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Many of us considering people in their 70's, 80's, and 90's picture frail featherweights who might blow away in a strong wind. While many seniors in these age groups lead quite active physical, intellectual, and social lives, others weaken in some or all of these areas as they age. Very often older people experience such a significant loss of bone density that they seem as if they have birds' bones. This dangerous condition of the skeletal system, known as osteoporosis, contributes to broken bones in the hip, wrist, spine, and other places.

Both elderly men and women suffer from osteoporosis, but women get it more frequently than men because women stop producing estrogen at menopause. Estrogen helps women absorb calcium, which is the key ingredient of strong bones. Doctors often prescribe estrogen replacement therapy for their older female patients at risk for the disease. Bone loss takes longer in men because of their generally larger frames, and because they do not usually experience a rapid decline of their hormones like women do.

The decline in bone density corresponds strongly with a decline in weight-bearing activity with aging. The old saying, "Use it or lose it" really holds true in this respect. Scientists discovered something very interesting when both male and female astronauts began returning from extended stays in the weightless environment of space: These young, healthy, very active people suffered from osteoporosis! Fortunately for them, this condition is reversible.

According to a principle known as "Wolff's Law", bone remodels itself in response to the stresses it endures. A decrease in demands placed on bone results in a like decrease in bone mass. Conversely, as our bones experience greater loads, they increase in mass in order to meet the demands placed upon them. It is no accident that athletes have big, strong bones to go with those big, strong muscles!

Two kinds of exercise aid in rebuilding bone mass. Weight-bearing activities like walking, stair-climbing, dancing, and T'ai Chi use a person's own body weight fighting gravity to increase the load on the bones. Many of these provide excellent cardiovascular benefits as well. Sitting on a bicycle or floating on the water while swimming are not weight-bearing activities, but they do offer resistance to the limbs. The second type of exercise that beneficially stresses bone includes these resistance exercises.

We more commonly associate resistance exercises with weight-lifting, but any exercise that uses the force of muscle helps build and maintain strong bones. Lifting weights does it particularly well. This is not suggesting that our seniors should become bodybuilders. However, a lot of excellent research supports weight-lifting for older people, especially if they have, or are at risk for osteoporosis.

Weight-lifting programs that work best for older people use light weights and high (15-20) repetitions. They do not involve lifting to maximum capacity or exercising to fatigue. On the contrary, while an effective exercise regimen must stress the bones more than usual daily activities do, routines involving max lifts and the like are almost always contraindicated.

Stretching gently before and after lifting helps avoid injuring the muscles. A good resistance program works all of the major muscle groups, including back, chest, shoulders, arms, legs, and abdominals. Working larger muscle groups like the back and chest before working smaller groups like the shoulders and arms avoids fatigue. Exercising the back and the chest always involves using the shoulders and the arms, but one can use the arms without using the back or the chest. Tiring out the arms first could prevent working on the back or the chest later on.

Some people work every muscle group in one session, and they exercise every other day. Others prefer their exercise in smaller doses. They only work certain muscle groups such as back, chest, and shoulders on one day, and arms and legs the next day. The many variations on this type of schedule can help cut down on the total time spent in the gym on any one day. A program should never work the same muscle group two days in a row, as the muscles need time to recover. In fact, if muscle soreness persists, waiting longer than two days before working the same muscle group again can help avoid injury.

No one should begin a new exercise program without a complete physical examination and medical clearance from the primary care physician. We also recommend that a trained health professional, such as a Certified Athletic Trainer, an Exercise Physiologist, or a Licensed Physical Therapist design and monitor the exercise routine.

The results of clinical trials show positively that a program of graded weight-bearing exercise effectively rebuilds strong bones, and most people can do it, regardless of age. Of course, it almost goes without saying that the earlier the better for beginning a regular program of physical activity. One cautionary note however: Children should not lift weights until later in their teens when their bones finish forming, otherwise their bones may not grow correctly. Even very young children, though, can and should engage in other forms of resistive and weight-bearing activities, which they usually do through normal play. The research literature demonstrates clearly that physically active young people age in a much healthier state than those who lead sedentary lifestyles, and their strong bones prove it.