Exercise plays a vital role in bone health and osteoporosis prevention. This is because bones and muscles respond and strengthen when they are 'stressed' by weight bearing or impact exercises, such as jumping, running, stair-climbing or dancing.
Regular exercise can help to:
- Build and maintain bone and muscle strength
- Improve strength and balance, to help prevent falls
Tailored to the patient’s needs and abilities, exercise also helps people who have suffered a fracture regain their mobility and strength.
The prevention of osteoporosis begins when we are young. Exercise, together with good nutrition, helps children build up their bone density and mass, making their bones stronger and less vulnerable to osteoporosis later in life.
It’s estimated a 10 per cent increase of peak bone mass in children can reduce the risk of an osteoporosis fracture as older adults by 50 per cent. Research has also shown that physically active young girls gain about 40% more bone mass than the least active girls of the same age. In girls, the bone tissue gained during the ages of 11 to 13 approximately equals the amount lost during the 30 years following menopause.
- It is recommended that children exercise at least 40 minutes a day. This should include sports with a weight-bearing element (cycling and swimming are non-weight-bearing) and/or activities such as dancing, skipping, running, jumping or walking.
Exercise in adulthood helps prevent bone loss and maintain muscle strength. Studies have shown people who are not physically active are more likely to have a hip fracture than those who are more physically active. For example, women who sit for more than nine hours a day are 50% more likely to have a hip fracture than those who sit for less than six hours a day.
Generally, the kind of exercise you do should be tailored to your needs and capabilities - and of course, it should be an activity that you enjoy! If you have osteoporosis or have suffered a spinal fracture you need to be more careful, especially when bending, and professional advice is recommended.
- Overall, most people should aim to exercise for 30 to 40 minutes three to four times each week, with some weight-bearing and resistance exercises in the program, as described below.
Weight bearing exercise
Choose an exercise that you enjoy doing, which will mean you are more likely to continue the activity long-term. Examples, such as, dancing, aerobics, jogging, walking, playing sports are all excellent, but exercise with less impact, such as using a treadmill, elliptical strider or step machine at home, or in the gym, are also a great way to strengthen bones.
Muscle strengthening / resistance exercise
These include activities where you move your body, a weight or some other resistance against gravity. They are also known as resistance exercises and include, lifting weights, using elastic resistance bands, weights machines or simply standing and rising onto your toes.
For example Tai Chi, yoga or Pilates helps to improve strength, balance and flexibility. Again, if you’ve had a spinal fracture due to osteoporosis, ask for advice, especially regarding exercises which involve bending at the spine.
Exercise helps prevent weak bones and falls in the elderly. As well as helping to maintain bone density, exercise also builds muscle tone and improves balance, thereby preventing falls - a major cause of osteoporosis fractures. Many studies have proven that people with better posture, better balance, and greater muscle power are less likely to fall and are therefore less likely to fracture. This is important because one-third of people over 65 have a fall each year and the risk of falling increases as age rises.
In fact, research has shown that for women over 80 years old, an individually tailored exercise plan that includes progressive muscle strengthening, training for balance, and a walking plan, can reduce the overall risk of falling and cut serious falls that lead to fractures. The balance aspect of this training is important. A study has revealed that after only 15 weeks of practicing Tai Chi (a Chinese exercise focused on balance), patients fall only half as much as their peers.
Anyone who has suffered osteoporosis fractures can benefit from special exercises and training (under medical supervision) to improve muscle strength and muscle function, which leads to greater mobility and improved quality of life.
An exercise programme for people with osteoporosis should specifically target posture, balance, gait, coordination, and hip and trunk stabilization rather than general aerobic fitness. A physiotherapist can recommend a targeted exercise programme suited to individual needs and capabilities.
The following types of movements and exercises may not be suitable for people with osteoporosis, particularly if they have spine fractures:
- Sit-ups and excessive bending at the waist
- Twisting movements such as a golf swing
- Exercises that involve abrupt or explosive movement, or high-impact loading (like jumping)
Exercise can play a crucial role in rehabilitation. Muscle strengthening exercises help to rebuild bone in those who have developed osteoporosis and can also provide relief from pain. Physiotherapists play an important role in rehabilitation, giving expert advice and developing exercise programmes tailored to a patient’s specific needs.
Chronic pain is most problematic in people with stooped back/curvature of the spine (known as kyphosis), which is most often due to osteoporosis fractures in the spine.
Kyphosis causes loss of height, poor posture, and a shift in the centre of gravity. In the worst cases, the curvature of the spine is so severe that the rib cage is pressed against the pelvis. Forced into this posture, patients can suffer severe pain and have trouble breathing.
Exercise can help relieve the pain and some of the symptoms of kyphosis. By strengthening the muscles in the back, the spine can be brought more upright. This has been shown to increase mobility and reduce pain, greatly improving the quality of life of the patient.
Intensive exercise training has been shown to lead to improvements in strength and function in elderly patients who have had hip replacement surgery. Exercise therapy helps patients significantly improve their ability to get up, walk, climb stairs and maintain posture.