New research is showing that impact training may improve people's bone mineral density at the low back and hip, and improve function. This concept applies to those with low bone mineral density, history of fracture, or at least moderate risk of fracture.
Here are some things to consider if you are interested in impact training.
Here are some things to consider if you are interested in impact training.
- It is recommended to first start with strength training before working up to low impact training.
- Strength training can include body weight exercises like squats, lunges and pushups as well as abdominal and back extensor training (1).
- For more information on resistance training see the “Too fit to fracture” recommendations here.
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https://osteoporosis.ca/wp-content/uploads/OC-23-103_TFTF_final-electronic_Osteoporosis-Canada-ENGLISH-1.pdf
Once you get more proficient with strength exercises, you could progress to low impact exercises that do not involve your feet leaving the ground. These include:
If someone has a high risk of fracture and history of several fractures it is recommended to to be slow with progressions or limit yourself to the lower impact exercises.
People ready to progress could start exercises such as
Guidelines from the ESSA recommend trying 3-5 sets, 10-20 reps, with 1-2 min of rest between sets.
KEYS TO NOTES
If new to impact exercises start with:
Low impact activities:
Progressions:
- heel drops
- stomping the ground
- or coming up quickly from the bottom of a squat.
If someone has a high risk of fracture and history of several fractures it is recommended to to be slow with progressions or limit yourself to the lower impact exercises.
People ready to progress could start exercises such as
- jumping
- hopping and
- skipping
Guidelines from the ESSA recommend trying 3-5 sets, 10-20 reps, with 1-2 min of rest between sets.
KEYS TO NOTES
If new to impact exercises start with:
- Conditioning (strength training)
- Progress to low impact training like heel drops, foot stomp, grapevine and other low impact physical activities
- Progress when and if appropriate:
- low squat jumps, hops, skipping, jogging on the spot to jogging ect. Side hops ect
- drop jump with soft landing
Low impact activities:
- Heel drops: Heel raise to get up on your toes. Passively drop onto your heels
- Grapevine: walk sideways while alternately crossing one foot in front of the other for three steps before performing a small hop to change directions
Progressions:
- Hop/Jump: Hop or jump forward with both feet. Progress to hopping on a single leg
- Jump squat: stand with feet shoulder width apart. Bend the knees and hips and perform a jump with both feet. Landing in the ‘squat’ position with both knees and hips flexed.
- Drop Jump: Stand on a step or box. Hop down and jump back up, with minimal knee bend
HEEL DROPS!
GRAPEVINE!
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FORWARD HOP!
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LATERAL HOPS!
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Sources
Bonefit training course summary references
Bassey, E. J., & Ramsdale, S. J. (1994). Increase in femoral bone density in young women following high-impact exercise. Osteoporos Int, 4(2), 72-75.
Bassey, E. J., Rothwell, M. C., Littlewood, J. J., & Pye, D. W. (1998). Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res, 13(12), 1805-1813.
Beck BR, Daly RM, Singh MA, Taaffe DR. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport. 2017 May;20(5):438-445. doi: 10.1016/j.jsams.2016.10.001. Epub 2016 Oct 31. PMID: 27840033.
Frost, H. M. (1987). The mechanostat: a proposed pathogenic mechanism of osteoporoses and the bone mass effects of mechanical and nonmechanical agents. Bone Miner, 2(2), 73-85.
Kato, T., Terashima, T., Yamashita, T., Hatanaka, Y., Honda, A., Umemura, Y. (2006). Effect of low- repetition jump training on bone mineral density in young women. J Appl Physiol, 100: 839-843.
Mosely, J.R., Lanyon, L.E. (1998) Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats. Bone, 23: 313-318.
Rodrigues, I. B., Ponzano, M., Hosseini, Z., Thabane, L., Chilibeck, P. D., Butt, D. A., Ashe, M. C., Stapleton, J., Wark, J., & Giangregorio, L. M. (2021). The Effect of Impact Exercise (Alone or Multicomponent Intervention) on Health-Related Outcomes in Individuals at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Sports Medicine (Auckland, N.Z.), 51(6), 1273–1292. https://doi.org/10.1007/s40279-021-01432-x
Rubin, C. T., & Lanyon, L. E. (1985). Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int, 37(4), 411-417.
Vainionpaa, A., Korpelainen, R., Leppaluoto, J., & Jamsa, T. (2005). Effects of high-impact exercise on bone mineral density: a randomized controlled trial in premenopausal women. Osteoporos Int, 16(2), 191-197.
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. J Bone Miner Res. 2018; 33(2):211-220. doi:10.1002/jbmr.3284
Winters-Stone, K. M., & Snow, C. M. (2006). Site-specific response of bone to exercise in premenopausal women. Bone, 39(6), 1203-1209.
Bonefit training course summary references
Bassey, E. J., & Ramsdale, S. J. (1994). Increase in femoral bone density in young women following high-impact exercise. Osteoporos Int, 4(2), 72-75.
Bassey, E. J., Rothwell, M. C., Littlewood, J. J., & Pye, D. W. (1998). Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res, 13(12), 1805-1813.
Beck BR, Daly RM, Singh MA, Taaffe DR. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport. 2017 May;20(5):438-445. doi: 10.1016/j.jsams.2016.10.001. Epub 2016 Oct 31. PMID: 27840033.
Frost, H. M. (1987). The mechanostat: a proposed pathogenic mechanism of osteoporoses and the bone mass effects of mechanical and nonmechanical agents. Bone Miner, 2(2), 73-85.
Kato, T., Terashima, T., Yamashita, T., Hatanaka, Y., Honda, A., Umemura, Y. (2006). Effect of low- repetition jump training on bone mineral density in young women. J Appl Physiol, 100: 839-843.
Mosely, J.R., Lanyon, L.E. (1998) Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats. Bone, 23: 313-318.
Rodrigues, I. B., Ponzano, M., Hosseini, Z., Thabane, L., Chilibeck, P. D., Butt, D. A., Ashe, M. C., Stapleton, J., Wark, J., & Giangregorio, L. M. (2021). The Effect of Impact Exercise (Alone or Multicomponent Intervention) on Health-Related Outcomes in Individuals at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Sports Medicine (Auckland, N.Z.), 51(6), 1273–1292. https://doi.org/10.1007/s40279-021-01432-x
Rubin, C. T., & Lanyon, L. E. (1985). Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int, 37(4), 411-417.
Vainionpaa, A., Korpelainen, R., Leppaluoto, J., & Jamsa, T. (2005). Effects of high-impact exercise on bone mineral density: a randomized controlled trial in premenopausal women. Osteoporos Int, 16(2), 191-197.
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. J Bone Miner Res. 2018; 33(2):211-220. doi:10.1002/jbmr.3284
Winters-Stone, K. M., & Snow, C. M. (2006). Site-specific response of bone to exercise in premenopausal women. Bone, 39(6), 1203-1209.
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