The osteoporosis medicine that no doctor prescribes
There is a treatment for osteoporosis that works, has no side effects, costs nothing – and almost no doctor prescribes it.
It's strength training.
This may sound like an exaggeration, and I will be careful with the nuances further down, because medications for osteoporosis are available and needed for many. But the basic statement holds true: putting stress on the body is one of the most effective ways to keep bones strong throughout life. And it is based on an insight that surprises most people – that muscles and bones are not two separate things, but two parts of the same system.
Let me explain.
We think wrong about the skeleton
Most of us carry an unconscious image of the skeleton as something dead and unchanging. A scaffolding of bones that we are born with, that keeps us upright, and that slowly deteriorates over the years without us being able to do much about it. You can train the muscles. The skeleton just is.
That picture is wrong.
Bone is living tissue. It is constantly being broken down and rebuilt, 24/7, throughout life. Inside the skeleton, there is a constant process of removal of old bone tissue and addition of new. The balance between the two determines whether the skeleton becomes denser or more brittle.
And this is the important thing that balance is affected by how you use your body. Just as a muscle that is used gets stronger, a skeleton that is loaded gets denser. It adapts to the demands you place on it.
The mechanism is actually quite elegant.
How stress builds bones
When you put stress on your bones lifting something heavy, jumping, or when a powerful muscle pulls on its attachment the bone tissue is subjected to a small strain. The bone bends microscopically. The cells inside the bone sense this strain and interpret it as a signal: more strength is needed here.
The answer is that the body builds bone tissue precisely where the load was greatest. The skeleton becomes denser and stronger , precisely in the places where it is exposed to the most force.
The opposite is also true, and it's worth knowing. A skeleton that is not loaded for example, in someone who is bedridden for a long time, or in astronauts in zero gravity loses bone density quickly. Without load, there is no signal to stay strong, and the body prioritizes bone.
The skeleton is constantly listening to what you do with it. If you put stress on it, it builds. If you spare it, it breaks down. It's exactly the same logic that applies to muscles.
Muscles and skeleton are the same system
Here comes the point that ties it all together , and which I think is the most useful insight in this entire text.
Muscles and bones are built from the same thing.
Load. And they build each other.
When you strength train, your muscles pull hard on their attachments to the skeleton. That pull is one of the most intense stresses your bone is exposed to. So the same workout that builds your muscle also builds the bone it's attached to. You can't train one properly without the other getting its share.
This means you don't have to choose.
You don't need one program for your muscles and another for your bones. A single approach regularly loading your body with weight takes care of both.
And the consequence of that is nice: you get two protective walls against the same danger from the same effort. Strong muscles and good balance prevent you from falling. A dense, strong skeleton prevents it from breaking if you do. The fall and the fracture are the two steps in what takes away the independence of many elderly people and strength training works against both at the same time.
What the research shows
This isn't just an appealing theory.
It's been tested, even on those who were long thought not to train hard at all.
In a notable study, researchers had women who already had osteoporosis or incipient osteoporosis train with heavy, controlled strength training combined with stress-related movements the exact opposite of the cautious "take it easy" that this group usually hears.
The results were clear. The women increased their bone density measurably, both in the lumbar spine and in the hip and these are the two places where fractures are most fatal. A hip fracture or a vertebral fracture can change the whole life of an elderly person, and that's where the effect came from.
At least as important.
the training was well tolerated. The participants coped with it, despite the long-standing fear that fragile bones would not be able to withstand heavy loads. That fear turned out to be exaggerated. With the right technique and the right escalation, the skeleton not only withstood the load – it was strengthened by it.
There are similar findings for men, and the overall research points in the same direction: sufficiently vigorous exercise, done regularly, improves bone density in older people.
The important catch - you have to hold on to it
Now to the nuances, because I don't want to exaggerate.
First and foremost: the effect only lasts as long as you do it. If you stop exercising, the gains wear off, and bone density slips back. It's the same thing with muscles – the skeleton doesn't retain a strength it no longer has any reason to have. So this isn't a cure you do once, but a habit you keep alive.
The second: strength training does not always replace medication. For some with pronounced osteoporosis, or at high risk of fracture, medication is both justified and important – and exercise is then a complement, not a replacement. Just like with most other things in health, it is rarely a matter of either or. Medication and exercise pull in the same direction and work best together.
Third: if you have already been diagnosed with osteoporosis, you should not throw yourself into heavy training on your own. In that case, it is wise to start under the supervision of a physiotherapist, who can safely apply the load and increase it at the right pace. The point is not that brittle bones are impossible to train – on the contrary, they feel good about it – but it should be done with technique and control.
What can you do?
For most healthy people over fifty, the message is simple and encouraging.
Strength train regularly, two to three times a week. The big exercises that put stress on the back, hips and legs are the most beneficial for the skeleton – squats, deadlifts of some kind, carrying heavy loads, standing up with a load.
Get on your feet and move.
Walking and everyday movement put a light load on your bones, and it's better than sitting still – even if it doesn't provide as much as heavier exercise.
Make sure the raw material is available.
The skeleton needs calcium and vitamin D to be able to build. In Sweden, the skin does not produce any vitamin D during the winter months, so a supplement is reasonable for most older people, and you mainly get calcium through dairy products.
And stick with it.
That's the only really important rule. The skeleton you build this year will only last if you keep giving it a reason.
The skeleton listens to what you do
If you take away only one thing from this text, let it be this: your skeleton is not a dead structure that inevitably withers over the years. It is living tissue that listens to how you use your body, and responds to strain by getting stronger.
This means that one of the things we fear most as we age becoming frail, breaking a hip, losing independence after a fall can be influenced much more than most people think. Not entirely. Genetics and age play a role. But much more than the passive image we often carry.
I'm 63 and I work out every day, and I do it as much for my bones as for my muscles even though it's the same workout that builds both. That's perhaps the best part about the whole thing: you don't have to do anything extra. The exercise you're already doing to stay strong also keeps your bones tight.
One effort. Two protective barriers. And no prescription needed.
Do you want to train in a way that builds both muscle and bone? The Bodyweight Diet app has programs you can do at home, built for those over fifty – to keep you strong, steady and independent all the way.
A word of caution: if you have been diagnosed with osteoporosis, previous fractures or another illness, check with your doctor or a physiotherapist before starting heavy training. The skeleton feels good from strain, but the right technique and the right escalation are important and for some, medication is needed in addition to training. This text is general information, not medical advice.
Kennet Bath
Founder, Bodyweight Diet
