By Lauren Harding, Registered Kinesiologist
What is osteopenia and osteoporosis?
Osteopenia and osteoporosis are conditions characterized by a loss of bone mineral density (BMD). BMD is a measure of the quantity of minerals (calcium and phosphorus) in a precise volume of bone. The difference comes in their severity.
Osteopenia indicates a lower BMD causing bones to be generally weaker. This bone weakness becomes more pronounced with osteoporosis as the bones become more brittle and porous (filled with air pockets), ultimately increasing the risk of fracture. Though less severe, osteopenia is a serious risk factor for developing osteoporosis.
Osteoporosis is often labeled as the ‘silent thief’ since bone loss occurs gradually, typically without symptoms. However, these four factors can signal underlying osteoporosis:
- Loss of height over time and/or development of a stooped posture
- Sudden back pain without any obvious cause
- Fracturing after a seemingly minor incident
How are these three conditions treated?
An excellent approach is early intervention physiotherapy treatment, accompanied by a well-designed exercise program. It is important to consult your doctor before starting a new exercise plan. As with any exercise, there is always risk associated.
Osteoporosis Canada recognizes exercise not only for increasing cardiovascular endurance, but also as a fundamental component to protecting your bones. Exercise maintains bone mass and builds muscle strength, as well as increases flexibility and range of motion, balance and coordination. Benefits also include reduced pain and inflammation, while promoting loss of excessive weight. Additionally, the risk of falling is reduced.
What types of exercise should I be doing?
There are 5 types of exercises recommended for individuals with osteopenia and osteoporosis:
|Types of Exercise||How Often Should I Do These?|
|Aerobic||3 to 5 days per week, a minimum of 150 minutes per week|
|Strength Training||2 to 3 times per week|
Aerobic exercise is considered any continuous, rhythmic activity that strengthens and stimulates the heart and lungs, thereby improving the body’s use of oxygen. It is recommended that ALL adults get 150 minutes of moderate to vigorous physical activity a week, or about 20 to 30 minutes per day, for at least 10 minutes at a time. During moderate-intensity activity, your heart beats faster and you breathe harder. The rule of thumb is that you are able to talk during these activities, but you are working too hard to be able to sing. During vigorous-intensity activity, your heart beats faster still and you continue to breathe harder. You are unable to say more than a few words at a time during vigorous activity. It is important with osteopenia and osteoporosis to do weight bearing aerobic exercises. Examples of weight bearing aerobic exercises include:
- Brisk walking, dancing, stair climbing, running, step aerobics, hiking, jogging, jump rope, and treadmill walking/running
In order to increase your muscular strength, you must work against resistance until your muscles feel tired.
This helps to reverse muscle atrophy, a condition that occurs when your muscles start to waste away due to lack of use. Furthermore, resistance training strengthens the muscles surrounding your joints, ultimately reducing further joint damage and decreasing risk of injury. ALL adults should do 2-3 days of strength training a week. Exercises using free weights (dumbbells), exercise bands or weight machines are strongly recommended. Examples include:
- bicep curls, sit-to-stand, lunges, rows, calf raises, bridges, triceps kickbacks, countertop push ups
Balance exercises help maintain your footing when an unexpected movement occurs in your daily life. Improving balance and coordination can reduce your likelihood of falling, therefore decreasing your fracture risk. Ironically, in challenging your balance, you run the risk of falling. For this reason, you must always take precautions such as having a chair nearby to hold onto. When you are training your balance, there are two main types of balance exercises:
- Static Exercises – Stand still in one spot holding a certain posture in order to practice balance. For example, standing on one foot on the floor.
- Dynamic Exercises – Balance is challenged more with adding movement. For example, walking ina straight line while touching the heel of one foot to the toe of the other with each step.
As you age, you lose flexibility which can increase your stiffness and discomfort, often preventing you from staying active. Stretching exercises help you to counteract this by increasing the range of motion of your joints and improving your flexibility. It is important to note that stretching should always be done after the muscles and the body are warmed up since stretching cold, stiff muscles increases your risk of injury. Just like in balance training, there are two main ways to stretch:
- Static Stretching – Take the muscles to their end range of motion and maintain that position for at least 30 seconds in order to enhance soft tissue and muscular flexibility.
- Dynamic Stretching – Functional, multi-joint movements that typically increase in range of motion and speed as the body begins to warm up.
While both are effective, dynamic stretching has been shown to be more beneficial than static stretching as a way to warm up prior to activity since it has been found to improve balance, strength, reaction time and agility. Static stretching, however, is still important and is most beneficial when performed at the end of exercise as a cool down. Static stretching can also be done separately when the body is warm as part of an everyday attempt to improve body mechanics, posture and flexibility.
We all have a natural curve in our spine, however, weak back muscles and/or spinal fractures can cause an excessive forward curvature of the spine. Rounding of the upper back is known as exaggerated kyphosis. This puts pressure on the front of your vertebrae, placing them at even great risk of fracture. Posture training exercises help to improve the alignment of your spine by correcting shoulder, back and neck positioning. Focus should be placed on exercises that strengthen the back muscles and reduce forward head posture. Abdominal exercises that strengthen the core muscles, help to maintain good posture as well.
To Sum Up
An exercise program is a vital component in the management of osteoporosis.
Regular participation in aerobic and strength training is fundamental, as well as balance, posture management and stretching. All in all, physical activity for individuals with osteopenia or osteoporosis can promote bone health and overall quality of life.