Treatment of osteoporosis is primarily activity-based. This places physiotherapists in an ideal position to provide great advice and guidance in formulating an appropriate and effective load-bearing and resistance exercise program. This is an essential part of a physiotherapists management plan for people with osteoporosis. Exercise is very good for all ages to help strengthen bones. However, it must be the right exercise, be carefully monitored, and the intensity must be gradually increased to avoid injury. Educating those with osteoporosis or those in high-risk groups is the first step in order to prevent further deterioration of bone mass or injury.
What is the biggest misconception about osteoporosis?
One of the biggest misconceptions is that people with osteoporosis should not lift weights or partake in high intensity exercise programs as they will break bones. A recent Australian study called the LIFTMOR trial, was undertaken to look at the effects of high intensity resistance and impact training (HiRIT) on post-menopausal women with low bone density. It involved studying 2 groups of women over 8 months. One group undertook a low impact exercise based program at home, and the other a supervised HiRIT exercise program. The results showed that those on the supervised HiRIT program improved their bone health and general muscle strength. Increasing muscle strength also improves balance to minimise falls and assists in the prevention of fractures if they do fall.
Another misconception is that people with osteoporosis should only do low impact exercises such as swimming and bike riding. Whilst these types of exercise are very good for overall cardiovascular fitness and muscle strength, they are not the most effective exercise for bone strength.
Some people with a genetic predisposition to developing osteoporosis say that it just happens to you due to your genes and you can’t do anything about it. The phrase “Gene’s load the gun but lifestyle factors pull the trigger” is an apt way of explaining how the condition progresses.
What are the risk factors for developing osteoporosis?
Bone density develops during childhood. It is important to exercise as a child, especially during early puberty when bones are growing most rapidly. Bone growth slows for women in their late teens, and early 20s for men, and this is the time when you reach your peak bone mass. After reaching peak bone mass, it slowly decreases over time. However, appropriate exercise can minimise bone density loss. If you have a sedentary lifestyle and do not exercise, you will lose more bone mass and develop brittle bones-osteoporosis.
Some people have a family history of osteoporosis and are genetically predisposed to developing it.
Women are more susceptible than men due to hormone changes post menopause.
For those over 50 years old, with certain medical conditions, their risk of developing osteoporosis also increases. These include diabetes, hyperthyroidism, digestive malabsorption diseases, rheumatoid arthritis, and chronic kidney and liver diseases.
Consuming a healthy diet with calcium rich foods is beneficial. Ensuring that the body’s vitamin D levels are maintained is important, as vitamin D helps the body absorb calcium which can impact on bone density.
Can we prevent osteoporosis with lifestyle choices?
By making appropriate healthy lifestyle choices relating to our diets and exercise, we can minimise our chances of developing osteoporosis.
- Choose the right exercise for our bones. High intensity, multi-directional weight-bearing exercise such as tennis are great for bones, as is resistance training. However, like any new exercise program, the amount, type of exercise, and intensity will depend upon your age, fitness level, and bone health.
- Seek advice from a physiotherapist to tailor a suitable exercise program. Physiotherapists are experts in exercise rehabilitation who can ensure that you are provided with a safe exercise program that matches your physical capabilities. If you have any underlying health issues, initially consult your doctor.
- Ensure you have a healthy diet, drink in moderation, and avoid smoking, as tobacco use may contribute to weak bones.
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