A woman who had been diagnosed with osteoporosis came to me for a fitness consultation. She was so stymied by her diagnosis that she had stopped exercising for fear of causing further damage to her fragile bones. The truth is that exercise is both a preventative and a treatment for this condition, but the strategies are completely different. There are many safe and effective exercises for osteoporosis, but you need to bone up on the guidelines.
The ultimate goal of exercise for osteoporosis is to reduce the risk of falls and hip fractures. Although most fractures occur in the spine (about 40 percent), a hip fracture has the most debilitating and life-altering effect. About 25 percent of fractures occur in the hip, most often in the upper part of the thighbone (the femur), and in about half of these cases, the individuals are not able to walk unassisted again. Fifteen percent of fractures occur at the wrist, often the result of an outstretched hand to break a fall.
This Five Point Exercise Plan offers you a well-rounded fitness training program for osteoporosis, including exercises to protect and strengthen the weakened bones, improve posture and core stability, and prevent falls.
1) Weight-bearing aerobic exercise. Why? Gravity exerts a positive force on the bones.
Protect the spine – avoid impact exercise and any jarring or twisting movements.
Perform low-impact exercise, like walking, at a brisk pace.
Add intervals of faster walking, if appropriate.
Incorporate hills, steps and inclines into your route to increase intensity.
2) Strength training. Why? The pull of muscle on the bone stimulates formation.
Do full-body strength training since loading is site-specific to the bones.
Reinforce vulnerable fracture sites: the hip, spine and wrist.
Strengthen the large muscles of upper legs as well as the smaller muscles of lower legs for stability.
Start with lighter weights and higher repetitions and progress to more challenging weights with lower repetitions.
3) Stretching. Why? To correct postural alignment and prevent a shift in the center of gravity which can increase the risk of falling.
Avoid spinal flexion (forward bending) in all positions (e.g. standing or seated toe touches, the plough) which places additional forces on the weakened vertebrae.
Restore normal spinal curves, especially the in upper body. Vertebral fractures and poor posture can cause excessive rounding of the mid-back.
Lengthen the spine and stretch the torso to maintain height.
Avoid stretching or strengthening areas prone to fracture when pain is present.
4) Balance, stability and coordination. Why? To enhance the skills that help you recover from a stumble, change direction and prevent a fall.
Static Balance: Practice stork stance, “tight rope” walk, etc.
Dynamic Balance: Practice weight shift, start/stop, change of direction.
Stability: use tools like balance pads, disks, foam rollers and stability balls to improve core stabilization.
5) Core training Why? To build strength and endurance in the postural support muscles of the trunk and pelvis.
In abdominal exercises, avoid spinal flexion (forward bending, as in a crunch) and flexion with rotation (as in a side crunch).
Do exercises like the plank and “dead bug” series, which work the abdominals with the trunk in neutral spine alignment.
Include exercises for the muscles that support the length of the spine, e.g. back extension exercises which require you to gently arch the spine.
Of course, this information should not take the place of guidance from your own physician or other medical professional. Always consult with your doctor before beginning an exercise program or becoming much more physically active.