How Exercise Can Help Osteoporosis
Bone mineral density and Osteoporosis | How Exercise Can Help Osteoporosis. Osteoporosis is a condition that causes our bones to become weaker and more fragile. It is typically diagnosed by looking at the bone mineral density (BMD) of important sites in the body (usually sites of potential fractures, including the hips, lower spine and wrist), which is measured using a low dose x-ray scan.
We know that BMD typically declines with ageing and is accelerated after menopause in women (due to loss of the hormone estrogen). Additionally BMD can be lost quicker with the use of some medications (corticosteroids) and with various dietary insufficiencies (vitamin D, calcium) and physical inactivity or immobilisation.
We often think of bones as being inert and static structures that don’t change much, but bones are in fact a very active structure within the body, constantly being remodelled by various cells in the bone itself to adapt to the mechanical stresses that are placed on it. It is for this reason that levels physical activity are so strongly associated with BMD.
The more stress that is placed on bone through activity, the stronger they become as this stimulus triggers the bone forming cells to begin to lay down new bone. Some interesting examples of this occur when you look at the BMD between the arms of tennis players: typically the racquet arm, which is subjected to higher stress has a higher BMD than the opposite arm. Similarly, astronauts who spend time in space are prone to significant decreases in BMD, owing to the lack of bone loading in the absence of gravity.
Plasticity of Bone
These examples illustrate the plasticity of bone and why exercise is one of the most important factors in improving BMD (or at the very least, preventing BMD loss) as we age. When it comes to exercise for improving BMD, exercise that involves load bearing (e.g. walking or jogging which requires you to support your body weight, compared to something like swimming which does not) is necessary to give bone the stimulus to adapt.
Resistance training with weights is also an effective form of exercise for improving BMD because the contraction of the muscle pulls on the bone, which can cause the bone to begin strengthening itself. But secondly resistance training plays a more important role in preventing falls.
The danger of osteoporosis is the increased risk of fractures after a fall, so an important part of managing osteoporosis is to decrease the risk of falling by improving both muscular strength around the large joints of the body (e.g. back, hips and knees) and also improving balance.
When we talk about improving balance, we are really focusing on improving our body’s awareness of its position in space (otherwise known as proprioception) and then our ability to control our body when moving through this space. Improving our capacity to do this means that we are better able to respond to unexpected changes in our environment that might have otherwise caused us to lose our balance and fall.
Even simple exercises such as balancing with one foot in front of the other or on one leg (with a support nearby) can be enough to begin challenging our balance and causing it to improve. This can then be followed by doing the same exercise with eyes closed, which again challenges the body even further.
Beginning an exercise program which includes load bearing exercise and gradual resistance training that incorporates balance exercises can prevent, or slow the declines in BMD associated with age and other medical conditions that could otherwise lead to osteoporosis and the subsequent risk of fractures.
We often tend to only think about exercising for improving BMD in older adults, however there is never an age that is too early to start. The younger you are, the better, as the declines can be prevented for even longer to further reduce the risk of developing osteoporosis as you age.
If you have been diagnosed with osteoporosis or are interested in improving your bone mineral density, consider contacting on of our Exercise Physiologists at Functional Health who can help to develop an individually tailored program to suit your needs and achieve your goals.
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