Osteoporosis why exercise

You might need some tests first, including:. In the meantime, think about what kind of activities you enjoy most. If you choose an exercise you enjoy, you're more likely to stick with it over time. Because of the varying degrees of osteoporosis and the risk of fracture, you might be discouraged from doing certain exercises. Ask your doctor or physical therapist whether you're at risk of osteoporosis-related problems, and find out what exercises are appropriate for you.

Strength training includes the use of free weights, resistance bands or your own body weight to strengthen all major muscle groups, especially spinal muscles important for posture.

Resistance training can also help maintain bone density. If you use weight machines, take care not to twist your spine while performing exercises or adjusting the machines. Resistance training should be tailored to your ability and tolerance, especially if you have pain.

A physical therapist or personal trainer with experience working with people with osteoporosis can help you develop strength-training routines.

Proper form and technique are crucial to prevent injury and get the most from your workout. Weight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening.

These types of exercise work directly on the bones in your legs, hips and lower spine to slow mineral loss. They also provide cardiovascular benefits, which boost heart and circulatory system health. It's important that aerobic activities, as beneficial as they are for your overall health, are not the whole of your exercise program. It's also important to work on strength, flexibility and balance.

Swimming and cycling have many benefits, but they don't provide the weight-bearing load your bones need to slow mineral loss. However, if you enjoy these activities, do them. Just be sure to also add weight-bearing activity as you're able.

Moving your joints through their full range of motion helps you keep your muscles working well. Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example, or after a minute warm-up. They should be done gently and slowly, without bouncing.

Avoid stretches that flex your spine or cause you to bend at the waist. Ask your doctor which stretching exercises are best for you. Fall prevention is especially important for people with osteoporosis. Stability and balance exercises help your muscles work together in a way that keeps you more stable and less likely to fall.

Simple exercises such as standing on one leg or movement-based exercises such as tai chi can improve your stability and balance. If you're not sure how healthy your bones are, talk to your doctor. Don't let fear of fractures keep you from having fun and being active. Edward R. Laskowski, M. Specifically, the bent-over row targets the posterior part of the deltoid in the shoulder. These include reduced need for some medications that can contribute to the risk of falls, and better management of other health problems.

A sedentary lifestyle, poor posture, poor balance and weak muscles increase the risk of fractures. A person with osteoporosis can improve their health with exercise in valuable ways, including:. Always consult with your doctor, physiotherapist or health care professional before you decide on an exercise program.

Factors that need to be considered include:. A combination of weight-bearing aerobic and muscle-building resistance exercise is best, together with specific balance exercises. Swimming and water exercise such as aqua aerobics or hydrotherapy are not weight-bearing exercises, because the buoyancy of the water counteracts the effects of gravity.

However, exercising in water can improve your cardiovascular fitness and muscle strength. People with severe osteoporosis or kyphosis hunching of the upper back who are at high risk of bone fractures may find that swimming or water exercise is their preferred activity. Consult with your doctor or healthcare professional. Even though walking is a weight-bearing exercise, it does not greatly improve bone health, muscle strength, fitness or balance, unless it is carried out at high intensity such as at a faster pace, for long durations such as bushwalking or incorporates challenging terrain such as hills.

However, for people who are otherwise inactive, walking may be a safe way to introduce some physical activity. A person with osteoporosis has weakened bones that are prone to fracturing. They should avoid activities that:. The exact amount of exercise required for people with osteoporosis is currently unknown.

However, guidelines suggest:. You need to continue your exercises over the long term to reduce your chances of a bone fracture. Regular exercise is an essential part of any osteoporosis treatment program. See your doctor before starting a new exercise program. See what the experts recommend along with real life examples of what you can do and what you should avoid. New multicomponent exercise recommendations combine muscle strengthening and balance training as a means of reducing falls and resulting fractures for people living with osteoporosis.

Too Fit to Fracture is a series of exercise recommendations for people with osteoporosis or spine fractures. It was developed by expert consensus using the Grading of Recommendations Assessment, Development, and Evaluation GRADE method, which is endorsed by the World Health Organization and the Cochrane Collaboration, to determine the quality of evidence for each recommendation in the existing scientific literature.

Osteoporosis Canada has developed a video series on exercise and osteoporosis in partnership with the University of Waterloo and Geriatric Education and Research in Aging Sciences Centre which provides ideas for safe and effective exercise and physical activity. The video series tells the stories of four very different people with osteoporosis and showing you their innovative solutions to keep healthy and active.

The information contained in these videos is not intended to replace medical advice. Consult your healthcare provider or a physical therapist about what exercises are right for you. The meta-analysis conducted by Nikander et al. It is interesting to note from this review how the most challenging high impact exercise programs, such as jumping, are only effective when they are associated with other low-impact exercises.

Bolan at al. Giangregorio et al. In particular, it is stated that such individuals should not engage in aerobic training to the exclusion of resistance or balance training. Xu et al. They suggest that each session should be between 30 and 60 min, 3 or more times per week for at least 10 months.

Also, in the review of studies analyzed by Marquez et al. Combined exercise and group exercise programs, including weight-bearing activities, balance training, jogging, low-impact loading, high magnitude exercise, muscle strength, and simulated functional tasks, are advised to determine BMD increasing or at least to preserve it.

However the combination of exercise should be tailored on the patient's clinical features. No agreement exists on the best protocol in terms of duration, frequency, and the type of exercises to be combined. The most relevant effect was detected at the spine. The vibration of the entire body is a physiotherapy intervention based on the use of a high frequency mechanical stimulus generated by a vibrating platform Whole Body Vibration or WBV that activates the mechanoreceptors of the bone favoring osteogenesis.

The results of the studies included in two systematic reviews [ 1 , 61 ] conclude that the treatment with a WBV seems to be more effective than simple walking and of similar efficacy to strength training to improve bone mass at specific sites femoral neck and spine in postmenopausal women.

To obtain these results, Dionello et al. The positive effect of WBV in improving BMD in different sites is supported also by other reviews [ 29 — 31 ] and confirmed by Oliveira et al. Fratini et al. Thus, it is better if the subject during the treatment assumes static postures, such as full-standing or hack squat.

However, many factors e. Conversely, a previous systematic review [ 34 ] showed that while the use of vibration platforms can improve muscle strength in the lower limbs of elderly patients, it does not seem to induce significant changes in bone mineral density in women.

Similarly, while the analysis performed by Cheung and Giangregorio [ 41 ] on 5 systematic reviews shows only a modest clinical improvement of BMD at the hip in postmenopausal women, the review of Jepsen et al. Training with vibrating platforms is reported to have effect on enhancing muscle strength, improving balance, and reducing the risk of fall in osteoporotic patients, while controversial findings on improvement of BMD in different sites were reported.

Although several exercise recommendations for individuals with osteoporosis have been proposed, reviews are often inconclusive, for the methodological variability emerging from the studies. However, results from the Cochrane review [ 15 ] suggest a relatively small, statistically significant, but possibly important effect of exercise on bone density in postmenopausal women compared with control groups.

The exercise types most effective on BMD for the neck of femur, which should be considered in clinical practice, appear to be the progressive resistance strength training for the lower limbs. The most effective intervention for BMD at the spine has been suggested to be the multicomponent training exercise programme. Weight-bearing aerobic exercise and training with vibrating platforms may have also an impact in improving BMD.

These evidences are relevant not only because they support the possibility to increase BMD in postmenopausal women, but also because they confirm the possibility to prevent further bone loss in osteoporotic patients, thus limiting the risk of fractures. Key considerations for future research lines emerge from this review: 1 the need for studies to evaluate the effects of the longer-term exercise; 2 the need for studies on male patients; 3 the need for studies that use evaluation criteria of the outcome that are more sensitive to changes in the bone structure; 4 inclusion of parameters such as diet or drugs as a covariate in the analysis of the effects of the exercise; 5 the need to stratify studies on the effects of exercise on BMD based on age; and 6 the need to understand the effects of deconditioning.

National Center for Biotechnology Information , U. Journal List Biomed Res Int v. Biomed Res Int. Published online Dec Author information Article notes Copyright and License information Disclaimer. Corresponding author. Maria Grazia Benedetti: ti. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. Abstract Physical exercise is considered an effective means to stimulate bone osteogenesis in osteoporotic patients. Introduction According to the literature, the level of bone loss in a postmenopausal woman increases with age, respectively, with a loss of 0.

In general, therapeutic exercises for osteoporosis can be ranked in two types of activities: Weight-bearing aerobic exercises , such as impact activities or any other exercise in which arms, feet, and legs are bearing the weight, i. Materials and Methods 2. Methodological Problems Emerging from the Studies Several critical issues in the evaluation of evidence, limiting in some way the conclusion of this review, were highlighted in the Cochrane reviews [ 3 , 15 ].

Table 1 Systematic reviews and meta-analyses on Exercise and Osteoporosis. Effects of training on bone mass in older adults: a systematic review. Sports Med. Strength exercise seems to be a powerful stimulus to improve and maintain bone mass during the ageing process. Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life. BMC Med. The findings from these studies also suggest that exercise regimens that include moderate- to high-magnitude impacts from varying loading directions may represent the optimal mode to enhance bone structure and strength.

Effect of weighted exercises on bone mineral density in post-menopausal women. A systematic review. J Geriatr Phys Ther. The exercise program must be incorporated into a lifestyle change and be lifelong due to the chronic nature of bone loss in older women.

McMahon M. What impact does aquatic therapy have on bone density in postmenopausal women? If it has a positive or maintenance effect, what are the programme parameters that facilitate these outcomes? Aqualines ;29 1 Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. The most effective intervention for BMD at the spine was combination exercise programmes compared with control groups.

Our results suggest a relatively small statistically significant, but possibly important, effect of exercise on bone density compared with control groups. The effect of exercise on pQCT parameters of bone structure and strength in postmenopausal women -- a systematic review and meta-analysis of randomized controlled trials.

Osteoporos Int. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Plos one. However, diverse methodological and reporting discrepancies are apparent in the published trials on which these conclusions are based.

Other forms of exercise that provide greater targeted skeletal loading may be required to preserve bone mineral density in this population. Effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis.

The effect of physical exercise on bone density in middle-aged and older men: a systematic review. Osteop Int. Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. J Orthop Translat. This beneficial effect is better observed in long-term TCC practice.

Effects of tai chi exercise on bone health in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials.

A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes. Br J Sports Med. Other forms of impact exercise appear less effective at preserving BMD in this population. However, diverse methodological and reporting discrepancies are evident in current published trials. Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis. Due to substantial clinical heterogeneity of the target groups and specific demands of exercise modes, it is unclear which exercise program is optimal.

The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis. J Bone Miner Metab. High-impact-alone protocols are effective only on hip BMD in this group. However, diverse methodological and reporting discrepancies are evident in published trials. Whole-body vibration exercises have no beneficial effects on bone in postmenopausal or elderly women.

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