Osteopenia, Sarcopenia and Dynapenia: Why Loading Matters for Ageing Well

Build strength today to support the life you want tomorrow.

Whether you enjoy hiking, lifting weights, playing golf, gardening or keeping up with your children and grandchildren, your bones and muscles help make it possible.

Looking after them is worthwhile long before you notice a problem.

Three conditions, osteopenia, sarcopenia and dynapenia, describe changes in bone density, muscle health and strength. Understanding them can help you make informed choices about exercise, whether your goal is prevention, improving performance or managing an existing diagnosis.

Our upcoming seminar, Strong for Life: The science of ageing, presented by Mark Derrick and Chris Seville, will explore how strength training can support your health as you age.

What are the three “penias”?

Osteopenia: reduced bone density

Osteopenia means bone mineral density is below the normal reference range, but has not reached the threshold used to diagnose osteoporosis.

You can feel fit, active and strong while having low bone density. A diagnosis is an opportunity to review your bone health and take steps to protect it.

Sarcopenia: reduced muscle strength and muscle quantity or quality

Sarcopenia is commonly described as muscle loss, but it involves more than muscle size. Modern definitions place low strength at the centre of assessment, with reduced muscle quantity or quality helping confirm the diagnosis.

Muscle health matters for everything from sport and recreational activity to everyday tasks.

Dynapenia: reduced muscle strength

Dynapenia describes the loss of muscle strength associated with ageing.

Strength depends on both your muscles and how effectively your nervous system activates them. This means strength can decline without a substantial change in muscle size.

Think of the three as bone density, muscle health and strength: closely connected, but each deserving attention.

Why take a prevention approach?

You don’t need to wait for a low bone density result or difficulty with daily activities to start strength training.

Perhaps you are already active and want to keep enjoying your sport. You might be approaching retirement and planning walking holidays. Or you may want to build a more consistent exercise routine now.

In each case, the goal is to develop and maintain capacity for the activities that matter to you.

Being active is a great foundation. The next question is whether your exercise routine adequately challenges your bones, muscles, strength and balance. Different activities contribute in different ways, so a varied program can help cover these needs.

What is axial loading?

Axial loading means applying force along the length of a structure, such as a bone or the spine.

Standing creates axial loading through parts of your skeleton. Adding resistance to certain exercises can increase that load. Depending on the movement and technique, examples include weighted squats, overhead presses and carrying weights while upright.

These exercises also involve muscle pull and other forces that contribute to the training stimulus.

Axial loading can be a useful part of progressive resistance training. Its value depends on the exercise, the amount of load and how it is progressed.

How loading can support bones, muscles and strength

Giving bones a reason to adapt

Bone is living tissue that responds to mechanical demands. Appropriately prescribed loading can help maintain or improve bone strength.

To stimulate bone formation, known as osteogenesis, exercise needs to provide a sufficiently challenging stimulus. Simply moving or repeatedly lifting a very light weight may not provide enough stimulus for meaningful bone adaptation.

In the Australian LIFTMOR trial, screened postmenopausal women with low bone mass completed eight months of closely supervised resistance and impact training. Their bone density and physical function outcomes were better than those of women completing a low intensity home program.

These findings support carefully progressed, supervised training for suitable participants. They do not mean everyone should begin with heavy lifting.

Building and maintaining muscle capacity

Resistance exercise challenges muscles to work against a load. Progressing that challenge helps develop the capacity needed for both recreation and everyday life.

That might mean stronger legs for hiking, greater capacity to carry equipment, or maintaining the strength to move confidently as you get older.

Resistance training is a central recommendation in Australian and New Zealand sarcopenia management guidance, alongside attention to nutrition.

Developing useful strength

Strength training involves practising the production of force against resistance.

A squat challenges your ability to stand against a load. A carry challenges your grip and ability to support weight. These movements can be adapted from beginner exercises through to demanding training for experienced exercisers.

Axially loaded movements are one option. Machines, bands and supported exercises can also provide useful resistance.

The right starting point is individual. The aim is a useful challenge that you can perform well and build on over time.

Make strength part of your long term plan

A balanced routine can include progressive resistance training for muscle strength, suitable weight bearing and impact exercise for bone health, balance training for steadiness, and aerobic activity for fitness and endurance.

Your goals should help shape the program. Someone preparing for a hiking holiday may train differently from someone returning to the gym or managing osteoporosis.

Ageing well can mean preserving independence, but it can also mean continuing to pursue ambitious, enjoyable goals.

Frequently asked questions

I’m already fit and active. Is this relevant to me?

Yes. Fitness has several components, and your current activities may challenge some more than others.

The seminar is relevant to people who want to maintain their health, improve their training or understand how to support their bones and muscles before problems develop.

Is walking enough?

Walking is a valuable activity, but it usually does not replace progressive resistance training for developing strength. Bone health guidance recommends resistance exercise and appropriate impact activity, alongside balance work.

You can keep walking while adding other forms of exercise to address these needs.

Should I start strength training before I have low bone density or weakness?

You don’t need a diagnosis to make strength training part of your routine. A prevention approach means considering what you want your body to keep doing, then developing an exercise plan that supports those goals.

Do I need to lift heavy weights?

You don’t need to start with heavy weights, but the amount of load does matter, particularly for bone health.

Bone formation, or osteogenesis, requires a sufficiently challenging mechanical stimulus. Very light resistance may be useful for learning technique or getting started, but may not provide enough stimulus to improve bone density. The load generally needs to progress as your capacity improves.

There is no single weight in kilograms that works for everyone. The stimulus depends on the exercise, the bones being loaded, your current capacity and how the load is applied. Both muscle forces during resistance training and suitable impact exercise can contribute.

The aim is to build towards an effective level of loading with good technique and appropriate guidance.

Is lifting safe with osteopenia or osteoporosis?

Resistance training is recommended for many people with low bone density. Exercise selection and loading should be individualised, particularly if you have a previous spinal fracture, multiple fractures following minor trauma, significant pain or a high risk of falling.

Can I have normal bone density but still have weak muscles?

Yes. Bone density, muscle quantity and strength are different measures. A bone density scan does not measure strength, and muscle size alone does not fully explain how much force you can produce.

How often should I train?

Osteoporosis exercise guidance recommends muscle strengthening activity on two or three days each week. Your overall program should also account for your other activities, recovery and individual needs.

How quickly will I see results?

Different changes happen at different rates. Strength and function may improve before measurable changes in bone density.

Bone adaptation takes time: the LIFTMOR trial assessed results over eight months. A sustainable routine and appropriate progression are more useful than expecting an immediate change on a scan.

Is the seminar suitable if I’ve never been to a gym?

Absolutely. It is intended for people with a range of exercise backgrounds, from beginners to those who already train regularly.

Join us for Strong for Life: The science of ageing

What do you want to keep doing in 10 or 20 years, and how can you support that goal today?

Join Mark Derrick and Chris Seville for Strong for Life: The science of ageing, bringing together Healthy Bodies Physiotherapy and MD Strength.

We’ll explore osteopenia, sarcopenia and dynapenia, explain how loading can support bone and muscle health, and discuss how to choose an appropriate starting point.

Whether you are looking to prevent future problems, improve your current training or manage an existing condition, this seminar will help you understand your options.

Contact Healthy Bodies Physiotherapy on 03 9584 6919 to ask about the seminar and how to register.