How to Increase Bone Density as an Older Adult
Maybe you’re here because you’re thinking about the health of your bones and how to increase bone density as an older adult. If so, that’s awesome. If you’re here by accident, let’s start with why bone density is so important.
Why should you have healthy bones?
The health and strength of your bones is as important as the health of any other part of your body (muscles, vessels, organs, etc). Bones are incredible structures built to sustain the forces we put on them and designed to adapt to get even stronger with the forces we put on them. As an older adult, the biggest risk that comes with loss in bone strength is breaking a bone if you fall. One in 4 adults over 65 years old fall every single year in the US and almost 40% of those people sustain an injury that requires activity restrictions (source).
Not only are falls common, but having low bone density puts you at a greater risk of breaking a bone if you do fall. Breaking a bone sounds bad, but it doesn’t sound life threatening right? Well . . . injuries bad enough to limit activity as an older adult pose their own problems: rapid decline of muscle mass, potential depression, decrease in social interactions, decrease in autonomy, and high risk of not recovering well enough to be able to return to normal activity at the level prior to the injury. This cascade of events is very common, and has a massive impact on the quality of life of one’s later years. In fact, falls are considered the leading cause of injury related death in adults 70 and older, and one of the leading causes in disability for older adults due to this cascade of events (source).
Ok, enough with the depressing stats! You might be wondering how to prevent falling in the first place . . . great thought! Keep reading. But let’s talk about bones first. Now you see that healthier bones mean you’re less likely to break something if you fall, and to keep your bones healthy, you want high bone density.
The Truth About Osteoporosis
So, how do you increase bone density as an older adult? To answer this, let’s dive into understanding Osteoporosis. Even if you don’t have Osteoporosis, you’ve probably heard of it or know someone who has it. We’re going to reframe it based on current research about bone health, and it will serve as a great lens through which to understand your bone health regardless of your age.
In my webinar on Osteoarthritis last month, one of things I harped on is how the traditional (and outdated) view on Osteoarthritis implies that cartilage is an inert tissue. It’s as if we think of cartilage as a piece of plastic that has a limited number of hits from a hammer before it breaks. This is evident in the definition which includes “when cartilage in the joint breaks down over time” and in the well established description of cartilage damage as “wear and tear.”
Here’s the thing: our cartilage is not inert. It’s a live, biological tissue that breaks down (which is normal) AND rebuilds just like every other part of your body from your skin to your blood vessels. In the webinar, I suggested a new definition of Osteoarthritis that takes all of that into consideration.
The traditional and outdated view on Osteoporosis (and Osteopenia which is the precursor to Osteoporosis) is very similar. Osteoporosis, as defined by the NIH is “a bone disease that develops when bone mineral density and bone mass decreases” (source). Just like Osteoarthritis, the prognosis is bleak, pharmaceuticals are prescribed to slow further bone loss, and lifting heavy things is cautioned against to avoid fractures. However, we know that just like cartilage, bone is a live biological tissue. It’s not inert with a limited shelf life. Yes, it breaks down – which is a normal and healthy part of tissue remodeling in the human body! – AND it builds back up.
So, let’s redefine Osteoporosis:
“Osteoporosis is a condition in which the breakdown (resorption) rate of bone is happening faster than the rate at which the new bone matrix is forming.”
This new definition allows us to think about Osteoporosis as something that happens in the context of the whole body including the stress, or lack there of, being placed on your bones.
The LIFTMOR Trial
The good and well-researched news is: Your body has the capacity to bring bone building back into balance under the right conditions, AT ANY AGE.
The LIFTMOR trial is a famous study from 2018 that put post-menopausal Osteoporitic women in a heavy strength training and impact training program for 30 minutes, twice a week for 8 months. They compared them to a group in a light strength training program (think 2lb weights, bodyweight and floor exercises). The increased bone density results of the heavy training and impact group were so good that this study has been responsible for much of the slowly changing mainstream perspective around Osteoporosis.
Belinda Beck, one of the authors of the trial, said in a recent interview:
““As far as I can tell, I think we will struggle to ever find a drug that will be able to replicate the action of exercise – physical loading on muscle and bone. Because you can’t replicate the stimulus and any drug that is found to work probably will still need exercise to manifest its benefits.””
Whether you have Osteoporosis or not, whether it’s in your family or not, your bones follow the same rules of adaptation as the rest of your musculoskeletal system. If you don’t use it, you lose it and your bones will adapt negatively to being underused. So, specific high load strength training and impact impact training are your golden keys to how to increase bone density as an older adult. Not only that, strength training can also reduce your risk of falling.
How do you begin training your bones in a slow and safe progression to prevent, mitigate, and even reverse bone loss?
You’ll learn all of this and so much more in an upcoming webinar with Karin Weinstein. Karin is a yoga teacher and strength trainer, and a coach at The MOB. She’s spent a lot of time digging into the current research on Osteoporosis and applies these practices for bone health in coaching work. Karin will talk about why strength training is the best intervention for Osteoporosis, the best balance training to prevent falls, and how to begin the whole process in a way that feels safe and gradual.