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Let’s make progressive overload more approachable for bone health! Progressive overload is a term you hear often in fitness, especially when it comes to building stronger bones. But what does it actually mean? Progressive overload is the gradual increase in stress placed on the body during exercise to stimulate the musculoskeletal and nervous systems to adapt. I think many of us fall into the trap of believing that adding more weight is the only way to progressively overload our bodies. While increasing resistance is certainly one effective strategy, it also has its limitations. As we increase the demands on our bodies, we need to consider the health of our joints, muscles, connective tissues, and other structures involved in movement. The good news? Adding weight is just one of many tools we can use to progress our training! In Episode 87 of The Bone Health Blueprint podcast, I break down several other ways to approach progressive overload, including: 1.Increasing the number of repetitions 2.Increasing the number of sets 3.Increasing training frequency 4.Progressing to more challenging movements 5.Introducing exercise variations 6.Changing movement velocity The goal is to take a more well-rounded approach to progressive overload—one that allows us to continually challenge our bodies while being mindful of our ability to recover and adapt. Adding weight can be a great tool for building strength and stimulating our bones. But we can also take advantage of other programming strategies to become stronger, more resilient, and more capable. Remember, progressive overload is about more than lifting heavier. It’s about finding the right ways to keep challenging your body while still targeting improvements in our bones. 🦴💪🏻

The jump is only the beginning. The most important part may be how you land. If the goal is to use impact as a tool for bone health, our bones respond to several factors, including: • Landing forces of approximately 3× body weight or greater • A rate of force development around 43 body weights per second • Novelty and variation in the direction of loading to help limit accommodation And all of these factors are influenced by how you land. Research has shown that a flat-footed landing with a slight bend in the knees and hips can meet or exceed these bone-loading thresholds, even from relatively small jump heights—around 2–4 inches. But this landing technique isn’t appropriate for every type of jumping. As jump height or intensity increases, or when jumping from a box or platform, a softer, more athletic landing is generally more appropriate. This allows the muscles, joints, and connective tissue to better absorb and distribute the forces without unnecessarily exposing the body to forces far beyond what is needed. More isn’t always better. If your goal is bone-focused impact, think smaller jump heights and a controlled, flat-footed landing with a slight bend in the knees and hips. If your goal is power and neuromuscular development, you can jump higher and more explosively, using a softer, more athletic landing to help absorb the increased forces. The goal isn’t simply to jump higher. The goal is to use the right jump and the right landing for the adaptation you’re trying to create. Clissold, T., et. al. Jump-landings that supersede bone health threshold requirements for premenopausal women. Archives of Sports Medicine and Physiotherapy. 2022. pages 1-6

What is our capacity to improve muscular strength and muscle mass as we age, even into our 9th decade of life? A classic study published in JAMA provides a powerful answer. Researchers took a group of nine individuals in their 90s who had been living in a long-term care facility for an average of 3.5 years and put them through an 8-week high-intensity progressive strength training program. The program was simple. Three times per week, participants performed single-leg knee extensions for 3 sets of 8 repetitions at 80% of their one-repetition maximum. Every two weeks, their 1-RM was retested and the resistance was adjusted to ensure they continued training at the appropriate intensity. The results were remarkable. After just 8 weeks, the group improved their strength by an average of 174%. The average amount of weight lifted increased from 17 pounds to 45 pounds. But perhaps even more importantly, those improvements in strength carried over into everyday life. Some participants went from needing assistance to stand up from a chair to standing independently. Others who required a cane or other walking aid at the beginning of the study no longer needed one by the end of the program. Then came the other side of the equation. Once the study ended, all participants returned to their previous sedentary lifestyle. Just 4 weeks later, they had lost an average of 32% of the maximum strength they had gained. A powerful reminder of the old saying: If you don’t use it, you lose it. The ability to build strength, muscle, and physical capacity does not suddenly disappear because we reach a certain age. We know that exercise can create meaningful change throughout the lifespan. The key is finding an appropriate starting point, progressively challenging the body, and most importantly, creating a sustainable habit that keeps us moving forward. It’s never too late to get stronger. Study discussed: Fiatarone MA, et al. High-intensity strength training in nonagenarians: Effects on skeletal muscle. JAMA. 1990;263:3029–3034.

Resistance training is one of the most powerful tools we have to protect our strength, muscle mass, and independence as we age. But it’s not just about doing resistance training, it’s about how hard we train. Higher-intensity resistance training has been shown to produce greater improvements in muscle strength and mass than moderate intensity training. And perhaps even more importantly, those benefits may persist long after structured training ends. A recent study, “Heavy resistance training at retirement age induces 4-year lasting beneficial effects in muscle strength,” followed 369 adults with an average age of 71 for four years after completing a year-long resistance training program. The results were striking: Those in the high-intensity training group maintained their strength compared to baseline four years later, while those in the moderate-intensity group experienced declines in strength. In other words, training hard today may help build a greater reserve of strength to carry with you as you age. That’s one reason I believe appropriately dosed, progressive resistance training should be a cornerstone of any long-term approach to healthy aging and bone health. I dive deeper into this study and share my key takeaways in Episode 84 of The Bone Health Blueprint. Reference for this episode: Bloch-Ibenfeldt, M, et. al. Heavy resistance training at retirement age induces 4-year lasting beneficial effects in muscle strength: a long-term follow up on a RCT. BMJ Open Heart Sport & Exercise Medicine. 2024;10, 1-5

Building and maintaining your ability to generate power becomes increasingly important as you age. And when it comes to bone health, it’s not optional, it’s essential. Power is your ability to produce force quickly. It’s what helps you catch yourself when you trip, stabilize when you lose balance, and move with confidence in unpredictable situations. Training for power stimulates your nervous system to recruit fast-twitch muscle fibers, the ones responsible for producing higher force and faster reactions. These fibers are critical for both performance and protection. But here’s the catch: if you don’t train power, you lose it quickly. So how do you train it? Focus on the concentric (lifting) phase of movements: • Stand up quickly from a squat • Press a weight overhead with intent • Step onto a box with speed and control The goal is simple: move with as much intention and intensity as possible, while staying controlled and safe. Because your strength, your speed, and your ability to react are some of the most powerful tools you have to protect your bones. Articles used for this episode: McMillan, J. Power training for older women: strategies to improve function, confidence, and fall resistance. Strength and Conditioning Journal. 2026; Volume 48, number 3, 158-166 I recommend that you read this article! Lots of great take-away messages that you can use in your own training. And if you're looking for a supportive environment where you can work with me and others on the same journey you're on, be sure to check out trubeehealth.com and join my Strength for Bone Health online fitness community. See you there!

A meta-analysis involves a comprehensive and exhaustive literature review of a specific topic with a specific question and involves very strict inclusion and exclusion criteria for the investigations used for review and analysis. This is a great way for researchers to create a generalizable recommendation for a specific population.  The purpose of this investigation was to review, using a meta-analysis, the published randomized controlled trials and controlled trials on the effects of exercise training programs on bone mass of pre- and postmenopausal women. A majority of the studies reviewed for this investigation were 8 months or longer in duration, which is important as bone turnover takes time, many times this amount of time or longer to see measurable change.  Many studies involving higher intensity impact (2-3 days per week) saw significant and positive change in bone mass at the lumbar spine and/or the femoral neck. Additionally, studies involving resistance training (done around 75-80% of 1RM) saw either a protective effect or positive effect on bone mass. The overall treatment effect for the randomized controlled trials were found to be around 0.9% per year, meaning that exercise training programs prevented or reversed bone loss of almost 1% per year compared to the controls. Additionally, the osteogenic effects of exercise training seemed to be site-specific to the anatomical sites at which the mechanical strain occurred. Based on these data and more recent data, resistance training at 75%-85% of 1RM using compound exercises 2-3 times per week seems to have a protective and/or positive overall effect on bone mineral density.Impact training using moderate to higher intensity 2-3 times per week seem to have a positive effect on  bone mineral density as well. If possible, combining both resistance and impact training at this intensity level may be the best approach for positive results in bone health. Beginners and those with less experience should likely start with lower intensities of both types of training and slowly progress over time under the guidance of a qualified professional. Article used for this episode: Wolff. I. et. al. The effect of exercise training programs on bone mass: A meta-analysis of published controlled trials in pre- and postmenopausal women. Osteoporosis International (1999) 9:1-12. If you'd like to learn more about how you can work with Dr. Nick, be sure to check out his website trubeehealth.com or his Instagram page at dr.nicktrubee.

Ep. 81: Position Statement: Exercise guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients A position statement provides the author(s) stance on a topic based on the sum of all the evidence of a debatable topic. Osteoporosis treatment and management is not one-size-fits-all. Personal history, background, capacities and abilities of each person will differ, resulting in different approaches for combating or preventing bone loss.  However, having a defined structure in place based on evidence and randomized controlled trials provides some insight on how to approach exercise for each person. This episode dives into many important questions, such as:  The effectiveness of resistance training for osteoporosis?The type of resistance training that should be considered?Are impact exercises effective for improving osteoporosis? How can impact exercises effectively be applied?For each of these questions the authors have scoured the research databases to provide evidence in their support of using specific exercise to prevent or reverse osteoporosis.  Alongside these data, I give my perspective on how to apply these to your training based on my nearly two decades of experience working with individuals who’s goal is to create stronger bodies and bones! Article used for episode 81 of The Bone Health Blueprint: Bae. S.et. al. Position Statement: Exercise guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients. Journal of Bone Metabolism. 2023;30(2): 149-165. Want to take a deeper dive into your own training and work with Dr. Nick? Be sure to visit his website at trubeehealth.com and join his Strength for Bone Health community.

I call the heel drop exercise the "gateway into impact training." But does it actual meet or exceed the threshold for being osteogenic? Most research will define an impact training exercise that meets or exceeds 3-4 times your bodyweight as osteogenic, meaning it has the capacity to signal the bone for growth. Additionally, impact training and jump training can be less than approachable or do-able for many people. So, can the heel drop fill the void between no impact training and full on jump training? Does the heel drop meet the threshold to be osteogenic? Listen up as we dive into this article and shed some light on the forces at play (no pun intended) during this approachable and fun exercise. I also provide some insight as to how you can implement the heel drop into your routine on your journey to stronger bones. Article used for this episode of The Bone Health Blueprint: Ryan, CM. et. al. The osteogenic quantification and reliability of the heel drop and press up drop. International Journal of Science, Technology and Society. 2021; 9(6): 294-300. If you're interested in taking a deeper dive into training for bone health, be sure to check out Dr. Nick's website at trubeehealth.com.

This was an interesting study done in premenopausal women, ages 20 - 35 years old, during a 26 week long investigation. Three groups were used, a resistance training group, step-aerobics high impact group, and a control group.  The resistance training group completed a strength training routine at 65-80% of their 1RM, 3 times per week using the following exercises: leg press, back squat, leg extension, leg flexion, seated calf, standing calf, back extension and abdominal curl.  The step-aerobic high impact group performed a traditional step aerobics routine to music. After a 6 week familiarization period, subjects incorporated two legged landings (with an aerial phase). The number of landings increased from 50/session in week 7 to an average of 100/session in weeks 12-26. Tune in to get the full breakdown on the results of these two exercise modalities on bone mineral density and to get Dr. Nick's full take and discussion on how to implement the findings to your current workout program. Article used for this episide: Dutto, D.J. et.al., Effect of 6-month high-impact step aerobics and resistance training on BMD and tibial bending strength in sedentary premenopausal women. Osteoporosis International. (2022) 33:695-701. Want to learn more about how you can work with Dr. Nick? Be sure to check out his website https://trubeehealth.com/ or his Instagram page @dr.nicktrubee

The Bone Health Blueprint is your evidence-based guide to building stronger bones and maintaining independence for life. In every episode, I break down current research on exercise for osteoporosis prevention and bone growth, explain what the findings really mean, and give you practical, approachable strategies you can use immediately in your own fitness routine. As a doctor of exercise physiology with nearly two decades of experience in exercise and bone health, I help you cut through the confusion and focus on what truly works. Thanks for being here—and welcome to The Bone Health Blueprint.

In this episode, I dive into the research behind an intriguing combo: high-intensity progressive resistance training paired with self-talk. The featured study explores how these two strategies affect muscle strength and functional performance in older adults—and the results are worth paying attention to. I break down what the study found, how self-talk influenced outcomes, and what it all means for designing effective, evidence-based training programs for aging populations. Whether you’re a coach, clinician, or just curious about strategies for healthy aging, this episode will give you clear takeaways you can apply immediately. 👉 Tune in to learn how combining mindset and movement may be the key to unlocking better strength and performance later in life. Ferrando, V., et. al. Effects of high intensity progressive resistance training combined with self-talk on muscle strength and functional performance in older adults. Journal of Strength and Conditioning Research. 39(7)/736-744.

In this episode, I dive into a research review that analyzed the effects of full-body resistance training in postmenopausal women. The article pulls together findings from multiple studies to assess how structured strength training impacts metabolic health, bone density, muscular strength, and overall quality of life. Whether you’re a practitioner, a postmenopausal woman, or simply interested in the science behind strength training, this episode breaks down the evidence in a clear and practical way. 🎧 Tune in to learn what the research says—and what it means for your training approach. Islam, J. et al. Characteristics of resistance training programs targeting improvements in health outcomes in postmenopausal women: A scoping review. Journal of Strength and Conditioning Research. 39(7)/815-822.

Here’s why your split routine isn’t working… Let’s say you decided to do something adventurous and go on an ice fishing trip. You hit up the outdoor store and buy a ton of new equipment, warm clothes, supplies, etc. You jump on the plane and head to somewhere cold with a frozen lake. The day is finally here and you’re out on the ice starting to drill and pick away at making your fishing hole. Brutal work by the way. You finally get to fish and have a decent first day and catch a few fish. You say to yourself, that was a lot of work for a little return. Dissatisfied and exhausted from the work the day before, you choose to spend the rest of the week exploring the other attractions in the area.  On the last day of the trip, you decide to give fishing one more try. You grab your equipment and head back to your spot, only to notice the hole you worked so hard for is frozen completely over. You’ll have to do all that work again to be able to fish. Heck with it, you decide to pack it in and head back to the hotel. This is exactly what you’re doing with your split routine workout. You work hard for a small return, only to leave those muscle groups unattended for too long. It’s very difficult to accumulate enough volume for each muscle group to see the results you’d like to see, unless you love to exhaust each muscle group, day-in and day-out, week after week. You’d think there has to be a better, more enjoyable, and more efficient way to make positive changes, both physically and mentally. I think there is, and there is a lot of data that shows another way is possible. Want to get to know me better? Follow my on Instagram @dr.nicktrubee

Let’s talk about trust. Webster will tell you trust is “assured (or guaranteed) reliance on the character, ability, strength, or truth of someone or something OR one in which confidence is placed.” But what if that “one” where confidence is placed is YOU in regards to YOURSELF? Trusting others is one thing while trusting yourself is an entirely different situation. WHY? Because there is no one to blame, no one to fall back on, no one to look to when a change needs made… other than YOURSELF. This reflects many of the people I’m grateful to work with, as they have been struggling with trusting their own BODIES. Whether its returning from an injury or getting diagnosed with osteoporosis, it’s so difficult to trust that your body is still capable of great things! I understand you might think of this situation as a negative, one where you feel helpless and hopeless. However, I see this as a huge positive. It’s truly a moment in time where you get to appreciate all that has lead up to what’s current and choose to take a different direction. A direction where you get to choose the destination and all the twists and turns to get there. Interested in joining my private online fitness community? Get a free 7-day trial by tapping this link: Free 7 day trial Follow my on Instagram @dr.nicktrubee Ideas for a new episode? Email me at [email protected]

Progressive overload, simply stated is doing more work than you’ve done before, strategically over time. It doesn’t have to be linear, and really shouldn’t be. However, when you zoom out there is a trend in the upward direction. Here are a few ways to apply an overload to your current routine… 🔹Gradually adding more weight over time (again, non-linear but the trend line moves upward when you zoom out) 🔹Adding more reps  🔹Adding  more sets  👉🏻The 3 above are ways of increasing overall VOLUME 🔹Changing the velocity of the movement either concentric, eccentrically, or both 🔹Increasing time under tension (aka more work per rep) 🔹Decreasing rest time within the workout (more work per unit time), or rest time between workouts 🔹Incorporating new or novel movements - more of an effect on the neuromuscular system. This can also include working through movement progressions of similar movement patterns. 🔹Impact and plyometric training - increasing contact points, speed of the movement, height of the jump or landing. Consider trying adding 1 or 2 of these strategies to your current routine if you're in a rut, hit a plateau, or need to spice things up in order to refocus.