Exercise for osteoporosis treatment in Singapore: Can weight training increase bone mineral density?

Osteoporosis is a challenging disease to live with. You know that you are more susceptible to fractures. You become afraid of falling. You start to move less.

With osteoporosis, a lot of older adults start avoiding exercise. This often lead to deconditioning of the body. Beyond the expected muscle atrophy (muscle wasting) that will happen as a result of disuse, we also see weakening of their muscles, reduction of mobility, and general reduction in the capacity for daily life activities.

Instead of helping osteoporotic patients, less physical activity actually lead to an increase in their risk of falling. This is particularly problematic. In attempting to help themselves, they ended up increasing harm to themselves.

Humans are designed to exercise. The older you are, the more you need to strengthen your muscle!

seniors exercise class singapore
One of our senior exercise classes at Square One Active Recovery. Regardless of your age and fitness level, we can work with you to help you achieve your recovery and health goals!

In Singapore, there’s a false assumption that older people should be moving less. Because we think they that their body is more frail, and that they are more likely to cause harm to themselves. Fortunately for us, this is not true.

Even with aging, our body remains adaptable, robust, and resilient. With the right exercises and a safe approach to exercise, older Singaporeans can actually use working out to help them age better! It’s not just a case of walking more or stretching more, working out for seniors also include weight lifting and muscle strengthening activities.

In fact, strength training is so invaluable for seniors that both World Health Organisation and Ministry of Health (Singapore) advocates muscle strengthening exercises for older adults. The recommendation for lifting weights increase from twice a week for everyday Singaporeans to thrice a week for Singaporeans above 65 years old!

You heard that right. The older you are, the more you have to lift.

Is weight training safe for osteoporotic seniors?

When we look at workout options for seniors in Singapore, they tend to be limited to low intensity, low load exercises. This gives a false impression that older adults cannot do high intensity interval training or heavy weight lifting.

Because of this cultural practice, we start to see patients who are diagnosed with osteoporosis and osteopenia becoming excessively cautious about what their body can or cannot do.

No, we are not recommending osteoporotic patients to go bungee jumping at Sentosa or urban skiing at Snow City. What we are saying is that with an evidence-based approach, seniors with bone mineral density issues can exercise themselves to a full, functional, and happy life!

Osteoporosis doesn’t mean you cannot lift weight

Yes, you heard that right. To some extent, we are saying it can reverse osteoporosis. Without the use of medication or injections!

This research becomes from the works of Steven Watson and colleagues at Griffith University. They recruited 100 women above 60 years old and with low bone mass in their experiment. The women underwent 30-minute exercise sessions, twice per week. The first two to four weeks were focused on teaching lifting techniques through a variety of body weight and low load exercises.

In the next phase of the experiment, four exercises were introduced: deadlift, squat, jumping chin ups/drop landings, and overhead press. The ladies were able to perform these movements by the end of the second month.

For the rest of the programme, the participants performed three main lifts: deadlift, squat, and overhead press in a 5×5 format. The weight was kept at 80-85% of their 1RM. Impact loading was also conducted by through jumping chin ups with drop landings.

Isn’t it impressive? Not only did these ladies not get injured, they also showed amazing results! They “grew” taller and bone mineral density for both hip and lumbar spine improved. Without saying, their functional performance also improved. It’s a win, win, win, win, situation!

Yes, you can jump with osteoporosis!

Just to be clear, all the ladies in this programme were at least 60 years old and were confirmed to have low bone mineral density. The injury rate of this programme is also zero!

On top of weight training, the ladies also did impact training. Impact training is done by getting the participants to jump as high as possible and pulling themselves up on to a pull on bar. Following which, they let go of the bar, and allow themselves to land on the ground.

We think that osteoporosis means brittle bones. Brittle bones mean the bones will shatter upon impact. These women with osteopenia were jumping high and landing on the ground to train themselves to become more robust and resilient.

Again, we are not recommending that you do that. But we are suggesting that, with the right training, you can.

Low intensity workout is not as effective against osteoporosis

Some of you may be thinking, what if I just did low load and low impact exercises? In other words, what if I skip the weight training and the jumping? Will I still get the same results?

Unfortunately, no.

A follow up study compared the high intensity weight training versus a low intensity exercise programme and found that the higher intensity workout delivered better outcomes. This makes sense right? The bigger the stimulus, the more responding there should be. This follows Wolff’s law and has been well accepted by the research community. Why should osteoporosis be any different?

To give context, the low intensity workout group still did a fairly robust exercise programme. For their workouts, they did walking, lunges, calf raises, standing forward raise, shrugs as well as some spinal stretches.

So for those of you who think you get enough exercise from walking . . . well, you don’t. World Health Organisation and Ministry of Health Singapore is ample clear on that. You need at least two days of muscle strengthening days if you are below 65. If you are above 65, you need at least three days! Walking does not count as muscle strengthening. Walking cannot replace weight training.

Chiropractic treatment for osteoporosis Singapore

Let’s be super clear here. Your osteoporotic or osteopenic treatment should NEVER involve chiropractic adjustments or any form of spinal manipulation. World Health Organisation, in their guidelines on safety of chiropractic, is clear that “the spine and ribs are particularly vulnerable to osteoporotic fracture.”

There is no good reason for you to receive a spinal adjustment given the risks involved!

This doesn’t mean a chiropractor cannot help. Lucky for you, Square One Active Recovery takes an exercise + education + lifestyle change approach to helping our clients achieve their recovery goals. No chiropractic adjustments required!

Our unique exercise, education, and lifestyle change in our recovery programme empowers you to take charge of your own health. This means you can attain your recovery goals without needing regular treatments! An exercise-based approach is aligned to best evidence practice, and also congruent to what chiropractic is about since its founding days.

In that sense, we are not reinventing the wheel.

chiropractic clinic singapore

Most chiropractors in Singapore don’t want you to know this: exercise is part of chiropractic since its infancy. We see that early chiropractors did utilise exercise as part of their treatment approach. This is why B.J. Palmer’s chiropractic clinic is full of exercise equipment!

So, what we are doing at our practice is 100% part of chiropractic.

Yes, we do realise that few chiropractors in Singapore do what we do. Most chiropractors here prefer a crack-and-go treatment approach. You may be wondering why. Well, it’s because chiropractic adjustments only take five minutes to perform and the relief lasts for a few days or a couple of weeks, max. This means it’s good for business!

Then patient turnover is also high (i.e., can see many patients in a day, up to 300 sessions per week!!) and it is extremely lucrative (i.e., patients have to keep coming back)! No wonder chiropractors choose to focus on cracking spines!

With the growth of science and research, we starting to learn more about body, and what actually helps with recovery. Both chiropractors and pain patients alike would have to keep up in order to achieve good outcomes. Yes, all of us have our own biases, beliefs, values. We are not denying that.

What we are saying is that, at some point, all of these have to go if we want good outcomes. We have to keep up with times. Especially if you are not getting better.

Have a think about it. You can’t keep doing the same thing and expecting a different result. What you need for extraordinary results is a radical change. This can start with the type of treatments you choose.

If you are sick of not getting better, and you want good results with your treatments, drop us a message via the contact form below to find out how we can help you achieve true freedom from pain.



Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.