Your bones are living tissues that are constantly breaking down and rebuilding. And diseases that change bone architecture, such as osteoporosis, spell trouble.
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“Osteoporosis happens because the cells that break down bone are more active than those that are in charge of building bone, putting you at risk for fracture” explains orthopaedic physical therapist Jennifer Danzo. “Osteoporosis is a major health concern. Half of all women and one-quarter of all men over age 50 will have a fracture caused by osteoporosis in their lifetime.”
Fortunately, exercise done properly can help to rebuild bone and reduce the likelihood of fracture, says Danzo. Here are her recommendations if you have osteoporosis and haven’t had a bone fracture.
In order to notice changes in bone density, cardiovascular workouts should involve weight-bearing. Swimming and biking aren’t weight-bearing, so walking, jogging and dancing are more effective, she says. It’s also important to dial up your exercise intensity while you’re working out.
To see improvements in bone density, it’s a good idea to “surprise” your bones when you are out for a walk. You can do this by speeding up your pace, changing directions (try going backward or sideways!) or finding a hill or two to navigate. Alternating higher-intensity exercises two to three days a week with lower-intensity activities four to five days a week is most effective.
Work with free weights, use weight machines at the gym or do floor exercises to gain strength. “Recent studies have confirmed that it’s important to lift enough weight to stimulate bone growth,” Danzo says. “Because of this, you will need to do fewer reps with heavier weights.”
- Most of us don’t lift as much weight as we should. To determine how much weight you should be lifting, search for a “1-Rep Max” calculator available on many websites. Then aim for 70 to 80% of your 1 Rep Max.
- Remember that exercise is site-specific, so target the areas that are most prone to fracture: the spine, hips and wrists.
- Weight training is recommended two to three times a week.
- One area that often needs attention is the spinal extensor muscles, which lie over the spine. Strengthening your spinal extensor muscles will allow you to improve your posture and reduce fracture risk. You can do the following exercise daily:
- You can also improve your bone density with bone-loading exercises. An excellent one is stomping. All you need to do is stomp your feet, four stomps on each foot twice a day, using enough force to crush a soda can. This can lead to an increase in bone density in your hips.
Lengthening tight muscles will reduce back pain, and promote good spinal mechanics and posture. Muscles that are commonly tight include those you use to:
- Arch your back (spinal extensors).
- Raise and rotate your shoulders (shoulder elevators and external rotators).
- Lift your knees (hip flexors).
- Pull your feet toward your body (ankle dorsiflexors).
Danzo says you should perform stretches slowly and smoothly, “to a point of stretch, not pain.” For maximum benefit, do stretches once or twice a day and hold for 20 to 30 seconds.
Yoga and Pilates? Helpful or not?
You might have wondered if yoga or Pilates (core-strengthening) classes would be safe to do if you’ve got osteoporosis.
Danzo advises caution: “Yoga and Pilates are helpful for stretching and lengthening, but include many flexion-based (forward bending) poses.” If you are interested, she advises being careful and working with knowledgeable yoga and Pilates instructors. And let them know you have osteoporosis.
What to avoid
Exercises that keep your spine in a straight or slightly arched position are generally safer than exercises that involve bending forward. That’s because most spine fractures occur in a flexion-based (forward bending) position, says Danzo.
If you’ve already had an osteoporotic fracture, avoid exercises that involve forward bending, side bending and rotating the trunk. Proper strengthening of your lower abdominal and back muscles will also help to attain the optimal spinal position.
Fortunately, you can develop a safe, effective personal exercise program — even if you’ve had a fracture, she says. Ask your doctor whether a referral to a physical therapist might be worthwhile.