Exercise to Decrease Osteoporosis

Facts about bones and osteoporosis: 

• Peak bone mass happens in our late 20s to early 30s.   
• Bone loss occurs at the rate of 0.5% per year after the age of 40.  

• Post-menopausal women lose bone at the rate of 5-6% per year for up to ten years.   
• In women over 45 years of age, osteoporosis accounts for more days spent in the hospital than diabetes, myocardial infarction or breast cancer.(1) 
• In the USA, 55% of people over the age of 50 have either osteopenia or osteoporosis.(2) 
• Osteoporosis can largely be prevented with lifestyle considerations.

Risk factors for osteoporosis include:  

• Decreased calcium and vitamin D intake 
• Physical inactivity and sedentary lifestyle 
• Smoking 
• Drinking more than three alcohol drinks a day  

• Eating disorders 
• Being female 
• Advanced age 
• Being thin  
• Diabetes 

• Thyroid deficiency 
• Gastrointestinal disorder  
• Rheumatoid arthritis 
• Autoimmune disorders 
• Chronic obstructive pulmonary disease 

• End stage renal disease 
• Congestive heart failure 
• Depression 
• Metabolic acidosis 
• Impaired neuromuscular function 

• Men and women with annual height loss > 0.5 cm (3) 

Studies show exercise is helpful at decreasing osteoporosis risk: 

• Physical activity and fitness reduce risk of osteoporosis and fracture.(4,5,6) 
• Bone mineral density in post-menopausal women can be maintained or increased with therapeutic exercise.(7,8,9) 

• In the frail elderly, activity to improve balance and confidence may be valuable in fall prevention.  Studies have shown that individuals who practice tai chi have a 47% decrease in falls and a 25% decrease in hip fracture rate of those who do not (10) and that tai chi can be beneficial for retarding bone loss in weight bearing bone in early post-menopausal women.(11) 

Physical therapy for osteopenia and osteoporosis is helpful for the following reasons: 

• Improves balance 
• Decreases risk of falls 

• Increases bone mass and muscle strength 
• Improves posture 
• Helps decrease depression 
• Improves overall well being 

Physical therapy to improve bone density includes a combination of strength training, balance, flexibility and weight bearing aerobic activity.  If you have low bone mass, you should see a physical therapist to be given a home exercise program specific to your needs.   

Strength training includes the use of free weights, resistance bands and body weight.  Strengthening the muscles of the back is especially important for posture and bone safety.  Proper form with exercises is crucial, and depending on the severity of your osteoporosis, certain positions should be avoided while exercising. 

Good balance is important to prevent falls, which is when fractures usually occur.  Simple exercises such as standing on one leg or movement exercises like tai chi will improve your balance and stability. 

Maintaining flexibility will help you be able to move your joints through their full range of motion to keep your muscles working properly.  Avoid curling your spine forward, though, as this can cause a fracture in the spine of someone with severe osteoporosis. 

Examples of good weight bearing cardiovascular exercise include walking, dancing, stair climbing, gardening and hiking.  This type of exercise helps build bone mass in your legs, hips and lower spine. 

References:

• Kanis JA, Delmas P, Burckhardt P, et al. (1997) Guidelines for diagnosis and management of osteoporosis.  The European Foundation for Osteoporosis and Bone Disease.  Osteoporosis Int 7:390. 

• www.nof.org (http://www.nof.org) (2011)

• Moayyeri A, Luben RN, Bingham SA, et al.  (2008) Measured height loss predicts fractures in middle-aged and older men and women.  The EPIC-Norfolk prospective population study. J Bone Miner Res 23:425.

• Brooke-Wavell K, Jones PR, Hardman AE, et al. (2001) Commencing, continuing and stopping brisk walking: effects on bone mineral density, quantitative ultrasound of bone and markers of bone metabolism in postmenopausal women.  Osteoporosis Int 12:581

• Bonaiuti D, Shea B, Iovine R, et al. (2002) Exercise for preventing and treating osteoporosis in postmenopausal women.  Cochrane Database Syst Rev:CD000333.

• Karlsson M (2004) Has exercise an antifracture efficacy in women? Scand J Med Sci Sports 14:2.

• Preisinger E, Alacamlioglu Y, Pils K, et al. (1995) Therapeutic exercise in the prevention of bone loss.  A controlled trial with women after menopause. Am J Phys Med Rehabil 74:120.

• Hartard M, Haber P, Ilieva D, et al. (1996) Systematic strength training as a model of therapeutic intervention.  A controlled trial in postmenopausal women with osteopenia. Am J Phys Med Rehabil 75:21.

• Kemmler W, Lauber D, Weineck J, et al. (2004) Benefits of 2 years of intense exercise on bone density, physical fitness, and blood lipids in early postmenopausal osteopenic women: results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS). Arch Intern Med 164:1084.

• Chan K, Qin L, Lau M, et al. (2004) A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil 85:717

• Hauer K, Specht N, Schuler M, et al.  (2002) Intensive physical training in geriatric patients after severe falls and hip surgery. Age Ageing 31:49.

A physical therapist whom has experience working with people with bone loss can help you develop a specific exercise routine tailored to your needs.  Proper form and technique are crucial to preventing injury and getting the most out of your workout. 

Call today to get started on improving your bone density through exercise.  303-900-2282