What is osteoporosis?Osteoporosis is a condition characterised by weak and fragile bones that are liable to fracture. Normal, strong and healthy bones contain large amounts of minerals, which make them strong. The amount of these bone minerals within our bones is referred to as our bone mineral density (BMD). Show
Our bones are in a constant state of flux, with bone being broken down and remodelled and rebuilt continuously. When bones break down faster than they rebuild, our bone mineral density decreases. Our BMD is highest when we are aged in our 20s, and then as we get older our BMD gradually declines. If this loss of minerals from the bone is excessive, our BMD will become very low, and we will develop osteoporosis. Osteoporosis is a common cause of fractures in older Australians, especially women. In women, the greatest rate of bone loss occurs in the years immediately following menopause. How can exercise help?Exercise to prevent osteoporosis: Regular weight-bearing exercise in children and teenagers helps produce strong bones; in adults it helps to maintain bone mass; after the menopause it can be part of an overall treatment plan that aims to slow the rate of bone loss; and in adults over 65 years physical activity can be used to both reduce the rate of bone loss and avoid injury to bones by improving muscle strength and balance. The strength of your bones also determines the type of exercise that is appropriate and safe for your bones. Certain types of exercise have been shown to minimise the loss in BMD, and in some research studies to even produce an increase in BMD. This is beneficial for both the prevention and the treatment of osteoporosis. If you already have osteoporosis or other medical conditions, you are over 60, or you are over 45 and have not exercised regularly in recent times, speak to your doctor about designing an exercise programme that is suitable for you. Which types of exercise can help improve bone strength?The best types of exercise for decreasing the risk of developing osteoporosis are:
Exercises such as swimming and cycling help improve cardiovascular fitness and build muscle strength, but are not as effective at preventing osteoporosis as weight-bearing exercise. So if you are already swimming or cycling regularly but not doing any other forms of exercise, you should consider adding weight-bearing and/or resistance exercise to your weekly routine. Always check with your doctor before starting a new exercise regimen. Weight-bearing exerciseWeight-bearing exercise is exercise that’s done while you are on your feet, with gravity exerting a force. According to Osteoporosis Australia, weight-bearing exercises that are high impact (e.g. aerobics, running and jumping) have an even more beneficial effect in improving bone strength than low-impact exercises (e.g. leisurely walking). To maintain the bone-strengthening benefits of weight-bearing exercise, you need to keep up the exercise regularly, for the long term. If you stop exercising, the benefit wears off. Experts advise 45–60 minutes of weight-bearing exercise 3 days per week to increase the strength of your bones. Strength (resistance) trainingStrength (resistance) training involves lifting weights with your arms or legs. Resistance exercises can involve weights that you hold or have strapped to you, or resistance machines where you use a programmed weight. Alternatively, some resistance exercises use your own body weight as the load. Strength training helps improve your bone health by putting strain on the bones, which helps make them stronger. As your body adapts to each new level, you will need to increase the resistance to continue to improve bone strength. There is some evidence indicating that progressing to heavier resistances is most effective in preventing the loss of, and encouraging an increase in, BMD. Doing a programme of resistance exercises 2-3 times a week has been shown to help maintain and even increase bone mineral density in women who have gone through menopause. Resistance training also helps to build up and maintain muscle mass, which helps reduce the risk of falls. Talk to your doctor or physiotherapist before starting a resistance training regimen. Balance exercisesBalance training is an important part of looking after your bones. Working on your balance can improve your stability and help prevent falls, which is important because falls can cause fractures. Recommended balance exercises include:
Start with a balance exercise that you find easy and work up to those you find harder — you can also challenge yourself by closing your eyes during exercises that you’ve mastered. Weight-bearing and resistance training for allSince the prevention of osteoporosis is a far better strategy than trying to reverse it, all adults should undertake regular weight-bearing and/or resistance training regardless of their age. In young people this will help to increase their BMD to higher peak levels, which will then reduce the risk of it declining to osteoporotic levels later in life. Continuing with this exercise throughout your life will minimise the decline in BMD that occurs with age and further reduce the risk of osteoporosis in old age. General precautionsRemember, if you are unfit or have any medical problems, you should check with your doctor before starting an exercise regimen. Almost everybody will benefit from weight-bearing and resistance exercise, but if you are unfamiliar with it, starting off with low-impact exercise and working your way up to high-impact exercise may be the best approach. If you are uncertain, seek professional advice. Osteoporosis prevention resistance training exercises
EquipmentFor this exercise programme you’ll need a sturdy chair (without arms) that has a high back, approximately level with your waist. If your chair is the correct size, when sitting with good upright posture, your bottom should rest against the back of the chair while your feet are flat on the floor and the backs of your knees touch the seat of the chair. You’ll also need a pair of portable or strap-on wrist weights and a pair of strap-on ankle weights. When starting out, use the lightest weights you can lift comfortably. However, you will need to increase the weight as you grow stronger. This is vital for building strength. Wear comfortable, non-restrictive clothing, thick socks and comfortable exercise shoes. Exercise tipsWarm up firstWarm up first by doing a repetitive, gentle movement such as walking for a few minutes or slowly going through the motions of a couple of the weight-training exercises, minus the weights. This helps circulate blood to your muscles and reduce the risk of an injury. Slow repetitionsPerform each exercise slowly 8–10 times. A slow repetition means taking about 3 seconds to lift the weight, 1 second to rest, then 3 seconds to lower the weight. Repeat for the opposite leg or arm, where necessary. These 8–10 repetitions make up one ‘set’. An exercise session should consist of 2–3 sets each of 6–8 different types of resistance exercises. It’s best to rest for 10–14 seconds between repetitions. Don’t hold your breathRemember to breathe regularly during these exercises. For example, take a deep breath in, then breathe out slowly as you lift the weight; breathe in as you lower the weight. Do not hold your breath while lifting or lowering the weight. You should not feel painYou should need to use strong effort when lifting the weights in these exercises, but remember to stay within a range of movement that does not cause you pain. Stretch your musclesAfter you have completed all the exercises in the sequence, gently stretch, in turn, all of the muscles you have just worked. A day of restDo these resistance exercises on 3 days of the week, always allowing a non-weight training day between weight-training days, so that your muscles can recover. ProgressionDo not increase the weight that you lift until you can easily complete the 8th repetition of an exercise. Gradually add enough weight to challenge your muscles, so that it feels hard or very hard to complete the repetitions. When you can lift a weight 8–15 times, then add more weight to challenge your muscles again. Repeating this process will help build strength. Make sure you don’t overdo it, however: if you can’t lift a weight 8 times in a row, it’s too heavy for you so use a lighter weight. Talk to your doctor or a qualified fitness professional to make sure your exercise programme is right for you.
1. Osteoporosis Australia. Exercise. Updated April 2019. https://www.osteoporosis.org.au/exercise How does exercise help to prevent osteoporosis it?Osteoporosis is characterised by the loss of calcium in a person's bones, which makes them more likely to fracture (break). Exercising regularly reduces the rate of bone loss and conserves bone tissue, lowering the risk of fractures. Exercise also helps reduce the risk of falling.
Can weight bearing exercise reverse osteoporosis?We know from long term studies that high intensity, high frequency exercise will play a significant role in bone preservation and formation. Intense weight bearing over time can reverse osteoporosis.
Why Weight bearing exercise is important?Muscles – Weight-bearing exercises help build muscles that support and protect your joints, increase overall balance, and even improve your reaction time, all of which can help prevent potential injuries.
Does walking with weights help osteoporosis?Some studies suggest that working out with weights, such as walking with weights, can help people improve bone mass density and reduce the risk of fractures. To strengthen both muscles and bone, there needs to be some resistance. Some methods of providing resistance during exercise include: resistance bands.
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