Ehrman et al., (2013) says that once a patient has enough bone density loss to be diagnosed with osteoporosis, most of the loss is not able to be rebuilt. Therefore, prevention of bone loss is the main focus and exercise consisting of a variety of modes is the primary treatment method (Ehrman et al., 2013 & Reibe et al., 2018). Consistency is key when it comes to seeing the benefits of an exercise program and there are certain criteria that have to be met to make different modes beneficial for preventing bone loss. One article stated that aerobic and resistance training provide the weight-bearing stimulus necessary to increase bone density, but resistance training was found to have a greater effect than aerobic training alone (Layne & Nelson, 1999). Therefore, resistance training is the most effective mode for building muscular strength as well as preventing bone density loss because it encapsulates all of the necessary criteria (Ehrman et al., 2013). 

Several studies have shown the benefits of regular resistance training to prevent bone density loss - both before it begins as well as a way to prevent further loss from happening once it starts. Because resistance training loads the bones in a variety of directions that they are not necessarily accustomed to, this leads to an increase in bone strength (Hong & Kim, 2018). The increase in bone strength has been found to be especially beneficial for the cortical bone which forms a protective layer and makes up ~80% of bone mass (Ott, 2018). Research by Rhodes et al., (2000) studied 44 sedentary but healthy women with a mean age of ~68 and had them participate in three weekly one-hour progressive resistance training sessions for a year. The results showed significant changes in strength as well as an increase in bone density which, when muscular strength and increased bone density is combined, may improve functional capacity/independence, slow the progression of osteoporosis, and improve quality of life (Rhodes et al., 2000).      

Prevention is easier than reversal is most any disease or condition. Unfortunately, once loss is great enough, bone density loss cannot be completely reversed, and this is where preventing further loss from happening through exercise such as weight-bearing exercise and resistance training (along with other lifestyle modifications and perhaps medication) is necessary. However, research by Hinton et al., (2015) studied the effects of resistance training or jump training for a year on 38 moderately active, osteopenic men (from -1 to -2.5 T-score SD) ranging in ages from 25-60. In addition to the activity researchers randomly assigned the participants to, each received calcium and vitamin D supplementation. The results showed that both resistance training and jump training increased whole body and lumbar spine bone density while resistance training alone was shown to increase total hip bone density (Hinton et al., 2015). Generally, high impact exercises such as the jump training these participants did is inadvisable in those with more advanced stages of osteoporosis. However, this research shows that resistance training is a safe and effective way to increase bone density mass in whole body, lumbar spine, and hip areas after loss has occurred. 

*Always check with your physician for their exercise recommendations especially if osteopenia or osteoporosis is a factor for you. 

References

Ehrman, Gordon, Visich, & Keteyian. (2013). Clinical Exercise Physiology. Human Kinetics.

Hinton, P. S., Nigh, P., & Thyfault, J. (2015). Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial. Bone, 79, 203–212. https://doi.org/10.1016/j.bone.2015.06.008 

Hong, A. R., & Kim, S. W. (2018). Effects of Resistance Exercise on Bone Health. Endocrinology and metabolism (Seoul, Korea), 33(4), 435–444. https://doi.org/10.3803/EnM.2018.33.4.435 

Layne, J. E., & Nelson, M. E. (1999). The effects of progressive resistance training on bone density: a review. Medicine and science in sports and exercise, 31(1), 25–30. https://doi.org/10.1097/00005768-199901000-00006 

Ott S. M. (2018). Cortical or Trabecular Bone: What's the Difference?. American journal of nephrology, 47(6), 373–375. https://doi.org/10.1159/000489672 

Riebe, D., Ehrman, J.K, Liguori, G., & Meir, M. (Eds.). (2018). ACSM’s guidelines for exercise testing and prescription. (10th ed.). Wolters Kluwer.

Rhodes, E. C., Martin, A. D., Taunton, J. E., Donnelly, M., Warren, J., & Elliot, J. (2000). Effects of one year of resistance training on the relation between muscular strength and bone density in elderly women. British journal of sports medicine, 34(1), 18–22. https://doi.org/10.1136/bjsm.34.1.18