Yes, you can build stronger bones

It's no fun finding out that your bones are weaker than they should be – I know, because it happened to me. But did you know that we can regrow bones to make them stronger again?

Throughout our lives, our bones are continually broken down and rebuilt. Special cells called osteoclasts break down old or damaged bone cells. The calcium that releases into our bloodstream is used for vital bodily functions, such as activating our nerves and moving our muscles. Then other cells, called osteoblasts, build new bone tissue, using calcium that we ingest through our diet.

Up until the age of about 30, our bodies build more bone than is broken down. The level stays steady for a couple of decades but then we begin to lose more bone tissue than we build, and our bones become less dense and more brittle. Oestrogen (in women) and testosterone (in men) are both important hormones for maintaining bone density but they both decline as we age. The biggest bone-density decline occurs in women in the years after menopause, when our levels of oestrogen plummet.

The term osteopenia is used to describe bones that have less bone mineral density than they should have. Osteoporosis means that they have become so weak that they have an increased risk of fracture. Most hip fractures are caused from low impact falls. Almost one third of them occur in men, and they have a higher risk of dying within the following 12 months.

How strong are your bones?

You can find out the density of your own bones by asking your doctor for a bone density scan, which uses a special low-radiation type of x-ray called a dual energy x-ray. It is known as a DEXA scan.

During the test you lie (fully clothed) on a padded table while one x-ray device passes over your hips and lower spine, and another one passes underneath. You don’t feel anything and it only takes about 15 minutes.

The results of the test are usually presented as a T-score, which is the difference between the bone mineral density of a healthy young adult compared with that of your own bones.

• A T-score of -1 or above is normal.

• A T-score of -1 to -2.5 indicates osteopenia

• A T-score of -2.5 or below indicates osteoporosis

A bone density scan is recommended for all women over 65 and men over 70. In Australia it is free for everyone over 70.

Can we make our bones stronger again?

Yes! If we combine the right exercise with good nutrition (to get the right vitamins and minerals), we can reduce boss loss and the risk of fractures.

And that’s worth doing because one in four people over 65 fall at least once a year. And if that fall breaks a hip, one in three will die within 12 months.

How does it work?

When our muscles contract they put pressure on our bones, which stimulates the bones to increase their density. The more we (correctly) stress our bones with exercise, the stronger they become.

The best types of exercise for increasing bone density are weight bearing and resistance training.

Weight bearing means that your body has to support at least its own weight – gravity is your friend! Swimming is a great exercise for general fitness but not so good for building bone because the water supports your weight. Good weight-bearing exercises are running, jumping, hopping, dancing and tennis.

---

When astronauts are in space their bones get weaker because the lack of gravity means their bodies are not supporting their own weight.

---

Resistance training is when you work your muscles against a weight or force, such as lifting weights, doing squats, push-ups and lunges or pulling against a resistance band. You need to progressively increase the weight or resistance over time to continue challenging your bones, which increases their density and strength.

Proven results

In 2018 Professor Belinda Beck and her colleagues from Griffith University published the results of an innovative, randomized controlled trial called LIFTMORE, which proved that specific resistance training exercises improved bone mineral density in postmenopausal women with low bone mass. (There was also a follow-up study for men in 2020 called LIFTMORE-M.)

The Onero™ program

Following the study, the researchers developed an award-winning, evidence-based, structured weights and exercise program called Onero, scientifically proven to strengthen bone and muscle in people with osteoporosis.

Practitioners have to be specially trained and the program is individually tailored to be safe and effective for each person.

Ongoing data show that the Onero program ‘increases bone mass, improves posture and decreases falls.’

A recent analysis outlined some of the significant improvements:

Lumbar Spine BMD: Increase of 4.0 to 4.1%

Total Hip BMD: Increase of 1.5 to 3.4%

Femoral Neck BMD: 2.4 to 4.5%

Back Extensor Strength: Increase of 27.8% to 49.1%

Fractures: decreased 91.7%

Falls: reduced from 45 the previous year to 25

The Onero program includes exercises to improve balance and coordination, which improves stability and reduces your risk of a fall. Surprisingly, many hip fractures occur in people who don’t even have osteoporosis, so improving balance to prevent falls is important for everyone.

It gets better!

An added benefit of such exercises is that having stronger muscles means you can more easily carry your shopping, play with your grandchildren or run with your dog. It’s very satisfying to witness your own improvement and feel empowered, and exercising with other people can also boost your mood.

The Onero™ program is accredited by both Exercise & Sports Science Australia and Healthy Bones Australia (formerly Osteoporosis Australia). Ask your doctor if it might be the right thing for you.

You can find your closest practitioner in Australia, New Zealand, the United States or Europe at the bottom of this webpage.

(The UK's Royal Osteoporosis Society also has some helpful videos of exercises to support bone strength.)

The Onero™ program might be just what you need to keep a spring in your step. And remember to give your body all the nutrition it needs to build that bone!