Stronger Bones, Stronger You: Osteoporosis Strength Classes to Build Your Confidence and Help You Take Charge.
By Physiotherapist, Nóirín Gobl Ní Chasaide
You've been handed a bone density report and a list of warnings. Don't bend. Don't lift anything heavier than a litre of milk. Be careful. So you stop picking up the grandkids. You leave the shopping bags for someone else. And every time you move, you wonder if this is the time something breaks.
There's a better way to look after your bones, and it starts with moving more, not less.
Twelve weeks of building bone, and confidence
We're just wrapped up our latest 12-week OB (Osteoblast) strength block at Total Physiotherapy. Osteoblasts are the cells that build new bone, which is exactly what this program is designed to encourage.
The block runs in three phases:
Weeks 1–4, Foundations: learning how to move well, brace your trunk and lift with good technique. We focus on a hinge, squat and overhead press pattern along with some balance and impact.
Weeks 5–8, Strength: steadily adding load as your technique and confidence grow.
Weeks 9–12, Osteoblast: working towards the loads the research shows are most effective for bone health.
The goal isn't to lift heavy for the sake of it. It's to build you up, safely and step by step, to the level of loading that the evidence tells us actually makes a difference to bone.
What's happening inside your bones
Osteoporosis means your bones have become less dense and more fragile, so they can be more likely to break. Osteopenia is the earlier stage, where density is lower than normal but not yet in the osteoporosis range.
Bone is living tissue, and it's always being renovated. Think of two crews on a building site: one pulls down old bone, the other lays down new bone. Many factors affect this but a common one which cause a rapid decline in bone density is menopause. The drop in oestrogen means the demolition crew starts outpacing the builders.
Here's the part most people don't hear. The building crew responds to load. Bone gets the message to get stronger when it's asked to handle brief, challenging forces, like lifting something heavy or landing from a small jump.
That's why the common belief that gentle exercise is safest, and heavy lifting is dangerous, has it largely back to front, and can potentially be harmful advice. Walking is great for your heart and mood, but on its own it usually isn't enough of a signal to build bone.
Why it's so hard to get started
If you've been diagnosed with osteoporosis, feeling hesitant is completely understandable. The diagnosis itself can create fear, especially fear of fractures.
On top of that, the advice is often confusing. One person tells you to rest and protect your spine. Another tells you to exercise but can't say how. Online, you'll find a hundred contradictory answers.
Then there's the gym itself. If you've never lifted weights, walking into a room full of barbells can feel daunting, and the idea of lifting heavy can seem like the opposite of what you've been told to do.
These barriers are real. A good program doesn't ignore them, it's built around them.
How we build strength without the fear
Confidence in the gym doesn't appear overnight, and I don't expect it to. Nobody in our classes is asked to lift their maximum in week one.
Everyone starts with a one-on-one assessment with a physiotherapist before joining a class. In that session we:
Go through your medical history, including your bone density results, any past fractures, other health conditions and medications.
Talk about what you're worried about, and what you want to get back to doing.
Explain how lifting affects bone, and how to and why it's safe to build up.
Coach your technique on the key lifts, starting light.
Take objective strength measurements, so you and I can track your progress through the block.
From there, the research is our guide, but it isn't a rigid template. If you have a sore knee, a stiff shoulder or another condition to manage, we adjust the exercise, the load or the pace. We meet you where you're at and work forward from there, with the added benefit of it being physio led, meaning we can find the safe and appropriate modifications.
In class, each lift is taught and practised; if needed, starting with slightly higher reps/lower weight and gradually building the weight and reducing the repetitions.
What does success look like? It's different for everyone. For some people, it's lifting a suitcase into the car without a second thought. For others, it's picking up a grandchild, getting back into the garden, or simply moving without that constant worry.
What the research says about lifting with osteoporosis
Our program is based on the LIFTMOR trial, an Australian study of postmenopausal women with low bone mass. Participants did supervised, high-intensity strength and impact training (deadlifts, squats and overhead presses at around 80–85% of their one-rep maximum, which is the most weight you can lift once) for 30 minutes, twice a week, over eight months.
Compared with a low-intensity home program, the high-intensity group improved bone density at the spine and hip, gained strength and function, and had no serious injuries. The key was a gradual build-up under supervision and lifting heavy.
What about the other options?
If osteoporosis is left alone, bone density tends to keep declining with age, which raises the risk of fractures over time.
Most people try a few things first:
Medication: for many people this is an important part of managing osteoporosis. Exercise works alongside medication, not instead of it. Talk to your GP about what's right for you.
Rest and avoiding lifting: understandable, but it usually leads to weaker muscles and bones and poorer balance, which makes falls more likely.
Walking or gentle classes: good for your overall health, and if deconditioned may be a good starting point, but usually not a strong enough signal for bone on their own.
A supervised program isn't the right first step for everyone. If you've had a recent fracture, or have new or unexplained back pain, see your GP first. We can work together once you've been cleared.
Start the next block with us
Our next OB strength block starts on 26 October. If you've been in a previous block, now's the time to lock in your spot. If you're new, start by booking a one-on-one assessment with me, Noirin or Michael, at Total Physiotherapy, so we can plan your starting point together.
Classes run every weekday, with options of late morning and in the evening, so you can pick a time that suits you. You don't need any gym experience, and you don't need to feel ready. That's what the first four weeks are for.
https://book.nookal.com/bookings/book/acEfdaFe-E0C4-6bAb-3bca-AE1EfcAe5B8E/location/YABLV
Reference
Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research. 2018;33(2):211–220. doi.org/10.1002/jbmr.3284