What do you want to achieve for your bones?’ This rather surprising question came from Rebekah Rotstein, who had worked with the Royal Osteoporosis Society and is founder of movement system Buff Bones®, when I interviewed her for my new book The Power Decade. My answer was that I wanted them to be dense, because I thought that would protect them in the years ahead. Rebekah invited me to view this another way, ‘Your goal is not just to have high bone density,’ she explained. ‘Your goal is to not fracture and to live a full, independent life. You do this by strengthening your bones and body. But you also need to maintain and improve your balance and responsiveness to avoid falls because falls lead to fractures.’

The lifetime risk of a fracture after the age of 60 is 44% for women and 25% for men, and these bone breakages may undo all our efforts to age well. Half of those who experience a hip fracture are unable to live independently afterwards. And as Rebekah pointed out when we talked on an Instagram live this week (you can catch up with that here), it’s not just hip fractures in older age we need to worry about: a wrist fracture in midlife can be extremely debilitating too. And complications following fracture kill more women than breast cancer. So of course we want to avoid fractures. To do that, Rebekah explained, we want to work on coordination, alignment, posture and mobility as well as strength when it comes to bone health. Ultimately, we want our bones to be resilient, rather than just ‘hard’.


In her classes, Rebekah brings together all the elements we need to move effectively. She advocates starting by thinking about our feet because, ‘if you want to talk about balance, you have to address the feet because you’re in an upright position. If you don’t have an awareness of where your body is in space, or the sensations your body is experiencing, how can you understand how to move?’ Simply massaging our feet first thing, or rubbing them against a tactile surface like carpet, will stimulate receptors in the feet which help us calibrate where we are in space.

Annabel and I are big fans of the ‘brushing your teeth standing on one leg’ trick to add extra age-well benefits to this most regular of tasks by improving balance. When we do it, we can feel movement – and a bit of a wobble – in our feet (unlike the flamingos in the picture above, who stand on one leg so gracefully!). Rebekah explains that this movement is also a form of calibration, helping us maintain balance. She urges us to try this barefoot because, as we age, we lose dexterity in our feet: we want to be able to feel the messages they’re sending us.  Annabel’s written about the importance of going barefoot here.

Rebekah urges us to work on our balance in different ways, standing on one leg but with additional elements to increase the challenge. Could you stand on one leg and move your arms, turn your head, close your eyes? How can you push this a little further? She also suggests standing on one leg on different surfaces, such as a carpet or padded mat rather than a wooden floor for additional challenge. Annabel and I talked about this during our Age-Well conversation for the launch of the Power Decade last week.


Bringing awareness to our spines, and how we load them, is part of the process of supporting our balance and making our whole skeleton more resilient. Rebekah suggests simple exercises to help avoid kyphosis. This term refers to curvature of the spine linked to loss of bone mass and fractures, and is a particular risk for post-menopausal women. Working on bone and muscle strength will help reduce that risk.

Rebekah advocates lying down on the floor face up first thing in the morning with knees bent, to unweight the spine. From that position, try slowly sweeping your arms in an arc as if you’re making angel wings while you breathe mindfully, to open up the shoulders. To strengthen the back, lie facedown with your arms by your side. From that position, lift your head, hands and shoulders off the ground without lifting your chest and feet, while still looking down. Build endurance as you go along.

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