Whether you’re a child climbing in the playground or playing sport, an adult managing work and family life, or an older adult wanting to stay active and independent, you need healthy bones! Poor bone health can limit your function, independence and quality of life.
For many people, bone health only becomes a priority when they experience a problem or start to notice the effects of ageing. However, did you know that bone mass is one of the most important modifiable factors in determining lifelong skeletal health (Hereford et al., 2025) and we need to think about it at every age.
The bony structure of your body is known as your skeleton. It is remarkable because it:
- Creates a structural framework which holds up soft tissue and organs to keep us upright
- Creates a stable foundation that works with muscles across joints to enable movement
- Provides protection for the brain, lungs, heart and pelvic organs
- Produces red blood cells and acts as a vital mineral storage location
Bone is adaptive, meaning that it forms, remodels and resorbs/breaks down depending on different circumstances (Hart et al., 2020). It may surprise you to know that peak bone mass is built by your mid-to-late 20s. At this age you have achieved the maximum bone mass you will have in your life.
Between 20-50 years old bone mass plateaus but can remodel and after 50 years bone mass begins to decline. Did you know that those who obtained a higher bone mass prior to their late 20s were found to be better protected against osteoporosis and fractures later in life (Hereford et al., 2025).
If you have already hit or moved past your late 20s milestone, fear not! It is never too late to optimise your bone health. This article will guide you through things you can do at each stage of life to help.
Childhood and adolescence
Many refer to this stage as the opportunity to “build your bone bank”. 40-60% of adult bone is accrued in childhood and adolescence (Hereford et al., 2025) so we need to prioritise bone health during this timeframe.
Top tips to consider:
Get children and adolescents engaged in physical activity. This could include things like jumping, running, playing on play equipment or team sports. It can also include active chores such as walking the dog or helping with gardening. Research suggests that physical activity 1-2 times per week at this age increases bone mineral content and density which reduces the risk of fracture in life (Hereford et al., 2025).
In addition, by engaging children and adolescents in physical activity you are fostering a culture which will have many more positive outcomes on their general health, improves motor skills, improves speed and power, builds self-esteem and reduces risks of injury (Hereford et al., 2025). During adolescence, participation in physical activity tends to decline, particularly amongst girls (Owen et al., 2017). For this reason encouraging children and adolescents to stay active and advocating for greater participation in sport is important.
Weight-bearing exercises and strength training are critical in helping children reach optimal peak bone mass
Good nutrition
Calcium-rich foods are an essential part of maintaining strong, healthy bones. Calcium is also important for muscle, heart and nerve health. Our favourite sources include anything dairy, tinned salmon/sardines, and almonds. If you need a non-dairy option go for calcium enriched plant-based milks. The Healthy Bones website has more information.
Vitamin D is vital for calcium absorption, healthy bone growth and maintenance. The best way to get this is spending some time outdoors, while balancing this with sensible sun safety practices. The Cancer Council of Australia recommends:
When the UV Index is 3 or higher (summer) spending a few minutes outdoors on most days of the week is adequate to get vitamin D
When the UV index is 3 or lower (autumn or winter) spending time outdoors in the middle of the day with some skin uncovered is appropriate to get adequate vitamin D
Food does not provide an adequate amount of vitamin D however it can be found in some food choices such as egg yolk, fatty fish and meat. The Healthy Bones website has more information.
Adulthood
As an adult wanting to optimise your bone health you need to “protect what you have built”
Research shows that combining weight-bearing exercise with resistance training is one of the most effective ways to maintain bone density throughout adulthood (Nikander et al., 2010; Ng et al., 2023).
In women specifically, bone health after menopause becomes extremely important. After menopause, levels of oestrogen drop and this can accelerate bone remodelling whereby bone resorption occurs at a faster rate than bone formation. Women can lose up to 10% of their bone mineral density within the first 5 years after menopause which significantly increases the risk of osteoporosis and fragility fractures (Australasian Menopause Society, 2026).
There is good quality evidence showing that a supervised, progressive, high-intensity resistance and impact training program safely improved bone density, muscle strength and physical function in postmenopausal women with low bone mass (Watson et al, 2018). This is exciting because it means you can do something to help your bones!
At Sydney Pelvic Clinic we have a Bone Builders exercise program run by physiotherapists and exercise physiologists developed based on this evidence to help you achieve these results. What sets the Sydney Pelvic Clinic Bone Builders program apart is our unique ability to help you improve bone strength while also protecting and optimising your pelvic floor. Our physiotherapists tailor your program to ensure it is both effective for bone health and appropriate for your pelvic floor, so you can build strength with confidence and exercise safely.
Older adults
In older adults the goal of maintaining bone strength is to “protect your bone bank”, remain strong and independent. A combination of weight-bearing, resistance training and challenging balance exercises are recommended for bone health, muscle health and to reduce the risk of falls and serious injury.
Beyond our Bone Builders program, we offer a range of classes designed to help you stay strong, active and confident as you age. Our Strength and Mobility classes are delivered in a convenient hybrid format, allowing you to participate either in the clinic or from the comfort of your home. Our 4:1 small-group classes provide individualised guidance to help you work towards your specific goals in a supportive environment.
Book an assessment with our team today, and we’ll help you find the program that’s the best fit for your needs, lifestyle and goals.
So what are you waiting for?
- If you have children help them be physically active and get good nutrition.
- If you have older parents make them aware of the importance of their bone health
- And for yourself, pick one thing you will do this week to optimise your bone health.
- The choices you make today can strengthen your bones for decades to come!
References
- Hereford, T., Kellish, A., Samora, J. B., & Reid Nichols, L. (2025). Understanding the importance of peak bone mass. Journal of the Pediatric Orthopaedic Society of North America, 7(2), Article 100031. https://doi.org/10.1016/j.jposna.2024.100031
- Hart, N. H., Newton, R. U., Tan, J., Rantalainen, T., Chivers, P., Siafarikas, A., & Nimphius, S. (2020). Biological basis of bone strength: Anatomy, physiology and measurement. Journal of Musculoskeletal and Neuronal Interactions, 20(3), 347–371.
- Owen, M. B., Curry, W. B., Kerner, C., Newson, L., & Fairclough, S. J. (2017). The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Preventive Medicine, 105, 237–249. https://doi.org/10.1016/j.ypmed.2017.09.018
- Nikander, R., Sievänen, H., Heinonen, A., Daly, R. M., Uusi-Rasi, K., & Kannus, P. (2010). Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life. BMC Medicine, 8, Article 47. https://doi.org/10.1186/1741-7015-8-47
- Ng, C.-A., Beck, B. R., Harding, A. T., Daly, R. M., & Weeks, B. K. (2023). Effects of moderate- to high-impact exercise training on bone structure across the lifespan: A systematic review and meta-analysis of randomized controlled trials. Journal of Bone and Mineral Research, 38(11), 1612–1634. https://doi.org/10.1002/jbmr.4899
- Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2018). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR randomized controlled trial. Journal of Bone and
- Mineral Research, 33(2), 211–220. https://doi.org/10.1002/jbmr.3284
- Australasian Menopause Society. (2026). Menopause and bone health – Decreasing the risk of osteoporosis [Fact sheet]. https://hub.menopause.org.au/Play?pId=b982016e-27ba-49ea-9689-051544d45a03
- Healthy Bones Australia fact sheets linked
https://healthybonesaustralia.org.au/wp-content/uploads/2022/10/hba-fact-sheet-calcium.pdf
https://healthybonesaustralia.org.au/wp-content/uploads/2026/03/hba-fact-sheet-vitamin-d-v3-6-3-26.pdf - Sydney Pelvic Clinic references linked
Exercise Therapy: Strength & Mobility Class
Exercise Therapy
Bone Builders Class - Cancer Council- linked
https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/vitamin-d
