Osteoporosis and Exercise Training

What is osteoporosis?

Osteoporosis is a disease in which the density and quality of bone are reduced, and is characterized by an increased risk of fragility fractures.

The loss of bone occurs silently and progressively. Often there are no symptoms until the first fracture occurs. Bone and muscle function are an integral part of locomotion, both of which are affected by advancing age.

How to diagnose osteoporosis?

Body Mineral Density tests are the most efficient type of tests to diagnose osteoporosis.

On the most common ways to measure the bone density is DXA (dual-energy X-ray absorptiometry) test.  DXA is a low radiation X-ray capable of detecting quite small percentages of bone loss. It is used to measure spine and hip bone density, and can also measure bone density of the whole skeleton.

According to the World Health Organization (WHO) criteria, osteoporosis and osteopenia are defined as the lowest bone mineral density (BMD) T-score of ≤−2.5 and −2.5 to 1.0 measured at the lumbar spine or hip, respectively.

Exercising and Osteoporosis

Exercise training has been recommended as a low-cost and safe non-pharmacological intervention strategy for the conservation of musculoskeletal health.

It is widely accepted that mechanical load induced by exercise training increases the muscle mass, produces mechanical stress in the skeleton, and enhances the osteoblast (cells responsible for the formation of bone) activity.

Resistance training or weight training is the primary exercise intervention for increasing muscle mass in humans.

It has been frequently prescribed by medical doctors and physiotherapists for people with osteoporosis, because it has been consistently shown to be safe and effective for improving muscle mass, size, and strength in middle-aged and older adults, including the frail elderly and even those with a history of fracture.

Resistance training benefits:

• Increase of muscle mass
• Stronger bones. Strength training increases bone density and reduces the risk of fractures and osteoporosis, which also leads in decrease of injuries
• Increases joint mobility
• Improves balance
• Weight loss by decreasing abdominal fat
• Improvement of cardiovascular health
• Improves mental health and increases cognitive functions
• Decreases risk of injury and fractures

Types of resistance training exercises:

• Lifting weights. Classic strength training tools such as dumbbells, barbells and kettle bells.
• Using resistance bands. The bands provide continuous resistance throughout a movement
• Using weight machines
• Lifting your own body weight
• Functional movements, such as standing and rising up on your toes, squats, lunges, sit-ups.

Based on the available information, weight lifting and resistance training either alone or in combination with other interventions (aerobic training, physiotherapy, swimming, cardiovascular training etc.), may be the most optimal strategy to improve the muscle and bone mass in postmenopausal women, middle-aged men, or even the older population.

Weight-bearing exercises are exercises that include activities that make you move against gravity while staying upright.

Exercises like:

• Yoga
• Hiking
• Nordic walking
• Dancing
• Cycling
• Running or fast walking
• Stair climbing
• Low-impact aerobics
• Swimming

Are exercises that can help keep bones strong and also are a safe alternative to weight lifting.

Conclusion

Exercise training, especially resistance training, is important for the maintenance of musculoskeletal health in an aging society.

Be patient. The bone-building phase in young adults takes up to four months, and it may take a lot longer if you have osteoporosis or are older.