So welcome to the third in the series of blogs on osteoporosis. You can find the other 2 here, giving an introduction to osteoporosis and some ideas on nutrition.
In this blog I want to look at the role of exercise in osteoporosis and the types of exercise which are important to do.
There are 2 main ways that exercise is important in helping osteoporosis
1. The bones are like any other part of the body - they exist on a use it or lose it basis. We all know that if we use our muscles they get stronger and adapt to what we do. The same is true of our bones, although it is much more difficult to see.
Consider a situation where you are lying down and not moving at all - no muscles are changing length (apart from the ones responsible for breathing of course) and little to no force is being put through the bones of your skeleton. Now if that is all the skeleton is needed for how strong do you think it needs to be? Not very - it's purely there to give some shape.
Now think about being up and walking - your feet are impacting the ground, force is being transmitted up through the long bones of the legs, your weight is being supported by the bones of your spine. Think how much more robust the skeleton needs to be to cope with these demands.
If you have osteoporosis it is important to do weight bearing exercise on a regular basis, to use and challenge the bones in order to help maintain their integrity.
And if you don't have osteoporosis - the same applies, especially if you are in the at risk groups discussed in the first blog of the series. By undertaking weight bearing exercise and strength exercise you can develop the strength of your bone structure and give yourself a better baseline to start from should you go on to develop the condition.
2. The second benefit for regular exercise is the effect it can have on the risk of slipping and falling.
As we age the ability we have to balance well and respond to changes in the surface we are on tend to reduce. As we walk along our brain receives messages from the feet, so it knows where they are and the position they are in. The brain can then adjust the muscles to help us keep our balance. This system is known as proprioception.
The good news is that this is a system that can be trained - by challenging it. You can practice your balance and get better at it. The upshot of this is that falls become less likely, and with that the risk of fractures also become less likely.
Fractures are a common complication with osteoporosis, most often due to trips and falls, and frequently involve fracture of the hip or femur (the large bone of the upper leg), which can be serious, particularly in the elderly.
So what should you do?
Weight bearing exercise, strengthening and balance exercises.
Walking is a great place to start. It provides the weight bearing you need along with the proprioceptive feedback you need to develop balance. If you are not very steady on your feet, stick to smooth flat surfaces, at least to start with. Depending on your ability and confidence you could try walking on more uneven surfaces, which will provide a greater balance challenge.
Other weight bearing exercises are climbing stairs, skipping, hopping and a variety of team and individual sports. In general the faster you move, the more impact you will create and it is always worth getting professional advice, from a doctor or osteopath, before you start a new form of exercise, especially where the intensity is significantly greater than your current exercise.
Balance exercises can also be helpful. Standing and single leg standing can both be useful to improve your balance. Make sure you are next to a wall or table or something you can hold to steady yourself should you need to, and build up slowly, until you can comfortably balance for a couple of minutes without the need to hold on.
There are many progressions to this which can help you further improve your balance and we can provide help and advice about these.
Finally it is also important to strengthen the muscles, they are vital to movement and help to support the bones and joints. There are many variations on strengthening exercises which will help, from squats for the legs and back, to lifting weights for the arms. Again, as with other forms of exercise it is often worth getting professional advice before embarking on a strengthening plan to ensure that the exercises are tailored and adapted to your current ability, and you know how to make them harder as you progress.
So the take away message from this? Be active. Walking is a great place to start. Challenge yourself to walk for at least 20 minutes a day if you are able - #try20. To give yourself a kick start we can help you find the appropriate exercises and level for you - just call to book or book easily and quickly online.
Ian is the founder and osteopath at Ian Thornley Osteopathy.
07738017206