76 Comments
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EG's avatar

Thank you for the comprehensive and detailed article with lovely medical illustrations. I used to work for the orthopedic tissue bank at my university and your article is the best I’ve seen so far.

Mary Pat Campbell's avatar

This is the most concise article I have seen. Thank you.

Angela Davies's avatar

Thankyou for covering the topic of bones. Having osteopenia I paid for my daughters to get a dexa scan early. Your blogs encouraged me to get a PT which I had last night, well worth it. I was lifting ie goblet squats, bench press, glute bridge, rows all heavier than I thought I could do.

Nutrition yoghurt, sardines, milk with vit D, natto for k2 if you can find it, mushrooms for 30 min in sunshine; I have these including supplements of vit D, k2. The mini trampoline I've at home (gathering dust) definitely don't feel any hard impact there are great YT workouts for cardio but getting outdoors so much better. Vibration plates saw Kylie Minogue used (maybe a scam) crossed my mind but thought it through. Thanks again.

Laura's avatar

Thank you-excellent information and helpful suggestions.

Marcus Maier's avatar

This is such a great, comprehensive review. The vibration plate data has been interesting as I have seen more and more marketing for it but it makes sense why it falls short with bone growth. Thanks for putting this together!

RayDarby's avatar

The frequency of vibration may make a difference. My wife is using the one used for astronauts that appears to be a low frequency unit compared to the their ones that get a lot of ad space. Not sure it’ll do anything but it’s worth a try with all the other things she is doing.

Marcus Maier's avatar

Most of the data I have seen is it can slow bone loss or minimal increase.

Marcus Maier's avatar

I think that is true that the vibration plays a role

Sarah V's avatar

Family Med NP here - BRAVO for this article!! By far the best summary I’ve read. Much appreciated! I continue to tell pretty much every patient every day that there’s no shortcut for “lifting heavy weights” !! Whether for weight loss, bone density, dementia prevention, cholesterol, A1c, or generally having a sense of well-being. I will continue to preach!

Kathyrn Merrithew's avatar

I just tried jumping off the bottom step-10 of them, and I think you recommended times 3. Not bad! My knees noticed, but my Smith and Nephew hips didn’t! Haha

Thank you for the helpful, practical info!

RLHS's avatar

Do you think that doing some training without shoes on is helpful at all? Does that help strengthen ankles and feet at all?

Howard Luks MD's avatar

It can improve balance and control.

Lael's avatar

So box jumps= jump down or jump down > box jumps? Box jumps don’t seem to have the same impact level imo -which seems to be what we’d be going for here

Leslie RG's avatar

I appreciate this guidance. I am strength training and have been lifting in some form for years except when recovering from injuries and foot surgeries. I am currently lifting heavy. How many sets/reps should you do when lifting 70-85% of your 1RM to build bone according to the LIFTMOR protocol? I have osteopenia (64 y.o) and am now adding jump training after reading this post. I did box jumps today on to a 12" box. I am going to send this to my endo MD. Years ago, when I told her I was lifting she said "All you have to do is walk" Good thing I did not listen to her. I am so glad I searched for your substack after listening to you on the GMB Fitness Podcast. Do you think doing the GMB body weight programs would build bone?

Howard Luks MD's avatar

You're already doing the work that matters most - consistent resistance training over the years. That puts you ahead of most people dealing with osteopenia.

For the LIFTMOR protocol specifics: 5 sets of 5 reps at 80-85% of your 1RM for the major lifts (deadlift, squat, overhead press). The key is the load and the impact, not the volume. You're creating mechanical stress that signals bone to remodel. Rest 2-3 minutes between sets.

Your endocrinologist was wrong. Walking is great for many things, but it doesn't provide enough mechanical load to stimulate significant bone formation. You need impact, and you need resistance. You're doing both now.

Box jumps on an 8-12" box are a solid start for impact training. As you adapt, you can progress the height or number of jumps, but don't rush it. Your connective tissue and bone needs time to adjust to plyometrics, especially if you're new to jump training. You don't want a stress fracture to set you back.

GMB programs? They're excellent for mobility, control, and movement quality. They'll keep you moving well and reduce injury risk. But bodyweight progressions alone probably won't provide enough load to drive significant bone density gains at this point. You need external resistance - barbells, dumbbells, weighted vests - to get the mechanical stress high enough. Think of GMB as complementary to your lifting, not a replacement.

Keep lifting heavy. Keep jumping. And keep ignoring doctors who think walking is enough.

AMK's avatar

Never thought about jumping, but will add it. Thanks!

Katherine's avatar

Thank you.

Susan hall's avatar

Does walking up and down hills and or mountain climbing help build bone den

Howard Luks MD's avatar

Good question... the answer is- it depends. If it's technical terrain where you are hopping down from rocks to the trail, etc, then yes. If it's a casual stroll, then no- it won't build new bone, but it will help to mitigate further loss.

Sarah V's avatar

Ironically, rule #1 of hiking is don’t jump off or over anything, because you don’t want to be hopping miles back home with a broken ankle! I suppose after reading this that jumping and hopping around on a trail that’s not too long or too far away would make sense though!

Dawn Shepard's avatar

Excellent read! Thank you.

Philipp Maerzhaeuser's avatar

What a great and comprehensive article.

Thank you Howard.

Radha Narayanan's avatar

An excellent article about osteoporosis,strength training. Very well explained.Thanks.