Exercise to prevent osteoporosis

What is osteoporosis?

Osteoporosis is a condition characterised by weak and fragile bones that are liable to fracture. Normal, strong and healthy bones contain large amounts of minerals, which make them strong. The amount of these bone minerals within our bones is referred to as our bone mineral density (BMD). Our BMD is highest when we are aged in our 20s, and then as we get older we gradually lose some of the important minerals, causing our BMD to decline. If this loss of minerals is excessive, our BMD will become very low, and we will develop osteoporosis.

How can exercise help?

Certain types of exercise have been shown to minimise the loss in BMD, and in some research studies to even produce an increase in BMD. This is beneficial for both the prevention and the treatment of osteoporosis.

Which types of exercise can help improve bone strength?

resistance training helps improve bone strengthcycling - not a good exercise to help improve bone strengthwalking helps improve bone strength
swimming - not a good exercise to help improve bone strengthkick boxing helps improve bone strengthskipping helps improve bone strength

The best types of exercise for decreasing the risk of developing osteoporosis are:

  • regular weight-bearing exercise (such as walking, jogging and dancing); and
  • strength (resistance) training (such as lifting weights, push-ups and squats).

Exercises such as swimming and cycling help improve cardiovascular fitness and build muscle strength, but are not as effective at preventing osteoporosis as weight-bearing exercise. So if you are already swimming or cycling regularly but not doing any other forms of exercise, you should consider adding weight-bearing and/or resistance exercise to your weekly routine. Always check with your doctor before starting a new exercise regimen.

Weight-bearing exercise

Weight-bearing exercise is exercise that’s done while you are on your feet, with gravity exerting a force. According to Osteoporosis Australia, weight-bearing exercises that are high impact (e.g. aerobics, running and jumping) have an even more beneficial effect in improving bone strength than low-impact exercises (e.g. walking).

Strength (resistance) training

Strength (resistance) training involves lifting weights with your arms or legs. Strength training helps improve your bone health by putting strain on the bones, which helps make them stronger. As your body adapts to each new level, you will need to increase the resistance to continue to improve bone strength. There is some evidence indicating that progressing to heavier resistances is most effective in preventing the loss of, and encouraging an increase in, BMD.

Talk to your doctor or physiotherapist before starting a resistance training regimen.

Weight-bearing and resistance training for all

Since the prevention of osteoporosis is a far better strategy than trying to reverse it, all adults should undertake regular weight-bearing and/or resistance training regardless of their age. In young people this will help to increase their BMD to higher peak levels, which will then reduce the risk of it declining to osteoporotic levels later in life. Continuing with this exercise throughout your life will minimise the decline in BMD that occurs with age and further reduce the risk of osteoporosis in old age.

General precautions

Remember, if you are unfit or have any medical problems, you should check with your doctor before starting an exercise regimen. Almost everybody will benefit from weight-bearing and resistance exercise, but if you are unfamiliar with it, starting off with low-impact exercise and working your way up to high-impact exercise may be the best approach. If you are uncertain, seek professional advice.

References

1. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009; 41(7): 1510-30.
2. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39(8): 1435-45.
3. Osteoporosis Australia. Preventing osteoporosis: exercise [Website]. http://www.osteoporosis.org.au/osteo_prevention_exercise.php (accessed Feb 2010).
4. Fiatrarone Singh MA. Patient handout. Exercising to help prevent osteoporotic fractures: guidelines. Medicine Today 2007; 8(2): 61-64.
5. Fiatrarone Singh MA. Patient handout. Exercising to help prevent osteoporotic fractures: exercises. Medicine Today 2007; 8(3): 69-74.
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