Breaking the Myth of Fragility: Why I Told My Osteoporosis Patients to Stop Walking and Start Jumping

For the first decade of my career as a physical therapist, I thought I was doing everything right.

My days were filled with wonderful, dedicated patients—mostly women over 50, their faces etched with a quiet determination to fight back against the creeping diagnosis of osteoporosis or its precursor, osteopenia.¹

I was their partner in this fight, and I armed them with the standard-issue weapons recommended by nearly every major health organization: gentle, low-impact, weight-bearing exercise.

We focused on daily walks, balance training, and ensuring they were taking their calcium and vitamin D supplements.³

They were the perfect patients.

They walked for miles, they diligently took their pills, and they never missed an appointment.

Yet, as the months turned into years, a cold, unsettling pattern began to emerge.

I’d look at their follow-up bone mineral density (BMD) reports, and my heart would sink.

The numbers were barely budging.

Sometimes, they were getting worse.

Despite their unwavering commitment, the disease was still winning.

The most insidious part was the fear.

The more they focused on being “careful,” the more they seemed to dread a simple misstep, a patch of ice, or an uneven curb.

Their world, once expansive, was shrinking, defined by the terror of a fall and the fracture that would inevitably follow.⁶

Then came the day my entire professional philosophy shattered.

It was the day I got the call about Eleanor.

Eleanor was the model patient, the one you wish you could clone.

At 68, with a T-score that put her firmly in the osteoporotic range, she followed my “safe” exercise plan to the letter.

She walked her dog every morning, attended my balance classes twice a week, and had her diet dialed in.

She was doing everything she was told to do to protect herself.

One Tuesday afternoon, she was stepping off a curb—a movement she’d made a million times—when she stumbled.

It wasn’t a dramatic, tumbling fall.

It was a simple, awkward landing.

But it was enough.

The result was a comminuted fracture of her femoral neck, the top of her thigh bone.

The surgery was complex.

The recovery was grueling.

But the real loss was her independence.

That one misstep marked the end of her living alone, the end of her long walks with her dog, the end of the life she knew.¹

For me, it was a devastating professional failure.

I had given Eleanor and so many others a sense of security that was, in reality, an illusion.

The “safe” advice wasn’t just ineffective; it was dangerous.

It had armed my patients with a shield made of paper against a threat that required steel.

That day, I stopped being a dispenser of conventional wisdom and became a detective.

I had to understand why the playbook was so catastrophically wrong.

I had to find out what it

really took to build a stronger bone.

My journey would take me away from the patient-friendly pamphlets and deep into the foundational science of how our bodies adapt, leading me to a 19th-century law and the training secrets of elite athletes.

It would force me to question everything I thought I knew and, ultimately, lead me to tell my patients to do the one thing they feared most: jump.

Part I: The Epiphany — How a 19th-Century Law and Athletic Training Changed Everything

My obsession began in the dusty stacks of medical libraries and the digital archives of physiology journals.

I started ignoring the surface-level recommendations and dug into the core mechanics of bone itself.

I wasn’t just looking for a better exercise; I was looking for a better principle.

And I found it in the work of a German surgeon from the 1800s.

The New Paradigm: Wolff’s Law, Your Bones’ “Use It or Lose It” Contract

The epiphany that changed my practice is a concept called Wolff’s Law.

Developed by Julius Wolff, it’s a simple yet profound principle: bone is a living, dynamic tissue that will adapt to the loads under which it is placed.¹⁰

When you consistently subject a bone to a significant load or stress, it will remodel itself over time to become stronger and denser to more easily resist that load.

Conversely, if you remove the load—as happens with prolonged bed rest or in the microgravity of space—the bone will become weaker and less dense because the stimulus for maintaining its strength is gone.¹²

It is the body’s ultimate “use it or lose it” contract, written directly into our skeletal architecture.¹⁴

This completely reframed my understanding.

I had been treating my patients’ bones like fragile, precious porcelain that needed to be protected from any and all stress.

Wolff’s Law taught me that this was fundamentally wrong.

Our bones are not like porcelain; they are like a perpetually active construction site.

Imagine your skeleton is a high-rise building undergoing constant renovation.¹⁵

You have two crews working 24/7.

The demolition crew, called

osteoclasts, goes around breaking down and removing old, worn-out bits of the structure (bone resorption).

The construction crew, called osteoblasts, follows behind, laying down new, stronger material to replace it (bone formation).¹⁰

In a healthy young person, the construction crew easily keeps up with, or outpaces, the demolition crew, leading to a net gain in bone mass until we reach our peak in our late 20s.¹⁶

With osteoporosis, especially after menopause when protective estrogen levels drop, the demolition crew starts working overtime while the construction crew slows down.¹⁰

The result is a net loss of bone, leaving the structure porous and weak.

For years, my approach—and the standard medical advice—was to try and slow down the demolition crew with calcium and vitamin D while telling the patient to “be careful” not to damage the weakening structure.

But Wolff’s Law revealed the missing piece of the puzzle.

Embedded within the bone matrix are specialized foreman cells called osteocytes.

These cells are mechanical sensors; their job is to detect stress and strain on the building.¹⁰

When the load on the building is just the usual daily traffic (like walking), they don’t send out any special orders.

But when they detect a new, unusually high level of stress—a significant load—they sound the alarm.

They send out urgent biochemical signals that tell the construction crew (osteoblasts) to get to work, to build the structure back stronger and denser than before so it can handle that heavy load in the future.¹⁰

This led me to the most critical concept I had been missing: osteogenic loading.

This is the term for the minimum amount of mechanical stress required to trigger that bone-building alarm.

It’s the threshold that must be crossed to signal the osteoblasts to start building.

And here was the gut punch: research from the UK, using accelerometers to measure the forces of different activities, suggests that this osteogenic loading threshold is a force of approximately 4.2 times your body weight.¹⁸

This single number explained everything.

It explained why Eleanor, despite her thousands of miles of walking, was left unprotected.

The advice I had been giving was based on a fundamental mismatch between the intervention and the biology.

We were telling patients to engage in “weight-bearing exercise,” a term so broad as to be meaningless.

Walking, which generates a force of only about 1 to 1.5 times body weight, doesn’t even come close to knocking on the construction foreman’s door, let alone sounding the alarm needed for new construction.¹⁸

We were sending a polite request for renovation when the bone required a seismic jolt.

This wasn’t a minor error in dosage; it was a categorical failure to prescribe an input that could possibly generate the desired output.

Part II: The Scientific Blueprint for Building Bone

Understanding Wolff’s Law was the “what.” Now I needed the “how.” If walking wasn’t enough, what was? The answer, I discovered, lay in the world of sports performance and a type of training designed specifically to generate maximum force: plyometrics.

Deconstructing Impact: The Power of Plyometrics

Plyometrics, often called jump training, is a category of exercise focused on producing fast, powerful, and explosive movements.¹⁹

The magic of plyometrics lies in a physiological mechanism called the

stretch-shortening cycle (SSC).²¹

Think of it like stretching a rubber band before letting it fly.

The SSC has three phases:

1. The Eccentric Phase (Loading): This is the pre-stretch. When you land from a jump, your muscles rapidly lengthen as they absorb the impact. This stores elastic energy, just like pulling back the rubber band.²²
2. The Amortization Phase (Transition): This is the brief pause between the landing and the subsequent jump. The shorter this phase, the more energy is retained.¹⁹
3. The Concentric Phase (Explosion): This is the release. The muscle rapidly shortens, releasing that stored elastic energy to produce a more powerful contraction than it could from a static position.²²

This rapid cycle of deceleration followed by acceleration produces an explosive reaction that generates maximal force in the shortest possible time.²³

This is precisely the kind of high-magnitude, high-rate-of-loading signal that the osteocytes—our bone’s construction foremen—are exquisitely tuned to detect.¹⁰

It’s the physiological equivalent of a sledgehammer blow, demanding an adaptive response.

The Evidence: From the Lab to Real-World Results

My conviction grew as I moved from theory to evidence.

The research was clear and consistent.

A 2024 systematic review and meta-analysis—a study that pools the results of many high-quality clinical trials—looked at 19 trials with over 666 participants.

The conclusion was unambiguous: jump training was highly beneficial for improving bone density, with particularly pronounced effects at the femoral neck, the very part of the hip that is so vulnerable to the kind of fracture Eleanor suffered.

These benefits were seen in both younger and older adults.²⁴

Another meta-analysis confirmed that high-impact jumping significantly improved bone mineral content in the lumbar spine and femoral neck, especially in girls, highlighting the importance of this activity in building a strong “bone bank” early in life.²⁵

But the cornerstone of the evidence, the study that provided the blueprint for a new standard of care, was the LIFTMOR trial.

This landmark Australian study, whose name stands for Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation, was revolutionary because it dared to challenge the prevailing wisdom about safety.²⁶

The researchers took a group of postmenopausal women over 58, all with low to very low bone mass (osteopenia or osteoporosis), and randomized them into two groups for an 8-month program.²⁶

• The Control Group: This group performed a low-intensity, home-based exercise program—the kind of “safe” advice I used to give. It included light resistance training with a maximum of 3 kg weights, walking, and stretching.²⁶
• The HiRIT Group: This group participated in a twice-weekly, 30-minute, fully supervised program of High-Intensity Resistance and Impact Training (HiRIT). The program was brilliantly simple and brutally effective, consisting of just four key exercises: deadlifts, overhead presses, back squats, and a high-impact loading exercise called “jumping chin-ups with drop landings”.²⁶ The resistance exercises were performed at a high intensity (5 sets of 5 repetitions at over 80-85% of their one-repetition maximum), and for the impact exercise, participants were instructed to jump up, grab an overhead bar, and then drop, landing “as heavily as comfortably possible” to maximize ground reaction forces.²⁶

The results were nothing short of breathtaking.

After eight months:

• The control group, doing the “safe” exercises, lost bone density, as is typical for this population.
• The HiRIT group showed a clinically significant increase in bone mineral density of nearly 4% in their lumbar spine and nearly 2% in their femoral neck.²⁶
• The HiRIT group also saw dramatic improvements in their height (indicating better posture and spinal strength) and all measures of functional performance.²⁹
• And the most important finding of all? In the fully supervised, progressively loaded HiRIT group, there were zero fractures or serious injuries.²⁹

The LIFTMOR trial did more than just prove that high-intensity exercise works.

It provided a roadmap for how to do it safely.

Its success was not accidental; it was built on a foundation of four crucial pillars: screening (participants were carefully selected), preparation (the first month was dedicated to learning proper form with low loads), supervision (every session was led by a qualified exercise scientist or physiotherapist), and progression (loads were increased gradually as participants got stronger).²⁶

This resolved the great paradox I had been wrestling with.

The reason mainstream guidelines from respected bodies like the Mayo Clinic or the International Osteoporosis Foundation advise caution with high-impact exercise is the perceived risk of fracture.³⁰

This creates a chasm between the most effective intervention and what is considered safe.

LIFTMOR bridged that chasm.

It proved that the risk is not inherent to the impact itself, but to the

unsupervised, unprepared, and non-progressive application of it.

When done correctly, the most potent medicine for bone is also a safe one.

Furthermore, the study design highlighted another critical nuance: the need for a combined approach.

While meta-analyses show that jumping is fantastic for the hips, its effect on the spine is less clear.²⁴

The LIFTMOR protocol, which

did produce significant spinal improvements, paired impact loading with heavy, full-body resistance exercises like deadlifts and squats.²⁶

This makes perfect biomechanical sense.

The vertical ground reaction forces from a jump travel directly up the legs to load the hips.

But to create the necessary compressive forces on the vertebrae of the spine, you need to lift heavy things.

Therefore, the optimal program isn’t just “jump training”; it’s a combination of high-impact loading for the hips and high-intensity resistance training for the spine and the rest of the body.

To make this distinction clear for my patients, I developed a simple table.

Table 1: The Bone-Loading Spectrum: Why Your Daily Walk Isn’t a Bone-Builder

Exercise	Description	Estimated Ground Reaction Force (x Bodyweight)	Primary Bone Benefit
Swimming/Cycling	Non-weight-bearing; body is supported by water or the bike.	< 1.0x	Negligible bone-building effect. Excellent for cardiovascular health but must be supplemented with other exercises for bone.3
Walking	Low-impact; one foot is always on the ground.	~1.0x – 1.5x	Primarily a maintenance effect on bone; insufficient stimulus for significant new growth in most individuals.18
Brisk Walking/Hiking	Low-to-moderate impact; faster pace and varied terrain increase forces.	~2.0x – 3.0x	Minimal to modest bone-building benefit. Better than walking, but still likely below the optimal threshold.14
Running/Jogging	High-impact; involves a “flight” phase where both feet are off the ground.	~3.0x – 5.0x	Good benefit; approaches or meets the osteogenic loading threshold needed to stimulate new bone growth.18
Jumping/Hopping	High-impact; designed to maximize vertical force production and absorption.	4.0x – 8.0x+	Excellent benefit; clearly exceeds the osteogenic threshold, providing a powerful signal for bone formation, especially at the hip.18

This table became a powerful tool.

It allowed me to show patients, in black and white, why their diligent efforts with walking weren’t yielding the results they so desperately wanted.

It wasn’t their fault; they were simply using the wrong tool for the job.

Now, it was time to give them the right one.

Part III: The “Jump Start” Protocol: Your Progressive Path to Stronger Bones

Armed with this new understanding, I developed a protocol for my patients.

I call it the “Jump Start” program.

It’s not a one-size-fits-all prescription, but a progressive framework designed to safely and effectively introduce the kind of impact that builds stronger bones.

It is built on the LIFTMOR principles of preparation, progression, and respect for individual capacity.

The Non-Negotiable Safety Screen: Are You Ready to Jump?

Before a single jump is attempted, we must ensure the body is ready for the forces involved.

This is the most important step, as it turns a potentially risky activity into a safe and therapeutic one.

I have three non-negotiable prerequisites that I discuss with every patient, and I urge you to discuss them with your doctor or physical therapist.

1. The Strength Prerequisite: Can you perform a proper bodyweight squat? This is a critical test. A squat demonstrates that you have the necessary strength in your glutes, quads, and core to control your descent and, more importantly, to absorb the landing forces of a jump correctly. If you cannot squat with good form (e.g., keeping your chest up and knees aligned over your feet), then jumping is not yet safe. Your first step is to build that foundational strength.²⁴
2. The Balance Prerequisite: Do you feel steady on your feet? Poor balance significantly increases the risk of falls, and a fall is what we are ultimately trying to prevent. A simple self-screen is to try standing on one leg near a sturdy counter for support. If you are wobbly or cannot hold it for at least 10-15 seconds, your priority must be balance training before you begin impact exercises.⁶
3. The Medical Clearance Prerequisite: You must have a conversation with your healthcare provider. This is especially true if you have a history of recent fractures (particularly vertebral compression fractures), severe joint pain or arthritis, or other health conditions like heart disease that could make strenuous exercise risky.⁵

A Phased, Progressive Program: Building Confidence and Capacity

Once cleared for activity, the program begins.

It is broken into three distinct phases, each designed to build on the last.

The goal is to build not just physical capacity but also psychological confidence, systematically dismantling the fear of movement that so often accompanies osteoporosis.

Phase 1: Foundation (Weeks 1-4) – “Mastering the Landing”

The goal of this phase is not to jump.

The goal is to build the unshakable foundation of strength, stability, and control needed to make future jumping safe.

We are teaching the body how to absorb force correctly.

• Key Exercises:

• Chair Squats: Sit down and stand up from a sturdy chair without using your hands. This builds functional leg and glute strength.
• Bodyweight Squats: Once chair squats are easy, progress to full bodyweight squats, focusing on perfect form.
• Heel Drops: Stand on the edge of a step, rise up onto your toes, and then drop your heels down forcefully. This provides a small, controlled impact.³³
• Stomping: Simply marching in place and stomping your feet. The goal is to get used to the idea of creating impact.
• Balance Training: Practice tandem stance (heel-to-toe walking) and single-leg stands, holding onto a counter for support as needed.¹⁵

Phase 2: Introduction to Impact (Weeks 5-8) – “Getting Off the Ground”

Now that the foundation is set, we introduce low-level plyometrics.

The jumps are small, and the focus is on technique and letting the body and mind adapt to the new sensation of impact.

• Key Exercises:

• Jump Rope (or “Ghost” Jumping): Start with 30-60 seconds of jumping rope. If you don’t have a rope or find it difficult, simply “ghost” jump—perform the same motion, jumping just an inch or two off the ground.³⁴
• Two-Footed “Pogo” Jumps: Standing in place, perform small, continuous bounces, keeping your legs relatively straight and using your ankles like springs. The goal is minimal ground contact time.³⁵
• Low Box Jumps: Find a very low, stable surface (a 2-4 inch aerobic step is perfect). Practice jumping up onto the step with both feet and, importantly, stepping back down. We are not yet ready for the impact of jumping down.

Phase 3: Building Power (Weeks 9-12+) – “Reaching New Heights”

In this phase, we increase the intensity and complexity of the movements to maximize the bone-building stimulus.

This is where the real magic happens, but it can only be done safely after mastering the first two phases.

• Key Exercises:

• Full Squat Jumps: From a squat position, explode vertically, jumping as high as you comfortably can. Land softly back in the squat position to absorb the force.³⁴
• Box Jumps (Progressive Height): Gradually increase the height of the box you are jumping onto. The focus is on explosive power. Always step down until you are very advanced.
• Multi-Directional Hops: Perform small hops forward and back, and side to side. Bone loves to be surprised by novel loading patterns, and this challenges your stability in different planes of motion.³⁶
• Single-Leg Hops (Advanced): For those who have demonstrated excellent strength and balance, single-leg hopping is the pinnacle of at-home impact training. A well-researched protocol involves working up to 5 sets of 10 hops on each leg, with 15 seconds of rest between sets.³⁸ This should only be attempted after many months of consistent training and with professional guidance.

This entire framework is laid out in the table below, which I encourage my patients to print and discuss with their healthcare team.

Table 2: The Progressive “Jump Start” Program

Phase	Weeks	Primary Goal	Key Exercises (Frequency: 2-3 days/week)	Sets & Reps	Progression Criteria
1: Foundation	1-4	Build foundational strength, balance, and control. Master safe force absorption.	Bodyweight Squats: To a chair, then full depth. Heel Drops: Forceful drops off a step. Stomping: Marching with emphasis. Balance: Single-leg stands (near support).	2-3 sets of 10-15 reps. 2-3 sets of 30-60 sec holds.	Move to Phase 2 when all exercises can be performed with perfect form and no pain.
2: Introduction to Impact	5-8	Introduce low-level impact. Adapt neuromuscular system to jumping and landing.	“Ghost” Jump Rope: Small bounces in place. Pogo Jumps: Ankle-driven bounces. Low Box Jumps: Jump onto a 2-4 inch step, step down.	2-3 sets of 30-60 seconds. 2-3 sets of 8-10 reps.	Move to Phase 3 when you feel confident and controlled with these introductory impacts.
3: Building Power	9-12+	Increase impact magnitude and complexity to maximize bone-building stimulus.	Squat Jumps: Explode vertically from a squat. Box Jumps: Progress height slowly (4-12 inches). Multi-Directional Hops: Small hops in all directions. Single-Leg Hops (Advanced): After consultation with a PT.	3-4 sets of 8-12 reps. 3-4 sets of 10 hops per direction.	Progress slowly. Increase reps or jump height only when the current level feels easy and is pain-free.

Part IV: The Safety Net — Navigating Risks, Myths, and Realities

Adopting a new, more intensive approach to exercise requires courage, especially when you’ve been conditioned to be fearful.

This final section is designed to be your safety Net. It will clearly define who should stick to lower-impact options and directly confront the pervasive myths that can hold you back.

Who Should NOT Jump? The Clear Contraindications

High-impact training is a powerful tool, but it is not for everyone.

Based on authoritative guidelines from organizations like the Royal Osteoporosis Society and the Mayo Clinic, as well as sound clinical judgment, there are specific situations where high-impact exercise should be avoided.⁶

You should stick to lower-impact weight-bearing exercise and progressive resistance training if you have:

• A history of spinal fractures: The spine is more vulnerable after a compression fracture, and the focus should be on posture and back extensor strengthening, not high impact.³²
• Multiple non-spinal fractures: A history of many broken bones indicates a higher level of skeletal fragility where caution is paramount.³²
• Severe, painful joint arthritis: If your knees, hips, or ankles are already painful and compromised, the repetitive impact of jumping can worsen the condition. In this case, the focus should be on muscle strengthening without the impact.³²
• A high risk of falls: If you have significant balance deficits, muscle weakness, or a history of frequent falls, your primary intervention must be a targeted strength and balance program to reduce your fall risk. Impact can be added later, once you are stable and strong.⁶
• Other medical conditions that preclude high-intensity or high-impact activity. Always defer to the judgment of your medical doctor or physical therapist.⁴⁰

For these individuals, the goal is not to be sedentary.

The goal is to choose the right exercises: progressive resistance training, lower-impact activities like brisk walking or using an elliptical, and dedicated balance and posture work.⁴¹

Myth-Busting: Reclaiming Your Power from Fear

Misinformation about osteoporosis is rampant, and it almost always leans toward fear and inaction.

Let’s dismantle the most common and damaging myths with evidence.

Myth 1: “Exercise is too risky if I have osteoporosis. I might fall and break a bone.”

The Reality: This is perhaps the most dangerous myth of all.

While a fracture during exercise is a theoretical risk, the evidence overwhelmingly shows that inactivity is the far greater danger.

A properly designed exercise program, even one that includes impact, does two critical things: it strengthens your bones, making them more resistant to fracture, and it strengthens your muscles and improves your balance, which dramatically reduces your risk of falling in the first place.⁶

The LIFTMOR trial is the ultimate proof: the high-intensity group got stronger and had no injuries, while the “safe” low-intensity group got weaker.²⁶

Not exercising is the riskiest choice you can make.⁴²

Myth 2: “I have osteoporosis, so I should only do gentle exercises like walking, swimming, or cycling.”

The Reality: While these activities are excellent for cardiovascular health and should be part of a healthy lifestyle, they are not effective bone-building exercises.³²

Swimming and cycling are non-weight-bearing, providing almost no load to the skeleton.

Walking, as we’ve seen, provides a load that is too low to trigger significant new bone growth.¹⁸

Your bones don’t need to be coddled; they need to be challenged.

They require the specific stimulus of high-impact and high-intensity loading to adapt and grow stronger.⁴²

Myth 3: “It’s too late for me. You can’t build new bone after menopause.”

The Reality: This is demonstrably false.

While it is true that bone loss accelerates after menopause due to the drop in estrogen, it is not an irreversible slide into fragility.⁴³

The women in the LIFTMOR trial were, on average, more than 10 years post-menopause and had low to very low bone mass, yet they achieved significant increases in bone density in their hips and spine in just eight months.²⁶

Other studies have shown that even men in their 70s and postmenopausal women can build bone density with a simple one-legged hopping program.³⁸

It is never too late to make your bones stronger.

Myth 4: “I would know if I had osteoporosis. I’d feel my bones getting weaker.”

The Reality: Osteoporosis is called “the silent disease” for a reason.⁴

There are no symptoms.

You do not feel your bones losing density.

The very first sign for many people is a fracture from a minor incident—a fall from standing height, or even a strong cough or bending over to tie a shoe.⁴⁴

You cannot rely on your body’s sensations to gauge your bone health.

The only way to know is through a bone density scan (DXA).⁴³

Table 3: Myth vs. Fact — A Quick Reference Guide

Common Myth	The Evidence-Based Reality
“Exercise is too risky with osteoporosis.”	Inactivity is the greater risk. Supervised, progressive exercise strengthens bones and muscles, reducing your overall risk of falls and fractures.6
“Only gentle, low-impact exercise is safe.”	Gentle exercise is insufficient. Bones require high-impact and high-intensity loads to stimulate new growth. The key is safe, progressive application.18
“You can’t build bone after menopause.”	False. Landmark studies like the LIFTMOR trial prove that postmenopausal women with low bone mass can significantly increase their bone density with the right training.26
“I’d feel my bones getting weaker.”	Osteoporosis is a “silent disease.” The first sign is often a fracture. A DXA scan is the only way to know your bone density.4
“Osteoporosis is just a normal part of aging.”	Some bone loss is normal, but osteoporosis is a disease that can and should be managed. It is not an inevitable consequence of getting older.43

Conclusion: From Eleanor’s Fall to Joan’s Flight

My journey from a purveyor of ineffective advice to an advocate for high-intensity training was driven by the heartbreaking failure of the old model, embodied by Eleanor’s fall.

But the story doesn’t end there.

The true reward has been seeing the success of the new model, a success I see in patients like Joan.

Joan came to my clinic a year ago.

She was 65, recently diagnosed with osteoporosis in her hip, and she was terrified.

Her older sister had fractured a hip, and Joan saw her own future mirroring that slow, painful decline.

She was afraid to travel, afraid to play with her boisterous grandchildren, afraid of her own body.

She was the perfect candidate for the old, “safe” advice, but I knew that would be a betrayal.

Instead, we talked about Wolff’s Law.

We talked about the construction site inside her bones.

We started the “Jump Start” protocol.

Her first few weeks were filled with hesitation.

The chair squats felt strenuous, the idea of stomping felt silly.

But she was consistent.

By the end of the first month, she was squatting with confidence.

In Phase 2, her first “pogo” jumps were tiny, tentative movements, but they were a start.

A flicker of a smile appeared when she realized she could do it without pain.

The real transformation happened in Phase 3.

As she progressed to full squat jumps and then to low box jumps, her fear visibly melted away, replaced by a look of fierce concentration and empowerment.

She wasn’t just building bone; she was rebuilding her relationship with her body, reclaiming it from the narrative of fragility.

Ten months after we started, Joan had her follow-up DXA scan.

The results showed a 2.2% increase in the bone mineral density of her femoral neck.

Her doctor was stunned.

Joan was ecstatic.

But the number on the page wasn’t the real victory.

The real victory was the photo she emailed me last month.

It was of her and her eight-year-old grandson, both mid-air, jumping on a trampoline.

Her face was pure joy.

Your bones are not your enemy.

They are not fragile glass waiting to shatter.

They are living, breathing, and brilliantly adaptive structures, hungry for the right kind of challenge.

The journey to a stronger skeleton and a more confident life doesn’t begin with fear and avoidance.

It begins with a new understanding, a solid plan, and the courage to take that first, powerful, and intentional jump.

I urge you to take this information, share it with your doctor or physical therapist, and start a new conversation—one based on the science of adaptation, not the myth of fragility.

Works cited

1. Osteoporosis Risk Factors | UC San Diego Health, accessed on July 31, 2025, https://health.ucsd.edu/care/endocrinology-diabetes/osteoporosis/risk-factors/
2. Osteoporosis Risk Factors – Healthy Bones Australia, accessed on July 31, 2025, https://healthybonesaustralia.org.au/your-bone-health/risk-factors/
3. Osteoporosis | Better Health Channel, accessed on July 31, 2025, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis
4. Osteoporosis – causes, symptoms, diagnosis and treatments – Healthdirect, accessed on July 31, 2025, https://www.healthdirect.gov.au/osteoporosis
5. BONE BASICS, accessed on July 31, 2025, https://www.bonehealthandosteoporosis.org/wp-content/uploads/ExcerciseForYourBoneHealth.pdf
6. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis | British Journal of Sports Medicine, accessed on July 31, 2025, https://bjsm.bmj.com/content/56/15/837
7. Effects of balance training on balance and fall efficacy in patients with Osteoporosis: A systematic review and meta-analysis with trial sequential analysis | Journal of Rehabilitation Medicine, accessed on July 31, 2025, https://medicaljournalssweden.se/jrm/article/view/4529
8. New to osteoporosis and overwhelmed – Mayo Clinic Connect, accessed on July 31, 2025, https://connect.mayoclinic.org/discussion/new-to-osteoporosis-and-overwhelmed/
9. International Osteoporosis Foundation | IOF, accessed on July 31, 2025, https://www.osteoporosis.foundation/
10. Physiology, Bone Remodeling – StatPearls – NCBI Bookshelf, accessed on July 31, 2025, https://www.ncbi.nlm.nih.gov/books/NBK499863/
11. Wolff’s law – Wikipedia, accessed on July 31, 2025, https://en.wikipedia.org/wiki/Wolff%27s_law
12. “Wolff’s – law” and bone functional adaptation, accessed on July 31, 2025, https://www.veterans.nd.gov/sites/www/files/documents/resource/Wolff’s%20Law.pdf
13. Wolff’s Law: A Way of Understanding How Bones Change – WebMD, accessed on July 31, 2025, https://www.webmd.com/osteoporosis/what-is-wolffs-law
14. Wolff’s Law – Physiopedia, accessed on July 31, 2025, https://www.physio-pedia.com/Wolff%27s_Law
15. The Complete Osteoporosis Exercise Guide: Safely Building Confidence and Strength, accessed on July 31, 2025, https://inmotionptny.com/www-inmotionptny-com-osteoporosis-exercise-guide/
16. Osteoporosis – Causes – NHS, accessed on July 31, 2025, https://www.nhs.uk/conditions/osteoporosis/causes/
17. Osteoporosis – Symptoms and causes – Mayo Clinic, accessed on July 31, 2025, https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
18. BONESENSE on…. – OSTEOGENIC LOADING – Bone Health & Osteoporosis Foundation, accessed on July 31, 2025, https://www.bonehealthandosteoporosis.org/wp-content/uploads/Handout_OSTEOGENICLOADING.pdf
19. Plyometrics – Physiopedia, accessed on July 31, 2025, https://www.physio-pedia.com/Plyometrics
20. Designing a Plyometric Training Program | Muscle&Motion – Muscle and Motion, accessed on July 31, 2025, https://www.muscleandmotion.com/designing-a-plyometric-training-program/
21. The effects of plyometric jump training on physical fitness attributes in basketball players: A meta-analysis – PMC – PubMed Central, accessed on July 31, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9729929/
22. Chapter 19: Principles of Plyometric Training – Trainer Academy, accessed on July 31, 2025, https://traineracademy.org/cpt-textbook/principles-of-plyometric-training/
23. CURRENT CONCEPTS OF PLYOMETRIC EXERCISE – PMC, accessed on July 31, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC4637913/
24. Jump Training for Osteoporosis: Does It Increase Bone Mineral Density? – Melio-guide, accessed on July 31, 2025, https://melioguide.com/weight-bearing/jump-training-osteoporosis/
25. Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis | Request PDF – ResearchGate, accessed on July 31, 2025, https://www.researchgate.net/publication/377930121_Skeletal_site-specific_effects_of_jump_training_on_bone_mineral_density_in_adults_a_systematic_review_and_meta-analysis
26. LIFTMOR Controlled Trial for Osteoporosis and Low Bone Mass, accessed on July 31, 2025, https://melioguide.com/osteoporosis-exercises/liftmor-osteoporosis-osteopenia/
27. LIFTMOR: Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation – Griffith Research Online, accessed on July 31, 2025, https://research-repository.griffith.edu.au/server/api/core/bitstreams/b6b80b27-44f2-4f82-a315-370c13c7e34f/content
28. Strong, steady, and straight: Physical activity and exercise recommendations for osteoporosis – Physiotutors, accessed on July 31, 2025, https://www.physiotutors.com/strong-steady-and-straight-physical-activity-and-exercise-recommendations-for-osteoporosis/
29. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial – PubMed, accessed on July 31, 2025, https://pubmed.ncbi.nlm.nih.gov/26243363/
30. EXERCISE – International Osteoporosis Foundation, accessed on July 31, 2025, https://www.osteoporosis.foundation/sites/iofbonehealth/files/2022-09/exercisebrochure_web.pdf
31. Exercising with osteoporosis: Stay active the safe way – Mayo Clinic, accessed on July 31, 2025, https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989
32. Exercise for bone health – Royal Osteoporosis Society, accessed on July 31, 2025, https://theros.org.uk/information-and-support/bone-health/exercise-for-bones/
33. Physical Therapy Guide to Osteoporosis – Choose PT, accessed on July 31, 2025, https://www.choosept.com/guide/physical-therapy-guide-osteoporosis
34. Plyometric Jump Training Exercises – Verywell Fit, accessed on July 31, 2025, https://www.verywellfit.com/plyometric-jump-training-3120003
35. Basic Plyometrics for Runners – Run and Become, accessed on July 31, 2025, https://www.runandbecome.com/running-training-advice/basic-plyometrics-for-runners
36. The 16 Best Plyometric Exercises to Power-Up Your Training – BarBend, accessed on July 31, 2025, https://barbend.com/best-plyometric-exercises/
37. Getting the Jump On Healthy Bones! | Bill Burnett’s Success Studio | Simplified Personal Training, accessed on July 31, 2025, https://www.successstudiopt.com/blog/jump-for-your-bones
38. A Hopping Big Gain for Exercise Research: One-Legged Hopping …, accessed on July 31, 2025, https://betterbones.com/exercise/hopping-osteoporosis/
39. Exercise for individuals with osteoporosis, accessed on July 31, 2025, https://www.osteoporosis.foundation/health-professionals/prevention/exercise/exercise-individuals-with-osteoporosis
40. Too Fit To Fracture | Osteoporosis Canada, accessed on July 31, 2025, https://osteoporosis.ca/too-fit-to-fracture/
41. Osteoporosis Exercise for Strong Bones, accessed on July 31, 2025, https://www.bonehealthandosteoporosis.org/patients/treatment/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/
42. Breaking the myths: the truth about bone health and exercise for osteoporosis – Physiotherapist Brisbane City, Physio Therapy, accessed on July 31, 2025, https://northwestphysio.com.au/breaking-the-myths-the-truth-about-bone-health-and-exercise-for-osteoporosis/
43. Debunking 5 Osteoporosis Myths – McLeod Health, accessed on July 31, 2025, https://www.mcleodhealth.org/blog/debunking-5-osteoporosis-myths/?crb_phantom_pdf_paged=yes&single_post=yes&key=1616586309
44. Top 10 Myths about Osteoporosis – Cooper University Health Care, accessed on July 31, 2025, https://www.cooperhealth.org/sites/default/files/pdfs/Osteo-Top10Myths.pdf
45. Top 10 Osteoporosis Myths and the Facts You Need to Know – Network Health, accessed on July 31, 2025, https://networkhealth.com/grow-in-the-know/2024/05/top-10-osteoporosis-myths-and-the-facts-you-need-to-know