Bone Health, Menopause, and Exercise
Today (28 March 2026) at Next Gen Canberra, physiotherapists Millie and Amy gave a seriously useful talk on bone health, osteoporosis, and the kind of exercise that actually helps.
And honestly? It was one of those talks that should probably be shouted through a megaphone at every woman over 40.
Because bone loss doesn’t usually send you a polite little warning email first.
It just quietly chips away in the background… and sometimes the first sign is a fracture.
Cheery, I know. But also important.
Millie and Amy broke down what happens to bone as we age, why post-menopausal women need to pay particular attention, and why strength training, impact loading, and balance work deserve way more love in the bone-health conversation.
They also shared exciting news about their new clinic, Together Strong Physio, opening soon at Majura Park.
Let’s get into it.
Bone Loss Is Common. Ignoring It Shouldn’t Be.
One of the big points from the talk was this:
Bone density naturally decreases with age.
That part is normal.
But when that decline becomes significant, it can lead to osteopenia or osteoporosis, which increases the risk of fractures — especially from something pretty underwhelming, like falling from standing height.
That kind of fracture is called a minimal trauma fracture, and it’s a major warning sign that bone health may be compromised.
Millie explained that osteoporosis is often called a silent disease, because there are usually no obvious symptoms until something breaks. No flashing lights. No soundtrack. No dramatic “your skeleton is now buffering” moment. Just a fracture, seemingly out of nowhere.
That’s why prevention matters.
Why Women Need to Pay Extra Attention
A major focus of the presentation was women’s bone health, especially around menopause.
Why? Because estrogen plays a big role in maintaining bone density. After menopause, estrogen levels drop, and bone loss speeds up dramatically. According to the talk, women can lose 10–20% of bone mass in the first 5–7 years after menopause.
That is not a tiny dip. That is your skeleton going through a very rude adjustment period.
Millie and Amy pointed out that 75% of osteoporosis cases occur in women, due to a mix of factors including:
lower peak bone mass compared with men
faster bone loss after menopause
genetics
age
previous fractures
So yes, there are things you can’t change.
But thankfully, there are also things you absolutely can.
What Is Osteoporosis, Exactly?
Millie explained osteoporosis in practical terms.
It’s a condition where bone density drops low enough that fracture risk increases significantly. The structure of the bone becomes less robust, with thinner outer bone and more porous inner bone.
Think of healthy bone like a strong honeycomb.
Then imagine that honeycomb getting thinner, holey-er, and less connected.
Not ideal.
How it’s diagnosed
The main test is a DEXA scan, which measures bone density and gives you a T-score.
Here’s the general guide they shared:
0 to -1 = normal
-1 to -2.5 = osteopenia
-2.5 or lower = osteoporosis
Osteopenia isn’t technically the disease itself, but it’s basically your body waving a little yellow flag and saying, “Oi, maybe don’t ignore this.”
They also noted that once osteoporosis is diagnosed, the aim is to improve bone density and reduce fracture risk, even if the diagnosis itself remains part of your history.
So… Can Exercise Actually Help Bone Density?
Yes. Very much yes.
This was one of the strongest messages from the session.
Exercise is often underused when talking about osteoporosis, which is a bit wild considering how much good it can do.
Bone is living tissue. It responds to load.
When you place the right kind of mechanical stress through bone, it stimulates adaptation. In plain English: your bones get the memo that they need to toughen up.
Millie and Amy focused on three key exercise pillars for bone health:
Resistance training
Impact loading
Balance training
And no, this doesn’t mean flapping a pink dumbbell around once a fortnight and hoping your femurs feel inspired.
It needs to be specific enough to actually create change.
1. Resistance Training: The Big One
Resistance training was a major focus of the talk, and rightly so.
This includes any exercise where muscles work against resistance, such as:
weights
resistance bands
bodyweight exercises
reformer or strength-based Pilates
gym machines
But here’s the important bit:
It has to be challenging enough
Amy explained that bone responds to loads it’s not used to. So if you’ve been doing the same light routine for years, your body has probably stopped seeing it as much of a reason to adapt.
That doesn’t mean your current exercise is useless. It just means that progression matters.
General resistance training guidelines from the talk:
2–3 sessions per week
2–3 sets per exercise
focus on compound exercises like squats, deadlifts, presses, pulls, and push movements
work close to fatigue, with about 1–3 reps left in reserve
allow 24–48 hours of recovery before training the same muscle group again
That “reps in reserve” idea matters. You do not need to train until your soul leaves your body. But you do need to get close enough that your muscles know they’ve actually been invited to the party.
2. Impact Loading: Yes, Stomping Counts
This was probably one of the most practical parts of the talk.
Impact loading includes things like:
stomping
jumping
hopping
landing drills
These movements create force through the body, which helps stimulate bone growth.
Amy described stomping as level one. Simple, effective, and far less terrifying than telling someone with low bone density to start box jumping like they’re training for the Olympics.
The key message here was:
Progress slowly
If someone has low bone density, they may need to start with very gentle impact and build gradually over time. That might mean beginning with heel drops or firm stomps before progressing to double-leg jumps, then more dynamic movements later if appropriate.
No heroics required.
Just steady, sensible progression.
3. Balance Training: Because Strong Bones Still Need You Upright
Balance training matters because fracture risk is not just about bone density.
It’s also about whether you fall in the first place.
Millie and Amy highlighted that muscle weakness and reduced balance can contribute significantly to falls. So even if someone is working on bone density, balance work is still a big deal.
Examples included:
single-leg standing
unstable surfaces
turning the head while balancing
adding a cognitive task, like talking while balancing
That last one is particularly clever, because real life is not a quiet yoga studio with whale music in the background.
Real life is balancing while carrying shopping, shutting the car door, and being asked where the keys are for the seventh time.
Training balance under more realistic conditions makes sense.
What Should People With Low Bone Density Avoid?
This part was refreshingly practical.
Amy explained that one of the main things to be cautious with is:
Loaded spinal flexion
That means bending forward with a rounded spine under load, especially if someone has osteoporosis and is at risk of vertebral compression fractures.
Instead, they taught the concept of a hip hinge — bending from the hips while keeping the spine long.
This matters because people still need to move in everyday life. You still have to pick things up. You still have to get your shoes on. The goal is not to avoid movement. It’s to do it more safely.
They also cautioned against jumping into high-impact work too quickly without building up first.
Which is sensible.
Your bones like challenge. They do not like chaos.
The Research Bit — But Kept Human
One of the key evidence-based studies mentioned was the LIFTMOR trial, an Australian study that found supervised heavy resistance and impact training was safe and effective for postmenopausal women with low bone density.
That’s important, because there’s still a lot of fear floating around the idea that people with osteoporosis should avoid lifting anything remotely heavy.
The research says otherwise — provided the program is appropriate, progressive, and supervised when needed.
They also referred to the American College of Sports Medicine guidelines, which support progressive resistance training at least twice per week, with enough intensity to challenge the muscles and create adaptation.
Translation: bone health needs more than good intentions and a leisurely stroll past the dumbbell rack.
A Few Extra Important Points They Made
A few other gems from the talk:
1. Walking is good — but not enough on its own
Walking is excellent for general health. Nobody’s cancelling walking.
But if bone density is the goal, it’s often not enough by itself to create the stimulus needed for stronger bones.
2. Cardio still matters
They were very clear that resistance training shouldn’t replace all aerobic exercise. A combination works best.
3. Recovery matters
Bone and muscle adaptation need recovery time. Training hard every day without rest is not the flex people think it is.
4. Nutrition still matters
They deliberately didn’t go deep into nutrition in this talk, but they did note that calcium, vitamin D, protein, and overall nutrition matter hugely.
And yes, there’ll be a separate nutrition talk.
New Clinic News: Together Strong Physio at Majura Park
Alongside the bone health talk, Millie and Amy also shared news about their new clinic:
Together Strong Physio
is opening atMajura Park
in May.
The clinic will focus on helping people, particularly women, improve strength, bone health, and confidence with exercise. Their offering includes:
physiotherapy assessments
individualised exercise programming
small group strength sessions
support for people with osteopenia or osteoporosis
access to the ONERO model of training
collaboration with a dietitian focused on women’s nutrition through the life cycle
pelvic health physio support
That’s a pretty solid setup.
And importantly, their message wasn’t “ditch everything else and only do our thing.” It was more: keep doing what you enjoy, but if you need more specific guidance, more targeted support, or something designed around low bone density, they can help.
That’s a much better vibe than the usual health-industry nonsense of pretending one approach is the magical answer to everything.
If today’s talk had one central message, it was this:
Bone health is not just about getting older. It’s about what you do next.
Yes, aging affects bone density.
Yes, menopause changes the game.
Yes, genetics matter.
But exercise — especially progressive resistance training, impact loading, and balance work — can absolutely make a difference.
Not random exercise.
Not “I waved a theraband once in 2019.”
The right kind. Done consistently. Progressed properly. Matched to the person in front of you.
That’s where the magic is. Or, more accurately, the physiology. Which is less glamorous, but far more useful.
Millie and Amy’s presentation at Next Gen Canberra was practical, grounded, evidence-based, and exactly the kind of information more women need to hear.
Because bone health shouldn’t only become interesting after a fracture.
It should become interesting before your skeleton starts quietly filing complaints.
If you’re concerned about osteopenia, osteoporosis, menopause-related bone loss, or you simply want to train smarter as you age, it’s worth speaking with a qualified health professional who understands both the science and the real-world side of exercise.
And if you’re looking for that support locally, keep an eye out for Together Strong Physio at Majura Park.