Progressive Resistance Training to improve bone density

Progressive resistance training (PRT) simply means gradually increasing the resistance of the exercise you are doing over time. There is an old Chinese gym proverb that states:

“If the weight on the bar is not changing, neither are you”

Our bones and muscles are very good at adapting to load. If we gradually increase the load our muscles get bigger and our bones get stronger. This is why walking has limited benefit for osteoporosis – the load does not change (unless you put on a heavy backpack). Swimming and cycling have little to no benefit as they are non-weight-bearing.

At Regenerate we do not start you off in the gym with heavy weights. The first 6 weeks we call the Conditioning Phase. This is where we introduce the body to resistance exercises and allow you to get used to the exercises. We keep the exercises and movements relatively simple so that you gain confidence with what you are doing, particularly if you are new to gym based exercise.

It also means we can gauge if you have any weaker areas (such as an arthritic knee or a sore shoulder) that we need to work around or work specifically on with selected rehabilitation exercises. The art of programming exercises for osteoporosis is working around and with the clients existing injuries or weak points.

After the first 6 weeks we go onto phase two – the Strengthening Phase. This involves increasing the weights, doing less repetitions and working towards fatigue. For example, you are doing a strength exercise and you perform 10 repetitions of the movement but you could have actually done 15 if you pushed yourself. You will not get the same adaptation to the exercise because you have not “overloaded” the body. Again, this has to be done within your limits and may be limited by your injury history but many people simply stop an exercise before they fatigue and thus do not get the same benefit. Simply put, if you want your bones to get stronger you do need to push yourself in the gym.

Changing exercises every 6-8 weeks is also important. We challenge the body with full body exercises and apply load in different directions so the bones have to toughen up in multiple planes of motion. If you always apply resistance to a bone in one plane it will only strengthen in that plane. Changing exercises regularly also keeps you more motivated.

The other crucial aspect of exercising for Osteoporosis is balance exercises. All of our programs will include exercises to challenge and improve your dynamic balance. If you have Osteoporosis the crucial thing is to stay on your feet as most fractures happen with falls. Deterioration of balance occurs as we age but improvements can occur with training even in your nineties.

If you have Osteoporosis or Osteopenia you need to be exercising minimum 2-3 times per week (preferably three).  And it will be a lifelong commitment. Many of our members have been with us for greater than 10 years and have seen significant improvements in their strength and balance. We have also had clients whose bone density has increased although this is usually when combining gym exercise with Osteoporosis medications.

Adam Floyd Senior Physiotherapist Regenerate Physiotherapy