February 17, 2023
In this post we collaborate with guest author and registered CORU Physiotherapist Paul Conneely of PMC Physiotherapy to share some tips on exercise to maintain strong bones.
What is Osteoporosis?
Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years and often goes unnoticed until a person has a Bone Density (DEXA) scan or when a fall or sudden impact causes a bone to break (fracture).
Osteoporosis has many causes but is certainly more common in women after menopause. However, the drop in Oestrogen associated with menopause is not the only reason why someone might develop Osteoporosis.
Other Risk Factors
- Taking high-dose steroid tablets for more than 3 months
- Other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
- A family history of osteoporosis – particularly a hip fracture in a parent
- Long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
- Having or having had an eating disorder such as anorexia or bulimia
- Having a low body mass index (BMI)
- Not exercising regularly
- Heavy drinking and smoking
Exercise and Osteoporosis prevention
At PMC Physiotherapy, we are mainly involved in the exercise element of Osteoporosis prevention or exercise to try and improve bone density once Osteopenia (a precursor to Osteoporosis) or Osteoporosis is diagnosed. We know that for exercise to have a “building” effect on our bones, the exercise must have an element of impact.
A question all of our Physiotherapists get asked is “I know I need to exercise but I have an injury elsewhere and want to know what I can do to improve my bone health without exacerbating a current injury”
Correct diagnosis and exercise
To answer this question, we take a 2-pronged approach.
Firstly, our Physiotherapists will aim to diagnose, treat and manage the injury itself. If an injury is appropriately managed it should not be a barrier to exercise.
Indeed, appropriate exercise is likely to be a cornerstone of treatment for the injury.
Secondly, we look at the exercise recommendations for a person with Osteoporosis.
The Royal Osteoporosis Society in the UK recommends:
1. Impact exercise – at least 50 moderate impacts daily, this might include skipping, jogging, dancing etc.
2. Reduce time spent sitting and address any postural issues.
3. Strength training – at least 2-3 sessions of 20-30 minutes per week.
4. Flexibility training – yoga or pilates to improve balance, co-ordination, flexibility and reduce the risk of falling.
Within these guidelines to improve bone health, there are many options.
1. Impact Exercise:
Your Physiotherapist at PMC Physio will be able to grade this to suit your ability, level of injury or grade of Osteoporosis. This could be as simple as a walk or can be progressed to include high knee marching, hopping or even Plyometric training as we get stronger and fitter.
2. Reduction of time sitting:
This mainly aimed at prevention a kyphotic posture which may mean you are more likely to have spinal wedging or fracture. Reducing our time sitting can be done in many ways. A sit stand desk can be used in work to change position between sitting and standing. At home, we can choose to sit in a more upright chair than sitting on the couch.
3. Strength training:
This is where we literally have thousands of options. An experienced Physiotherapist will be able to suit the exercise to your level. If one exercise is sore, there is probably at least 10 other exercise options to work the same muscles but not be sore or too aggressive. In strength training we can also manipulate the weight you lift, the number of repetitions you do or the number of sets of exercise you do. We can even get a very good strength workout just by using our bodyweight. This is called Calisthenics. The possibilities are endless and here in the PMC Physio clinic in Dunboyne we have the expertise to guide you through this.
4. Fall prevention:
Part 4 is mainly aimed at reducing your risk of falls (and therefore reduce your risk of fracture). Here at PMC Physiotherapy, we often use the Otago falls prevention exercise programme. This is a gentle and scientifically proven way to reduce your risk of falling in later life. Like strength training, balance training can be graded to suit your ability of injury level. Community based classes such as Yoga and Pilates are also great ways of improving balance.
To summarise, a current or even long-term injury should not be a barrier to exercise in order to build your bone density. Exercises can be modified in many different ways to make sure they are appropriate to your level of fitness, type of injury and degree of Osteoporosis.
PMC Physio Dunboyne recommendation
If you are concerned about Osteoporosis or would like to learn more about bone health book an appointment with one of our physiotherapists. We also recommend to speak with registered CORU Dietician Sonja Lynch at What2eat where she focuses on long term health rather than food restriction and fad diets. Combined with a suitable exercise routine, Sonja can help you develop a tailored nutrition plan to improve bone health and reduce the risk of fractures.