3 Steps for stronger bones - Learn how exercise helps osteoporosis

Bones are normally very strong structures, but in some people they can become weak and easy to break – a condition known as osteoporosis. There are several factors that can cause osteoporosis ranging from malnutrition, lack of exercise, hormone levels, genetics and even certain illnesses.

When a person has osteoporosis the loss of bone strength is usually as a result of 2 processes:

1. A loss of bone mineral content and bone mineral density

2. Changes to the micro-architecture of the bone

Step 1: Build as much bone as possible when you’re young

Research has consistently shown that in order to have strong bones in old age, you have to optimise your bone strength as a child. By achieving a high peak of bone mass during your growing years, you can decrease the risk of suffering osteoporosis and therefore osteoporotic fractures later in life. Kids need to follow the following steps for strong bones:

• Do impact sport. Studies have shown that children who take part in sports like running, basketball, ballet and hockey have higher bone mineral density than children whose main sport is swimming or children who do not take part in any sport. This is because the mechanical forces from the impact stimulate bones to increase their bone mineral density and content.

• Follow diets high in calcium as well as magnesium and phosphorus. These minerals are some of the key building blocks of bone.

• Get enough Vitamin D. Your body requires Vitamin D in order to absorb calcium from your gut. In the UK we’ve seen reports of an increased incidence of rickets under school children in recent years. This is thought to be due to children spending more time indoors and not getting enough Vitamin D from the sun.

Step 2: Continue doing impact sport throughout your life

The research is very clear on the fact that people of all ages who take part in impact sport have better bone health than their sedentary counterparts. Impact activities create strong bones by increasing the bone mineral content and density of your bones.

Impact sport does, however, not mean that you’ve got to take up rugby or running! It can include walking, dancing, step classes – the list goes on.  Weight training may be an option if injury prevents you from doing stepping activities. You can also use weight training to increase the bone mineral density in your arms, since the activities named above mostly affect your legs and back.

I can’t do impact sport. Will swimming help?

Yes, there is some research that shows that swimmers have stronger bones than sedentary people. Swimming does not increase your bone mineral density but it changes the internal structure of the bone so that it is better at resisting bending and torsion forces.

The picture below is a magnified image of how your bone looks inside. Swimming helps to change the structure of these “pockets” or trabeculae and make them stronger.

Adapted from original image at Sbertazzo from https://commons.wikimedia.org/wiki/File:Bertazzo_S_-_SEM_deproteined_trabecular_-_wistar_rat_-_x100.tif

Some research suggests that swim sprint training produces better results than swim endurance training. This can possibly be attributed to the greater forces produced by the muscles when you sprint in the pool compared to steady swimming. There is also evidence that the push swimmers perform to get away from the wall helps with increasing bone strength.

While swimming may only hold a small benefits for bone strength, it does hold great benefits for your general health.

Step 3: Don’t forget the building blocks!

As mentioned above, you have to get enough Vitamin D as well as calcium, magnesium and phosphorus to maintain good bone health. If you live far from the equator, use sunscreen or rarely go in the sun, you may have to use Vitamin D supplements.

You can find out more about Vitamin D in this blog post. Please consult your doctor before you take any supplements as they may interact with other medication that you are taking.

Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.

About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn or ReasearchGate.

References:

Gómez-Bruton, Alejandro, et al. "Is bone tissue really affected by swimming? A systematic review." PLoS One 8.8 (2013): e70119.