Introduction
Imagine waking up one morning and realising your bones feel weaker—you’re slower to recover, you’re worried about a stumble, and you want to stay independent for years to come. At the London Osteoporosis Clinic, we meet many older adults who feel the same way. They ask: “What exercise should I do to keep my bones strong? What’s safe? What actually makes a difference?”
That’s why this article is for you. We’ll guide you through three key types of physical activity—weight-bearing, resistance training, and balance work—that build bone strength, reduce fall risk and support musculoskeletal health. You’ll also get practical tips on choosing safe exercises, adapting them for older age, and avoiding common pitfalls. Whether you’re starting out or already active, our aim is to empower you with clear, evidence-based guidance so you can move with confidence and protect your bone health for years to come.
Context & Importance
Why exercise matters for bone health
Bones are living tissue—they respond to mechanical loads and stresses by becoming stronger. As we age, bone mass and strength decline, increasing the risk of osteoporosis and fractures. But the good news is: targeted exercise can slow bone loss, improve muscle strength, and reduce falls. Research shows that adults engaging in regular weight-bearing and resistance work maintain higher bone mineral density (BMD) and better musculoskeletal health. nogg.org.uk+2PMC+2
The “forgotten guidelines”
Although aerobic exercise gets lots of attention, strength-training and balance activities are often under-emphasised. A UK evidence review described muscle & bone strengthening + balance activities as the “forgotten guidelines” for older adults. GOV.UK+1 The result: many older people fall through the cracks—active, yet neglecting the exercise that specifically supports bone and balance.
At the London Osteoporosis Clinic
We believe that exercise is not optional—it’s essential prevention. Whether you’ve been diagnosed with low bone density or want to stay ahead of risk, the right exercise makes a difference. Our philosophy centres on a balanced approach: combining weight-bearing impact, resistance training, and balance work, tailored to your age, risk level and physical ability.
Core Sections
1. Weight-Bearing & Impact Exercise
What it is
Weight-bearing exercise means you’re standing and your body weight pushes through the bones, creating the loading force that stimulates bone building. Impact adds extra force—jumps, hops, brisk walking. theros.org.uk+1
What the evidence says
The consensus statement “Strong, Steady & Straight” advises about 50 moderate impacts on most days for those without spinal fractures; or about 20 minutes of low-impact exercise most days if you’ve had vertebral fractures. endocrinology.org+1
Safe & effective practice
- Example low-impact: brisk walking, stair climbing, marching.
- Example moderate-impact: light jogging, low jumps, racket sports.
- Avoid high-impact if you’ve had recent vertebral fractures—start with low-impact and build gradually.
- For older adults, aim for dynamic movement—not just walking slowly. Change direction, vary speed.
2. Resistance (Muscle-Strengthening) Exercise
Why it matters
Muscle strength supports bone strength—when muscles pull on bones, they stimulate bone-building activity. Also, stronger muscles protect you from falls. nhs.uk+1
What the evidence says
Guideline reviews show that weight-bearing + resistance training together improve BMD in post-menopausal women and are recommended for hip/spine bone health. SpringerLink+1
Practical implementation
- Try 2-3 sessions per week of resistance work: free weights, resistance bands, bodyweight exercises.
- Basic movements: squats, hip hinges, push/pull, step-up.
- 8-12 repetitions per exercise before fatigue is reached. Introduce progression gradually. theros.org.uk
- Supervision from a trainer or physio is beneficial especially if beginner or with risk factors.
3. Balance & Stability Work
Why it matters
Most fractures in older adults happen after a fall. Improving balance, coordination and posture reduces falls risk—a key pathway to protect bone health. endocrinology.org+1
Evidence & guidelines
Older adults, particularly those at risk of falls, should include balance training at least twice weekly. Exercises improving steadiness, posture and reaction time reduce fall incidence. British Geological Survey+1
Simple, safe activities
- Heel-to-toe walking, side-stepping, single-leg stands (holding a chair).
- Tai chi, Pilates adaptations, dynamic balance routines.
- Use safe environment, support if required, and progress gradually.
4. Putting It All Together: A Balanced Weekly Routine
| Day | Focus | Example |
|---|---|---|
| Monday | Resistance | Squats + push-up + row with bands |
| Tuesday | Weight-bearing impact | 30-min brisk walk + 10 heel drops |
| Wednesday | Balance | Tai chi or single-leg stands + side-steps |
| Thursday | Resistance | Dead-lift variant + shoulder press |
| Friday | Weight-bearing | Stair-climb or low jump/march circuit |
| Saturday | Mixed + rest | Light walk + bodyweight core |
| Sunday | Rest & mobility | Gentle stretching, recover |
Adapt to your ability, risk status and preferences. If you have osteoporosis or prior fractures, you may need modified versions and professional supervision.
5. Safety and Special Considerations
- Always consult your GP or physiotherapist if you have osteoporosis, recent fractures, spinal issues or other comorbidities.
- Avoid high-impact jumps if you have untreated vertebral fracture risk. nogg.org.uk
- Use correct technique—poor form may increase injury risk.
- Monitor pain and fatigue—exercise should challenge but not overpower.
Conclusion
Exercise is far from optional—it is a cornerstone of lifelong bone health. By combining weight-bearing impact, resistance training, and balance work, you give your skeleton the best chance to stay strong, stable and resilient. At the London Osteoporosis Clinic, we help design personalised programmes that respect your age, bone health status and fitness level.
If you’re ready to move with confidence, reduce falls risk, and build stronger bones, start today. Book your personalised assessment and exercise plan with our expert team. Together we’ll help you stay active, independent and fracture-free for the long term.
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