Osteoporosis and exercise

Today, Longevity Exercise Physiology Drummoyne, Edgecliff, Marrickville, Bella Vista, Randwick, Pymble, Balmain, Neutral Bay and Coburg, Melbourne, discuss the effects of and how exercise can help people living with osteoporosis and osteopenia.

 

It is estimated that 924,000 Australians have osteoporosis, roughly 3.8% of the population. This number jumps to 1 in 4 for women aged over 75.

(ABS 2018)

 

Bone, like muscle, is constantly remodelling itself. In adults, the daily removal of small amounts of bone mineral, must be balanced by the formation of new mineral bone if strength is to be preserved. If the rates of absorption begin to outweigh rates of formation, our bones weaken, and overtime can become brittle and prone to fracture. Fractures due to osteoporosis are strongly linked to chronic pain, disability, loss of independence and an increased probability of mortality (Ensrud et al. 2019).

 

The formal classification of Osteoporosis is a T-score of < -2.5 on a Bone Mineral Density scan. Osteopenia, or low bone density, is classified as any T-score between -1.0 and -2.5.

 

Common Causes

Hormones play a crucial role in modulating bone formation. The primary driver for the increased risk of osteoporosis in post-menopausal women is the rapid decline of oestrogen, a strong promoter of osteoblast activity, which are the cells that produce bone. Women are at greater risk of developing osteoporosis because of the rapid decline in oestrogen levels during menopause. This results in approximately 2% bone loss per year for several years after menopause.

Other risk factors include:

• Age
• Family history
• Low calcium and Vitamin D levels
• Poor diet
• Smoking
• High alcohol intake
• Low BMI
• Not being physically active
• Some medications (e.g. ADT, used for treatment of prostate cancer.)

 

How can exercise help?

We know exercise is essential for the prevention and management of osteoporosis.  However, not all types of physical activity are equal in terms of protecting our bone mineral density.

 

Weight bearing, or impact loading exercises, such as hiking or jogging, have shown to be particularly effective in balancing this act of reabsorption and bone formation.

(Shanb & Youssef, 2014)

 

On the other hand, while great for our aerobic fitness and cardiovascular health, exercise such as swimming or cycling has no proven benefit for our bone health.

Strength training plays an important role. Studies have shown that progressive strength training can help prevent bone loss and may even build new bone. Progressive resistance training of large muscle groups that attach to osteoporotic sites is best. Squats, deadlifts, push ups and shoulder presses are just some examples of strength exercises that target common osteoporotic sites.

Additionally, a high-challenge balance training program included alongside strength workouts can reduce the risk of falling, and therefore falls-related fractures for people with osteoporosis.

Given its prevalence, it is important to remember that Osteoporosis does not equal fracture, but a combination of osteoporosis, poor balance, and reduced muscle mass may put you at a significant risk of fragility fractures.

 

Exercise Guidelines    

To achieve positive outcomes for our bone health, resistance training and impact loading exercise must be appropriately prescribed to elicit our desired adaptation.

The recommended prescriptive guidelines are as below:

• Strength training: 2x/week with 2-3 sets of 8 repetitions
• Impact-loading: 10-50 jumps per session (3–5 sets of 10–20 repetitions with 1–2 min rest between sets)
• Balance: 4-7 sessions/week of high-challenge tasks for approximately 30min

 

If you need an individualised exercise program to help you manage your Osteoporosis, give Longevity Exercise Physiology Edgecliff, Pymble, Marrickville, Randwick, Drummoyne, Balmain, Bella Vista, and Neutral Bay a call on 1300 964 002 to book in a session today!

 

Written by Nate Sutton

 

References

ABS (Australian Bureau of Statistics) 2018. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS.

Ensrud, K. E., Kats, A. M., Boyd, C. M., Diem, S. J., Schousboe, J. T., Taylor, B. C., … & Study of Osteoporotic Fractures (SOF) Research Group. (2019). Association of disease definition, comorbidity burden, and prognosis with hip fracture probability among late-life women. JAMA internal medicine, 179(8), 1095-1103.

Shanb, A. A., & Youssef, E. F. (2014). The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis. Journal of family & community medicine, 21(3), 176.