(646) 355-8777

Herman & Wallace Blog

Which Weight Bearing Activities Build Bone in Adults?

When It Comes to Bone Building Activities for Osteoporosis, there’s Weight Bearing and then there’s Weight Bearing!

Ask just about anyone on the street what one should do for osteoporosis and the typical answer is- weight bearing exercises. And they would be partially right. Weight bearing, or loading activities have been shown to increase bone density.1 But that’s not the whole story.

Regarding weight bearing exercises, the million-dollar question is, “How much weight bearing is enough to stimulate bone growth and how much is too much to compromise bone at risk for a fracture? We know that there are incidents of individuals fracturing from just their own body weight upon standing. Recently patients have been asking about heel drops and stomping, and whether they should do them. One size does not fit all.

An alternative is to focus on “odd impact” loading. A study by Nikander et al 2 targeted female athletes in a variety of sports classified by the type of loading they apparently produce at the hip region; that is, high-impact loading (volleyball, hurdling), odd-impact loading (squash-playing, soccer, speed-skating, step aerobics), high magnitude loading (weightlifting), low-impact loading (orienteering, cross-country skiing), and non-impact loading (swimming, cycling). The results showed high-impact and odd-impact loading sports were associated with the highest bone mineral density.

Morques et al, in Exercise Effects on Bone Mineral Density in Older Adults: A meta-analysis of randomized controlled trials, found that odd impact has potential for preserving bone mass density as does high impact in older women. Activities such as side stepping, figure eights, backward walking, and walking in square patterns help “surprise the bones” due to different angles of muscular pull on the hip. The benefit, according to Nikander, is that we can get the same osteogenic benefits with less force; moderate versus high impact. This type of bone training would offer a feasible basis for targeted exercise-based prevention of hip fragility. I tell my osteoporosis patients that if they walk or run the same route, the same distance, and the same speed that they are not maximizing the osteogenic benefits of weight bearing. Providing variety to the bones creates increased bone mass in the femoral neck and lumbar spine.4

Dancing is another great activity which combines forward, side, backward, and diagonal motions to movement. In addition, it adds music to make the “weight bearing exercises” more fun. Due to balance and fall risk many senior exercise classes offer Chair exercise to music. Unfortunately sitting is the most compressive position for the spine and is particularly problematic with osteoporosis patients. Also the hips do not get any weight bearing benefit. Whenever safely possible, have patients stand; you can position two kitchen chairs on either side, much like parallel bars, to hold on to while they “dance.”

Providing creativity in weight bearing activities using odd impact allows not only for fun and stimulation; it also offers more “bang for the buck!”


  1. Mosekilde L. Age-related changes in bone mass, structure, and strength--effects of loading. Z Rheumatol (2000); 59 Suppl 1:1-9.
  2. Nikander et al. Targeted exercises against hip fragility. Osteoporosis International (2009)
  3. Marques et al. Exercise effects on bone mineral density in older adults: a meta-analysis of randomized controlled trials. Epub 2011 Sep 16
  4. Weidauer L. et al. Odd-impact loading results in increased cortical area and moments of inertia in collegiate athletes. Eur J Appl Physiol (2014)
The Art of Reason
Physical Therapy Considerations for Patients with ...

Upcoming Continuing Education Courses

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Jan 23, 2021 - Jan 24, 2021
Location: Replacement Remote Course

Yoga for Pelvic Pain - Remote Course

Jan 23, 2021 - Jan 24, 2021
Location: Replacement Remote Course

Mindfulness for Rehabilitation Professionals - Remote Course

Jan 23, 2021
Location: Replacement Remote Course

Pelvic Floor Level 2A - Self-Hosted\ (SOLD OUT)

Jan 23, 2021 - Jan 24, 2021
Location: Self-Hosted Course

Pelvic Floor Level 2A - Portland, OR Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Benchmark Physical Therapy

Pelvic Floor Level 2A - Truckee, CA Satellite Location- RESCHEDULED

Jan 23, 2021 - Jan 24, 2021
Location: Tahoe Forest Center for Health and Sports Performance / Alliance Therapy Partners

Pelvic Floor Level 2A - Freehold, NJ Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Atlantic PT Center

Pelvic Floor Level 2A - Somerset, NJ Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Sports Medicine Institute

Pelvic Floor Level 2A - New York, NY Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: 5 Point Physical Therapy

Pelvic Floor Level 2A - Phoenix, AZ Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Spooner Physical Therapy

Pelvic Floor Level 2A - Richmond, VA Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Pivot Physical Therapy

Pelvic Floor Level 2A - St George, UT Satellite Location

Jan 23, 2021 - Jan 24, 2021
Location: Unity Health & Wellness Llc

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Jan 29, 2021 - Jan 30, 2021
Location: Replacement Remote Course

Postpartum Rehabilitation - Remote Course (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Satellite Lab Course

Jan 30, 2021 - Jan 31, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Oklahoma City, OK Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Oklahoma Physical Therapy

Pelvic Floor Level 1 - Greenville, SC Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Restore Pelvic Health and Wellness

Pelvic Floor Level 1 - Doylestown, PA Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Central Bucks Physical Therapy LLC

Pelvic Floor Level 1 - Annapolis, MD Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Encompass PT

Oncology of the Pelvic Floor Level 1 - Remote Course

Jan 30, 2021 - Jan 31, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Marietta, GA Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Southern Pelvic Health

Pelvic Floor Level 1 - Torrance, CA Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Women's Advantage Inc

Lumbar Nerve Manual Assessment and Treatment - Remote Course

Jan 30, 2021 - Jan 31, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Brooklyn, NY Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: PT of the City

Pelvic Floor Level 1 - Self-Hosted

Jan 30, 2021 - Jan 31, 2021
Location: Self-Hosted Course

Pelvic Floor Level 1 - New Orleans, LA Satellite Location (SOLD OUT)

Jan 30, 2021 - Jan 31, 2021
Location: Ochsner Therapy and Wellness/Ochsner Health System

Pelvic Floor Level 1 - Metairie, LA Satellite Location

Jan 30, 2021 - Jan 31, 2021
Location: East Jefferson General Hospital

Sexual Medicine in Pelvic Rehab - Remote Course

Feb 6, 2021 - Feb 7, 2021
Location: Replacement Remote Course

Osteoporosis Management - Remote Course

Feb 6, 2021 - Feb 7, 2021
Location: Replacement Remote Course

Manual Therapy for the Abdominal Wall - Remote Course

Feb 7, 2021
Location: Short Form Remote Course