Osteoporosis (meaning stems from the words 'porous bones') is a condition that causes bones to become thin, weak and fragile. As a result, even a minor bump or accident can cause a fracture (broken bone).
Fractures due to osteoporosis can result in chronic pain, disability, loss of independence and premature death (Bliuc et al. 2013).
Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone density). Any bone can be affected by osteoporosis, but the most common sites are the hip, spine, wrist, upper arm, forearm or ribs. Fractures in the spine due to osteoporosis can result in changes in posture and height loss. Osteoporosis usually has no symptoms until a fracture occurs – this is why it is often called the ‘silent disease’.
Why Exercise For Osteoporosis?
Exercise can help bones modify their shape and size so they become stronger and this can prevent injuries. Exercise also increases muscle strength and improves balance which can help reduce the risk of falls.
Approximately one third of people over 65 fall each year and it’s estimated that around 6% of falls result in a fracture. This makes maintaining bone density and preventing falls an important health issue. Physical activity plays role in primary, secondary treatment and prevention of osteoporosis.
Osteoporosis is common in Australia. In 2017-18, 3.8% of the population were diagnosed with Osteoporosis, an estimated 924,000 Australians.
Who Is At Risk Of Osteoporosis?
Risk factors associated with the development of osteoporosis include increasing age, sex, family history of the condition, low vitamin D levels, low intake of calcium, low body weight, smoking, excess alcohol consumption, physical inactivity, long-term corticosteroid use and reduced oestrogen level (Ebeling et al. 2013).
Osteoporosis is more common in women than men. In 2017–18, 29% of women aged 75 and over had osteoporosis compared with 10% of men.
Older age groups also tend to be affected. The proportion of women with osteoporosis increases with age, with those 75 and over being most affected.
How to know if I have Osteoporosis?
Diagnosis of osteoporosis requires an assessment of bone mineral density (BMD). The most commonly used technique is a specialised X-ray known as a 'Dual energy X-ray Absorptiometry (DXA) scan' to determine bone mineral density (BMD) in the hips and spine (IOF 2017).
What Exercise Should I Do For Osteoporosis?
Maintaining bone density is the aim. Weight-bearing activities that have some impact on bones such as running, jumping and skipping are usually encouraged. We would usually recommend some progressive resistance training also for those getting start.
Progressive Resistance Training:
An effective strategy to improve skeletal muscle mass, size and strength and should form the foundation of any exercise programs designed to reduce fracture risk.
Guidelines commonly suggest 2 days per week, 2-3 sets of 8 repetitions. Completing approximately 8 exercises per session should be included, targeting major muscle groups. Our exercise physiologists will complete and assessment with all our clients to assist setting this program up. Commonly we will target major muscle groups around the hip and back and/or other sites of osteoporosis
Balance Training:
As we age our balance usually declines due to the ageing process. The exciting part here is that we can slow the process of age related decline. We target both static and dynamic stability and balance to reduce the risk of falling and associated fracture. No, this does not just involve standing on one leg.
Impact Training:
Impact training is a type of exercise where you will load and stimulate bone growth in fast, novel and multidirectional ways.
CAUTION - If you have Osteopenia, you may perform moderate-high impact activities. If you have Osteoporosis, you may perform moderate impact activities only. This is where we usually draw the line and say, its time to see you Accredited Exercise Physiologist at Prescribe Exercise to assist.
**NOTE** If you are just starting out and you plan on going it alone, remember you are trying to improve your ability, but just as important is reducing your risk of falls, keep to a controlled and know environment to start and get close to something that you can hold on to if required.
It is important to see your GP or specialist prior to beginning exercise to know the areas (bones) affected by osteoporosis and the severity of osteoporosis. This will assist when you get/ask for a referral to your Accredited Exercise Physiologist (We recommend seeing a Prescribe Exercise AEP, but we are biased) to tailor your program in a safe and effective manner. If you are ready to see one of our team CLICK HERE TO BOOK or call us on (02) 4259 0384, we offer telehealth also.
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References:
Exercise Right Australia
Australian Institute of Health and Welfare