(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

Boundaries, Self-Care, and Meditation - Remote Course

May 22, 2020 - May 31, 2020
Location: Replacement Remote Course

Oncology of the Pelvic Floor Level 1 - Remote Course

May 26, 2020 - Jun 4, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Chicago, IL (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: Advocate Illinois Masonic Medical Center

Boundaries, Self-Care, and Meditation - Columbus, OH (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: The Ohio State University Wexner Medical Center

Pelvic Floor Level 2A - Syracuse, NY (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: SUNY Upstate Medical University

Gender Diversity and Pelvic Health - Livingston, NJ (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: Ambulatory Care Center- RWJ Barnabas Health

Pelvic Floor Level 2B - Maywood, IL (Rescheduled)

May 29, 2020 - May 31, 2020
Location: Loyola University Health System

Sexual Medicine in Pelvic Rehab - Remote Course (SOLD OUT)

May 30, 2020 - May 31, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

May 30, 2020 - May 31, 2020
Location: Replacement Remote Course

Sacroiliac Joint Evaluation and Treatment - Nashua, NH (RESCHEDULED)

May 30, 2020 - May 31, 2020
Location: St. Joseph Hospital Rehabilitative Services

Postpartum Rehabilitation - Foothill Ranch, CA (Rescheduled)

May 30, 2020 - May 31, 2020
Location: Intercore Physical Therapy

Pilates for the Pelvic Floor - Valencia, CA (Rescheduled)

May 30, 2020 - May 31, 2020
Location: Henry Mayo Newhall Memorial Hospital

Building Resilience Through Nourishment

Jun 2, 2020
Location: Short Form Remote Course

Pelvic Floor Series Capstone - Salt Lake City, UT (SOLD OUT)

Jun 5, 2020 - Jun 7, 2020
Location: Rocky Mountain University of Health Professions

Pelvic Floor Capstone - Remote Course

Jun 5, 2020 - Jun 7, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Jun 5, 2020 - Jun 6, 2020
Location: Replacement Remote Course

Pediatric Incontinence - Grand Rapids, MI (RESCHEDULED)

Jun 5, 2020 - Jun 7, 2020
Location: Mary Free Bed Rehabilitation Hospital

Pelvic Floor Level 2A - Kansas City, MO (Rescheduled)

Jun 5, 2020 - Jun 7, 2020
Location: Centerpoint Medical Center

Pelvic Floor Level 1 - Atlanta, GA (RESCHEDULED)

Jun 5, 2020 - Jun 7, 2020
Location: Emory Healthcare

Pelvic Floor Level 1 - Washington, DC (Rescheduled)

Jun 5, 2020 - Jun 7, 2020
Location: The George Washington University

Pelvic Floor Level 1- Canton, OH (Rescheduled))

Jun 5, 2020 - Jun 7, 2020
Location: Aultman Hospital

Restorative Yoga for Physical Therapists - Remote Course

Jun 6, 2020 - Jun 7, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 Part 1 - Remote Course (SOLD OUT)

Jun 6, 2020 - Jun 7, 2020
Location: Short Form Remote Course

Trauma Informed Care - Remote Course

Jun 6, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 - Berrien Springs, MI (Rescheduled)

Jun 7, 2020 - Jun 9, 2020
Location: Andrews University

Pelvic Floor Level 2B - Bay Shore, NY (Rescheduled)

Jun 7, 2020 - Jun 9, 2020
Location: Touro College: Bayshore

Pelvic Floor Level 1 Part 1 - Remote Course

Jun 11, 2020 - Jun 12, 2020
Location: Short Form Remote Course

Oncology of the Pelvic Floor Level 1 - Alexandria, VA (RESCHEDULED)

Jun 12, 2020 - Jun 14, 2020
Location: Inova Physical Therapy Center