By Exercise Physiologist Natalie Milverton
Osteoporosis and the Role of Exercise
Osteoporosis is an increasing health problem in Australia, especially with an aging population. Here at Beyond we want everyone to know the benefits of exercise for bone health! Many people see Osteoporosis as an inevitable part of aging; however, appropriate bone loading during life can play a protective role. Regular resistance and impact exercise can be as effective as, if not more than, medications to strengthen bones and prevent fractures. So why not move more and stay strong?
What is Osteoporosis?
Bones are constantly remodelling across the lifespan, with old bone tissue replaced by new bone tissue during a 3-9-month cycle. Osteoporosis occurs when the rate of bone mineral loss (e.g. calcium) is faster than the body’s ability to replace the minerals, contributing to reduced bone mass and poorer structural integrity. Osteopenia is when bone mineral density drops below normal levels, becoming a stepping stone to Osteoporosis. The most common sites of Osteoporosis are the spine, hips, and wrists, with women most affected especially following menopause.
During the younger ‘growth years’ bone density greatly increases, more so when mechanical strain is applied from jumping and running activities. You can think of this as laying down the structural foundation for adult bones. Bone mass peaks in the late 20s and gradually declines from approximately 40 years. While age, genetics and hormones may influence osteoporosis onset, regular exercise and a healthy diet (adequate vitamin D and calcium) can improve muscle and bone strength, helping to reduce falls and fracture risk.
What Exercise should I be doing?
Bone specific exercise goals change throughout life from forming maximal bone in childhood and adolescence, to optimising muscle and bone mass in young-middle adulthood and minimising bone loss in later life. The most stimulating types of exercise for osteoporosis are resistance, impact and balance training.
Resistance exercise aims to strengthen the muscles which move the skeleton. When a muscle shortens, stress is applied to the bone attachment point and must be specific to the area(s) of bone weakness. Repeated stress in the form of resistance exercise (2x weekly) and progressive increases in load and speed help to strengthen your muscles and bones, but also react and recover from any loss of balance.
Impact exercises (e.g. marching, hopping, 3x weekly) apply extra load and are more stimulating for bone building compared to low impact (e.g. walking, swimming). Dynamic movement, such as lunging forwards, sideways and backwards, distributes load in different directions and are more stimulating than repetitive loads (e.g. running). Movements performed in quick bursts encourage you to exert a higher amount of force over a short period of time, promoting more bone formation than slow, continuous activity.
Balance training is a valued part of a bone specific exercise program given bone density loss increases the odds that a slight bump or fall can cause a fracture and hospitalisation. Check out the blog “Want to prevent falls and potential fractures?” to learn more about how balance can be included in your movement routine so you stay steady when moving about!
You might be thinking this sounds intense, rest assured your Accredited Exercise Physiologist will tailor your program to your osteoporosis status, movement capacity and medical history. You will start slowly, gradually load up and progress to movements that stress bone differently to everyday tasks.
Accredited Exercise Physiologists are specifically trained in how to best prescribe exercise for many bone conditions and will collaborate with your GP to keep your program safe and engaging. Here at Beyond we are committed to helping everybody move through life. Don’t let Osteoporosis get you down, keep moving and keep your bones strong!
Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis (2016)
Erman, J.K., Gordon, P., Visich, P., and Keteyian, S. Clinical Exercise Physiology (3rd Edition, 2013). Osteoporosis (Ch 3)
R. Daly., Exercise for Osteoporosis, Sarcopenia and Falls. An Update on the Evidence: From Research to Practice (2019)