also lead to a decline in confidence and patients get too afraid to actually do activities outside of their homes.

All of this supports the idea that improving muscle strength and muscle function is beneficial for our bones. Exercise builds strong muscles, which in turn builds strong bones. Exercise also improves muscle control, balance and coordination, and reduces the risk of falling or suffering a fracture during a fall.

Even patients with fractures can benefit from special exercises and training, which can improve muscle strength and muscle function. This allows mobilization and improves daily life activities.

What type of exercise should I do?

There are two types of exercises that are important for building and maintain bone density: weight-bearing and muscle strengthening.

Weight-bearing exercise

High-impact weight-bearing exercises help build bones and keep them strong. This type of exercise should be avoided if you already have a fracture and is ideally suited for the young, although anyone can do this, provided that there are no existing fractures and if you are not sure, consult a healthcare provider. These exercises include high-impact aerobics, jogging/running, skipping, tennis and hiking.

Low-impact weight-bearing exercise is a safe alternative if you cannot do high impact exercise and is also good for your bones. These include using elliptical training machines, low-impact aerobics, using stair-step machines and brisk walking on a treadmill or outside.

Muscle-strengthening exercise

These exercises include activities where you either move your body, weights or some other resistance against gravity. They are also known as resistance exercises. These include lifting weights, using weight machines, using elastic exercise bands and lifting your own body weight.

Yoga and pilates can also improve strength, balance and flexibility, but caution needs to be exercised for those at increased risk of broken bones. A physiotherapist should be able to help you with the safest options.


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Healthy Bones

Tereza is the CEO of the National Osteoporosis Foundation and worked as a Nursing Sister in the field of Osteoporosis for 18 years prior to her appointment with the Foundation. She used to be the Educational Officer for the Foundation and co-wrote the patient brochure on Osteoporosis. Read more

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