What Exercise Should I Do if I Have Osteoporosis?
Being diagnosed with osteoporosis or osteopenia often raises an important question:
What exercise should I actually be doing?
Many people know that exercise is good for their bones, but there can be uncertainty about what type of exercise is most useful, how hard they should work, and whether certain activities are safe.
The good news is that exercise is an important part of managing osteoporosis. However, not all exercise provides the same stimulus to your bones and muscles.
For many people, an effective osteoporosis exercise program will include a combination of progressive resistance training, weight-bearing or impact exercise, balance training and general physical activity.
The key is finding the appropriate starting point and progressively building from there.
Why is exercise important if you have osteoporosis?
Our bones respond to the loads placed upon them.
As we get older, maintaining bone density becomes increasingly important. This is particularly relevant for women following menopause, when declining oestrogen levels can contribute to accelerated bone loss.
Exercise provides mechanical loading that can help stimulate bone while also improving the muscles responsible for supporting and moving your body.
This means an osteoporosis exercise program isn't only about your bone density.
We also want to improve:
muscle strength
balance
physical capacity
confidence with movement
ability to perform everyday activities
capacity to remain physically active as you get older.
Improving strength and balance can also be particularly important because reducing falls risk is an important part of reducing fracture risk.
1. Strength training
Progressive resistance training is one of the most important components of an osteoporosis exercise program.
This might include exercises such as:
squats or sit-to-stands
leg press
step-ups
calf raises
rowing exercises
pushing exercises
hip strengthening
exercises using free weights or resistance machines.
However, simply performing an exercise isn't necessarily enough.
The resistance needs to provide an appropriate challenge.
For someone who hasn't exercised for many years, that starting point might be relatively light. Someone who already trains regularly may require considerably more resistance to provide an adequate stimulus.
The aim is to progressively increase what your body can tolerate over time.
This is why an individualised strength program can be valuable.
2. Impact and weight-bearing exercise
Bones also respond to impact and weight-bearing activities.
Depending on the individual, this could range from walking and stair climbing through to more targeted activities such as stomping, stepping, hopping or jumping.
However, impact exercise isn't appropriate at the same level for everybody.
Someone who is physically strong, has good balance and has relatively mild reductions in bone density may tolerate considerably more impact than someone with significant osteoporosis, previous fragility fractures, poor balance or other medical conditions.
The answer therefore isn't simply:
“Everyone with osteoporosis should start jumping.”
Instead, we need to determine what level of loading is appropriate and whether it can be safely progressed.
3. Balance training
Bone strength is only one part of fracture prevention.
We also need to consider why fractures occur.
Many fractures occur following a fall. Improving balance and lower-limb strength can therefore be an important part of an osteoporosis management program, particularly as we get older.
Balance exercises can challenge different systems involved in keeping us upright.
This might involve changing:
foot position
the surface you're standing on
visual input
head position
movement speed
reaching or stepping tasks.
Like strength training, balance exercises should be appropriately challenging rather than simply repeating exercises that have already become easy.
Is walking enough for osteoporosis?
Walking is excellent exercise and provides many health benefits.
It can support cardiovascular health, general fitness, mobility and independence.
But if your goal is specifically to improve or maintain bone and muscle strength, walking alone may not provide enough stimulus.
This is an important distinction.
We don't want people to stop walking. Instead, walking can form one part of a broader exercise program that also incorporates appropriately prescribed resistance and, where suitable, impact exercise.
Should I avoid lifting weights if I have osteoporosis?
A diagnosis of osteoporosis does not automatically mean that you should avoid resistance training.
In fact, appropriately prescribed resistance exercise can be an important part of osteoporosis management.
What matters is how the exercise is selected, loaded and progressed.
Your program may need to take into account factors such as:
your bone density
previous fractures
spinal health
current strength
balance
previous exercise experience
joint or muscle problems
other medical conditions.
Certain movements or loading strategies may need to be modified for some people, particularly those with vertebral fractures or significant osteoporosis.
The goal shouldn't be to make someone frightened of movement. It should be to find appropriate ways to exercise and gradually build their capacity.
What if I've never done strength training before?
You don't need to already be strong to start strength training.
Your starting point simply needs to match your current ability.
For one person, the first step might be learning to perform a controlled sit-to-stand.
For another, it might be performing loaded squats, deadlifts or resistance-machine exercises.
There is no single osteoporosis exercise program that is appropriate for everybody.
The important part is establishing where you're starting from and then providing enough progression to continue challenging your muscles and bones.
Exercise after menopause
Bone health becomes particularly important for women during and after menopause.
The hormonal changes associated with menopause can accelerate reductions in bone density, which is why being proactive can be valuable.
If you are concerned about your bone health, speak with your GP about whether assessment of your bone density is appropriate.
If osteopenia or osteoporosis is identified, exercise can then form part of a broader management strategy alongside appropriate medical and nutritional management.
You don't necessarily need to wait until osteoporosis has significantly affected you before taking action.
What does an osteoporosis physiotherapy assessment involve?
At Body Fit Physiotherapy, we first want to understand the person rather than simply give everyone the same set of exercises.
An assessment may consider your:
osteoporosis or osteopenia diagnosis
previous fractures
medical history
current exercise levels
strength
balance
mobility
previous injuries or pain
personal goals.
From there, we can determine an appropriate starting point for your exercise program.
For some people, the priority may initially be building basic strength and confidence.
For others, the program may involve heavier resistance training and more challenging weight-bearing or impact exercise.
The program can then be progressed as your capacity improves.
What is the best exercise for osteoporosis?
There isn't one single exercise that is best for osteoporosis.
Instead, think about developing a well-rounded exercise program.
For many people, this means combining:
Progressive resistance training to improve muscle strength and load the skeleton.
Weight-bearing and appropriate impact exercise to provide additional stimulus to bone.
Balance training to improve stability and help reduce falls risk.
Regular physical activity to maintain cardiovascular fitness, mobility and general health.
Most importantly, the program needs to be appropriate for you.
Osteoporosis Exercise Program in Adelaide
At Body Fit Physiotherapy in North Adelaide, our Osteoporosis Program is designed to help people with osteoporosis and osteopenia exercise appropriately and progressively.
We assess your current strength, balance and physical capacity before developing an exercise program around your individual circumstances and goals.
The aim isn't simply to give you a list of exercises.
It's to help you understand what you should be doing, how hard you should be working and how your exercise should progress over time.
If you've been diagnosed with osteoporosis or osteopenia and aren't sure where to start with exercise, you can find out more about our Osteoporosis Program or contact Body Fit
Physiotherapy for further information.
To find out more visit: https://www.bodyfit.life/osteoporosis
This article provides general information and does not replace individual medical or physiotherapy advice. Exercise recommendations may need to be modified depending on fracture history, bone density, medical conditions and individual circumstances.
Comments