Designing a Resistance Exercise Program for Optimal Bone Health

by Adam Brown  BScPT, MClScPT
updated Mar 28, 2025

As we age, maintaining good bone health becomes increasingly important to prevent osteoporosis and fractures. Falls secondary to fractures are responsible for shortening the lifespan of many older adults. In fact, the mortality rate secondary to falls in older Canadians increased by 111% between 2001 and 2019 and 34% of these falls were caused by a hip fracture.

This data illustrates that improvements in Canadians bone density could have a significant impact on longevity of Canadian seniors. When falls are not caused by a hip fracture, but rather the fracture is the result of the fall, there are environmental considerations that may help to prevent these injuries.

To achieve excellent bone density it is best to start early in life with strategies that can have a positive impact over time. Quality nutrition, avoidance of smoking and alcohol and resistance exercise all play a crucial role in promoting bone strength and density. This article aims to provide some considerations on designing an exercise program tailored specifically for preserving and improving bone health.

Understanding Bone Health

Bones are dynamic structures that constantly undergo a process called remodeling, where old bone tissue is replaced by new tissue. This process is influenced by various factors, including genetics, hormonal balance, diet, and physical activity. Weight-bearing and resistance exercises are particularly effective in stimulating the formation of high quality dense bone tissue and strengthening existing bones.

Considerations For An Exercise Program To Improve and Maintain Healthy Bones

Weight-Bearing Exercises

Weight-bearing exercises involve working against gravity while staying upright. Activities like walking, jogging, and stair climbing are excellent for overall bone health as they engage multiple muscle groups, providing a comprehensive workout. These exercises must be included in any program aimed at improving or maintaining bone health. The stress that the bone undergoes during weight bearing is the stimulus that tells the body that strong bones are required!

Resistance Training

Resistance exercises involve using external resistance to create tension in the muscles and bones. This can be achieved through various means, including free weights, resistance bands, or body weight. When designing a resistance exercise program specifically for bone health, consider the following factors:

1. Types of Exercises: Include a mix of weight-bearing and resistance exercises targeting major muscle groups. Compound movements like squats, lunges, and push-ups are excellent as they engage multiple joints and muscles simultaneously.

2. Intensity and Progression: Start with light weights or resistance bands and gradually increase the load as strength improves. High-intensity exercises create greater stress on bones, promoting increased bone density. However, it’s crucial to balance intensity with proper form to prevent injuries.

3. Frequency and Duration: Aim for at least 150 minutes of moderate-intensity weight bearing aerobic activity per week, along with muscle-strengthening activities on two or more days a week, as recommended by health authorities like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) [1]. If this is much more physical activity than you are used to, work up to this amount gradually to prevent injury.

4. Rest and Recovery: Allow adequate rest between resistance training sessions to ensure muscles and bones have time to repair and strengthen. Overtraining can lead to injuries and hinder progress. Exercise generates the stimulus to cause the body to change. But the actual change occurs later when you have an opportunity to rest and recover from the session.

Proper Technique and Supervision

Ensuring proper exercise technique is vital to prevent injuries. Beginners, older adults, or individuals with existing health conditions should consider working with a qualified physical therapist to learn the correct form and techniques.
Nutrition and Hydration: For the body to adapt to your exercise program you must give it the building blocks to create new healthy tissues. Adequate nutrition is essential. Ensure the diet includes sufficient calcium, vitamin D, and other essential nutrients. Hydration is also crucial for overall health and supports the body’s natural processes, including bone remodeling.

Designing a resistance exercise program tailored to maintain good bone health involves a combination of weight-bearing exercises, resistance training, proper technique and adequate nutrition. By incorporating these factors into a well-rounded fitness routine, individuals can significantly enhance their bone density and reduce the risk of osteoporosis and fractures. If the idea of designing a program still seems daunting, connect with one of our physiotherapists for guidance.

References:

[1] World Health Organization. (2010). Global Recommendations on Physical Activity for Health. Retrieved from https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/

[2] https://www.canada.ca/en/public-health/services/publications/healthy-living/surveillance-report-falls-older-adults-canada.html

About the author

Adam Brown

Co-founder, Physiotherapist Learn More about Adam Brown