Gareth Sneath PT, MScCH, Grad Dip Man Ther, MCPA

osteoporosis – is a disease of bones that leads to an increased risk of fracture

Osteoporosis is a silent condition.  It reduces the strength of the bone without any outward signs or symptoms until one day you unexpectedly break a bone.  A simple fall breaks your hip,  lifting the laundry compresses a vertebra or when extreme, a sneeze breaks a rib.  These injuries are painful and can change your life. All of us can expect to lose some bone as we age but the best treatment is to strive to have the most bone possible. Fortunately, following the latest osteoporosis exercise treatment guidelines are a key component for preventing and treating this problem but to be effective you need to incorporate several different elements into your program.

I recently attended a two day BoneFit © workshop in Toronto which reviewed the latest research.  It looked at the exercise components in detail, including use of correct technique and form, safe progressions of exercise according to risk factors and avoidance of certain high-risk exercises and positions that are more likely to cause a fracture. The goals of each type of exercise are different and there are several things to consider when you choose exercise to manage your bone health.

What exercises you should you do to reduce the risk of breaking bones and improve bone health? Current research recommends you include these types of exercise:

  • “impact” activity such as brisk walking and stair climbing
  • strength/resistance training
  • balance and agility exercise
  • postural alignment

Impact activities

Impact activities are critical.  Impact loads the bone to stimulate bone cell activity. Walking on its own is not enough. Brisk walking or stair climbing is “job one” as it is safe and provides “impact” stress to bones. To be effective it needs to be performed for 30 minutes in a day.   These sessions should last a minimum of  10 minutes at a time.  Plan to include impact in your day at least 4-5 times per week.

Advantages of brisk walking or stair climbing:

  • Easily incorporated into your activities of daily living.
  • Helps balance
  • Cardiovascular benefits

Strength and Resistance Training

Brisk walking is great but does not build sufficient strength.  Adding in strength training is important and should include all the major muscles groups i.e. arms, legs, trunk.

To build strength, the resistance needs to be sufficient to create a sense of fatigue.  This can be achieved more safely using higher repetition with lower loads.  As you improve, the resistance should be gradually increased while avoiding overload.  To be safe you may need to see a professional for technical advice.  Sessions should be scheduled 2-3 times per week.

Advantages of strength and resistance training:

  • Loads the bones which stimulates bone cells
  • Reduces risk of falls

Balance and agility training

Challenging your balance and flexibility are important to reduce your risk for falling.  These exercises improve your ability to react and maintain balance when you are in more risky situation i.e. ice, uneven pavement. These types of exercises are recommended daily and should be performed for 15-20 minutes.  Incorporating them into your everyday life can make this time commitment more manageable i.e. stand on one leg as your computer boots up.

Typically these exercises incorporate the following movements.  When challenging balance you should ensure that you are in a safe and/or supervised environment to limit the risk of falling.

  • Functional movements in standing and walking
  • Random movements i.e. standing on a BOSU or foam mat
  • Walking and changing direction quickly

Posture

Posture is a key element of reducing the strain on the spinal vertebra.  It is also an important element of healthy aging as  a forward stooped posture is known to be a predictor of loss of independence as we age.

Typically postural exercises engage muscles that oppose the tendency to bend forward. Postural awareness exercises should be performed intermittently during each day.  These exercises typically:

  • Engage the “Go Tall” extensor muscles
  • Strengthen the abdominals and glutei muscles

A final component of treatment should also include teaching proper technique to protect the spine when lifting, reaching or leaning forward. Learn to lift with your legs, not your back.

The goal of treatment is prevention of fractures through the application of exercise therapy safely and consistently. Including all aspects can be a  challenge when you have osteoporosis or balance issues as it is important to ensure these exercises are performed safely.  An individually tailored program of exercise is an important part of the treatment of this condition whether for prevention of an injury or as part of recovery after a fracture.

Available at the Orthopaedic Therapy Clinic is a four part program which covers the Osteoporosis Exercise Treatment Guidelines in detail to ensure safe and correct performance of exercise plus tips on lifting and handling and how to move safely. The first session includes a comprehensive assessment followed by postural alignment techniques (1 1/2 hours). Each subsequent session (three in total, 1 hour duration each) covers strength and resistance exercise, aerobic and balance training. Please call the clinic or myself at 416 925 4687 to book this program or call or email me at gsneath@orthophysio.com.

Osteoporosis Canada has an excellent website for more information on exercise. The advice in this article is not meant to replace advice from your health care professional.