What is Osteoporosis and Osteopenia?
Osteoporosis and Osteopenia are differing severities of medical condition characterized by weakened bones, making them fragile and more prone to fractures. The bones lose density and mass, leading to a higher risk of fractures, especially in the hip, spine, and wrist.
Why does it occur?
Aging: Bone density tends to decrease with age.
Hormonal Changes: Women and men with low testosterone levels are at higher risk, typically post-menopause.
Genetics: Family history plays a role in determining susceptibility.
Dietary Factors: Inadequate calcium and vitamin D intake can contribute.
Lifestyle Choices: Lack of physical activity, smoking, excessive alcohol consumption.
Prevention and Management:
Nutrition: Adequate calcium and vitamin D intake through diet or supplements.
Regular Exercise: Specific exercises are outlined below to promote bone health.
Avoidance of Smoking and Excessive Alcohol: Both are linked to bone loss.
Medications: Bisphosphonates and other medications to strengthen bones. Talk to your GP or endocrinologist about this one.
How can Exercise Influence Bone?
When a person becomes active or increases their activity levels, the bones modify in size and shape to withstand the new loads. Once a bone has adapted to an activity, however, it ceases to change, therefore increasing exercise intensity and/or varying activities is necessary to continue to stimulate positive bone adaption.
Which Exercise is best for Osteoporosis?
Weight-Bearing Exercise
The maximization of bone mass throughout life requires engagement in a wide variety of weight-bearing activities that will impart high impact forces on the bones. Examples include running (emphasizing speed rather than duration), jumping and hopping (all directions), skipping, and sports that include those fundamental activities such as netball, tennis or hockey.
Resistance training
High-intensity resistance training (80-85% 1RM) is required to stimulate notable bone adaptation through muscle loading. Even people with markedly low bone mass who are highly deconditioned or frail (“high risk”) can strive for high intensity resistance training but should only do so with full supervision from an accredited exercise physiologist/physiotherapist. The progression of a program should be very slow with a strong focus on mobility and technique. Deep forward flexion, particularly loaded, should be avoided.
Balance Training
Balance Exercises will improve lower extremity neuromuscular function and thus prevent falls.
Talk to Maddie our accredited exercise physiologist to learn more about some home exercises you can safely complete to challenge your body.
Key Considerations when Exercising:
The key to effective exercise for osteoporosis is supervision by trained experts.
• Use it or lose it - gains in bone, muscle and balance from exercise will be lost if the exercise is stopped
• High-intensity resistance training should not be attempted with uncontrolled cardiovascular disease - lets keep your heart healthy too.
• Activities that involve twisting (golf) or abrupt unusual movements (squash) may cause fractures in a frail skeleton - this is something we would work up to.
• Pain beyond general muscle soreness after exercise should be investigated by a medical professional.
Exercise Recommendations:
Engage in a variety of exercises designed to maximized weight-bearing loading, muscle strength and balance.
Impact and Resistance Training:
Aim for 2 times per week, 30 mins per day:
• High intensity (80-85% 1RM) weight-bearing resistance training (esp. back and leg exercises)
• Graduated impact activities such as heel drops and foot stamps leading to jumps.
Recommended initial assessment first to ensure you have a safe and specific resistance and strength program targeted to your body.
Balance training:
Aim for 4 times per week, 30 mins per day: (This seems like a alot- but you can make it FUN)
• Such as Pilates or balance training . At MOVE we offer strength and balance classes on a Monday & Wednesday at 10.00am, Osteoporosis and Osteopenia program which will commence on September 16 as well as have an extensive clinical pilates timetable - learn more here.
• Challenging balance activities such as heel-to-toe walking on foam mats with arms above the head, stepping sideways over objects and walking backwards, walking on tip toe, and multi-tasking standing on one leg.
Strenght, balance and body weight training WORKS ! You can change your outcomes !
If you have a "Osteoporosis/Osteopenia", get in touch with us at MOVE so we can help you get moving and improve your bone strength together! Contact US!
References and further information:
1. Beck BR, Daly RM, Fiatarone-Singh MA, Taaffe DR: Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Science Med Sport 20(5): 438-445, May 2017
2. Watson SL, Weeks BK, Weis L, Horan SA, and Beck BR: 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. J Bone Miner Res, 2018 Feb;33(2):211-220.
3. Sherrington, C., et al., Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc, 2008. 56(12): p. 234-43.