According to the International Osteoporosis Foundation, 2.2 million Australians over the age of 50 are affected by Osteoporosis (1). Osteoporosis represents a condition that affects bone health and can affect numerous areas including the hip, spine, knees and wrist to name a few. Our bones produce new bone cells (bone formation) and gets rid of old bone cells (bone resorption), this process is known as bone remodelling and is a process that occurs throughout our lifetime. In Osteoporosis, the process of bone remodelling sees an increase in the rate of bone resorption with no increase in bone formation. This essentially means that we get rid of old bone cells at a faster rate then we create our new ones, causing an overall change in structural integrity of our bones.
The classification of this condition can be broken down into 2 groups and is related to our Bone Mineral Density (BMD). When you go for a bone mineral density scan, you will receive a T-score which represents the density of your bone. Below is the classification system:
- -1 or above. Bone density is normal
- -1 – -2.5. Bone density is moderately low and may represent osteopenia (early stages of osteoporosis)
- -2.5 or above. Bone density is low, highlighting the presence of osteoporosis.
So I have osteoporosis, can I exercise safely?
So how can I go about managing my osteoporosis? In conjunction with a medical intervention that your doctor may have prescribed for you, strength training has shown to be extremely beneficial for patients with osteoporosis. The application of a sufficient load that is placed on the skeletal system helps stimulate net bone formation at the stressed skeletal sites, and the most effective way to do this is through a well designed resistance training intervention (2). In fact, numerous research studies utilising a resistance training intervention have shown fantastic improvements in BMD (3). Its worthwhile to note that aerobic exercise interventions are not as successful as improving BMD, but should still be considered as part of the overall training plan as improvements in weight management will help in unloading joints of the lower limb via a reduction in weight.
So what now?
I have been told I can exercise, but where should I start? Consulting with your Accredited Exercise Physiologist or Performance Coach in combination with your GP will allow you to set out a specific plan, helping you manage your osteoporosis. Some things to consider are:
- Seeing a qualified professional in regards to exercise advice as performing a general program may not be the best way to start your strength training. Having a individualised strength program that is based on your assessment findings will be extremely beneficial to your osteoporosis
- Setting exercise goals that you wish to achieve to keep you motivated and foccussed
- Establishing suitable resistance training loads to allow you to perform strength training safely and effectively, something you coach will help you with
- Utilising feedback from a patient wellness tracker to highlight muscle and joint soreness to establish the proper training loads ongoing
- Progressively overloading your skeletal system to improve your muscular strength
- Incorporating a balance component to aid in falls prevention to reduce the onset of osteoporotic fractures
Plyometric training, a form of training that causes the person to exert a high degree of force for a period of time e.g. jumping has been researched to be beneficial for patients with osteoporosis as combined jumping and resistance training protocols show greater improvements in BMD the just strength training alone (4). Now when the word “jumping” or “plyometric” are used it doesn’t mean super explosive movements that you may see athletes performing, it could be simple step down patterns from a step or forward/backward hopping patterns on the ground. The key is to start slowly and progressively overload under guideance of an expert. This should be based on client goals and training status, but is a great tool to add into your training plan.
To wrap it up
If you have osteoporosis and are looking for ways to help manage your symptoms, I emplore you to undertake a resistance training program. This should be done in consultation with your GP and exercise physiologist or performance coach to allow maximal safety and effectiveness.
Written by Accredited Exercise Physiologist & Performance Coach Adam Luther
References
- https://www.iofbonehealth.org (International Osteoporosis Foundation)
- Zhao, R., Zhao, M., & Zhang, L. (2014). Efficiency of jumping exercise in improving bone mineral density among premenopausal women: a meta-analysis. Journal of Sports Medicine.
- Calatayud, J., Borreani, S., Moya, D., Colado, J., & Triplett, T. (2013). Exercise to Improve Bone Mineral Density. Journal of Strength & Conditioning.
- Hinton, P., Nigh, P., & Thyfault, J. (2015). Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: a 12-month randomized, clinical trial. Journal of Bone
