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Exercise to prevent and/or improve osteoporosis

You may think that osteoporosis or “brittle bones” is something that just “old” people have to worry about, but what you do when you’re young paves the road for when you’re older. We build most of our bone before the age of 25 and what we do in the years that follow can have a massive impact. In this article I’ll focus specifically on what type/volume of exercise is needed to prevent and improve osteoporosis. Other things like diet and Vitamin D are also very important and you can read more about that here.



In this article:

  • Impact activity

  • Strength training

  • Balance exercises

  • Posture exercises

  • Avoid sitting for long periods

  • Final thoughts

Here's the video of the livestream I did on this topic in the Sports Injury Group.



Impact activity


This type of exercise/activity is by far the most effective in stimulating bones to grow.

Other benefits include heart health, blood sugar control, muscle strength, healthy joints, improved balance and pain management.


Aim to do at least 20 minutes of moderate impact activity per day. This can be broken up into smaller portions throughout the day. If you’re doing a high impact activity like jumping or running, you only need 50 impacts per day for strong bones. You can read the full guidelines here.


Examples include: Running, walking, stair climbing, jumping, marching on the spot, dancing and even gardening (depending on what you do in the garden).



Strength training


When you do strength training, your muscles pull on your bones and this acts as a stimulus for your bones to strengthen themselves.


Besides helping with bone health, strength training also helps you to regulate your blood sugar levels, increases your muscle strength, improves your posture, protects your joints, improves your balance and helps to reduce pain.


Aim to do at least 2 to 3 sessions per week. Include exercises for your arms, back and legs.


Examples include: Bodyweight exercises, using weights or exercise bands, carrying shopping, gardening, house work, climbing stairs, Thai Chi, Yoga, Pilates etc. You should include exercises that strengthen your back muscles as this will also help with your posture.


Balance exercises


The main benefit of having good balance is that you’re less likely to fall and break a bone. The good news is that having strong muscles and being fit already improves your balance, so all the exercises in the previous 2 sections will also benefit your balance.


Aim to do some form of balance exercise every day. If your balance is poor, you would benefit from seeing a physiotherapist who can help you find a safe exercise to start with.


Examples: Most people can benefit from doing exercise that specifically challenge their balance for example standing on one leg or doing exercises like Thai Chi, Yoga or Pilates.


Posture exercises


Osteoporosis can lead to spontaneous fractures in your back and/or back pain. It’s very easy to stoop when you have pain in your back or your neck. The problem is that this can become a habit and that you can get stiff in that position. Having a stooped posture can actually put more strain on some of the muscles in your back and cause you more pain. It can also affect you balance.


Examples: To improve and maintain good posture you need to do a combination of balance, flexibility and strength training exercises – with special focus on strengthening the back and neck muscles.


Aim: These can easily be incorporated into your 2/3 strength training sessions per week.



Avoid sitting for long periods


Sitting for long periods in the day has a very negative effect on your muscles, joints and bones. It’s literally a case of “if you don’t use it, you lose it”. It decreases your bone density and muscle strength and stiffens up your joints.


Joints don’t have arteries going in to them. They need movement to get fluid and nutrients in and out. If you don’t move them for long periods of the day, you’re “starving” them to some extent. It’s hardly surprising that a recent study found prolonged periods of sitting to be the most aggravating factor for back pain!


Sitting for long periods of time has also been shown to increase your chances of diabetes and heart disease.


Top tip: Take active breaks at regular intervals during the day. For example, if you do a flight of stairs during your quick break, you’ll feed your joints and add to your muscle strength and bone density!


Final thoughts

  1. Exercise should be fun. If it’s not, find something else to do because you’ll likely lose interest.

  2. If you’re struggling to find activities that you can do without pain, consult a physiotherapist. Every person can do exercise – you just need to start at the right level and with the right type of exercises.

  3. Pain can be a big barrier to exercise. These days we know that medication is not always the most effective treatment for people with ongoing pain. If pain is a barrier for you, speak to someone who specialises in pain management about your options. Things like mindfulness, CBT, acupuncture, exercise, massage etc. can all help to bring pain down to a manageable level.

Please let me know if you have any questions. You’re also welcome to consult me online via video call if you would like more help with a specific injury.

Best wishes

Maryke


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, ResearchGate, Facebook, Twitter or Instagram.




References:

  1. Strong, Steady & Straight: NOS Exercise and Osteoporosis Consensus Statement

  2. Suri, Pradeep, et al. "Do Physical Activities Trigger Flare-ups During an Acute Low Back Pain Episode?." Spine 43.6 (2018): 427-433.

  3. Wilmot, Emma G., et al. "Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis." (2012): 2895-2905.