Epidemiological data show 200million people have osteoporosis worldwide – 1.2million Australians, 210.2million Americans, 15million European men and women over 50. Of Australian men over 50, 285000 will be osteoporotic, 2.48 million osteopenic by 2022.
A person’s bones adapt to regular mechanical ‘loading’. Animal research shows bone production is determined by the magnitude, and the rate and frequency of loading. Evidence shows dynamic-loading makes more bone than static loading. The optimal exercise prescription for the prevention and management of osteopenia and osteoporosis is the regular application of dynamic, high-magnitude loads to bones at a rapid rate. What does this mean in practice?
Dynamic refers to the requirement that the exercise requires motion. Standing will put a static load on your leg bones but running provides dynamic load.
High magnitude loads – means forces experienced by bones during exercise have to be relatively high – e.g. forces on leg & hip bones through jumping 30cm into the air & landing with two feet on a hard floor.
Applied at a rapid rate means just that – you might complete 5-6 of these 30cm jumps and landings in quick succession.
Combining high-intensity resistance training with high-impact jumping elicits high strain and strain-rates on bone. Theoretically this is an optimal exercise protocol for bone strength (Harding 2017).
Australian researchers, put women aged 61-71 years on either a low-load home-based exercise program or a supervised high-intensity high-impact program (called HiPRT). These women had lumbar spine T-scores of -2.15 ± 0.72 meaning all had osteopenic or osteoporotic lumbar bone densities. Both programs involved 2 x 30min exercise sessions weekly on non-consecutive days, over 8 months. Effects on bone density & strength were compared:
| HiPRT program | Low load program |
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There were no reported injuries in either group. So, what did researchers find?
| Test / Measure | HiPRT Group | Low Intensity Exercise Group |
| Body Height | Gained 0.4cm | Lost 0.3cm |
| Bone Mineral density (Neck of Femur) | Gained 0.3% | Lost 2.5% |
| Bone Mineral density (Lumbar spine) | Gained 1.6% | Lost 1.7% |
| Back extensor strength | Gained 65.7% | Gained 17% |
| Timed up & go test | Faster 2.6% | Slowed 3.3% |
| 5 Times Sit to Stand | Faster 6.2% | Slowed 1.6% |
| Functional Reach test | Gained 7.9% reach | Lost 1.3% reach |
The HiPRT women became faster, fitter, stronger & amazingly GAINED femur & lumbar bone density and increased their overall height. Low-load program women became slower, less fit, shorter and lost bone density. Can the contrast be any starker or the message any clearer?
The special thing about dynamic loading is that it creates strong movements of the fluids in your bone’s lacunar-canalicular network. These are the fluid filled channels between calcified bone in which your bone cells live. This fluid flow generates shear-stresses on the cell-surfaces of resident mature bone cells, bone–lining cells, and immature bone cells called osteoblasts, triggering cells to create new bone. So, now we know that new bone can be built after menopause in women, and in older men too. But, lifting weights, walking & probably slow jogging won’t help you build & strengthen bone. Nothing less than the dynamic loading exercises provides the right stimulus.
References:
- Watson SL, Weeks BK, Weis LJ, Horan SA, Beck BR, 2015, ‘Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial’, Osteoporos Int, vol 26 no12, pp 2889-94, https://pubmed.ncbi.nlm.nih.gov/26243363/
- Harding AT, Weeks BK, Watson SL, Beck BR, 2017, ‘The LIFTMOR-M (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men) trial: protocol for a semirandomised controlled trial of supervised targeted exercise to reduce risk of osteoporotic fracture in older men with low bone mass’, BMJ open, vol 7 no6, e014951, https://bmjopen.bmj.com/content/bmjopen/7/6/e014951.full.pdf
- Turner CH & Robling AG, 2005, ‘Exercises for improving bone strength’, Br J Sports Med, vol 39 no4, pp188-9, https://bjsm.bmj.com/content/bjsports/39/4/188.full.pdf
- Controversial LIFTMOR Trial Commentary, 2015, Therapilates Blog, https://therapilates.wordpress.com/2015/08/11/controversial-liftmor-trial-commentary/
- https://www.youtube.com/watch?v=9EZw_wrFnmI
Article Written + Submitted by:
Andreas Klein Nutritionist + Remedial Therapist from Beautiful Health + Wellness
P: 0418 166 269