How Exercise Prevents, Treats Osteoporosis

It may seem counterintuitive to think that someone with brittle bones could prosper from exercise. The fear of fracture or a worsening of the condition may prevent those with osteoporosis from engaging in physical activity. But the latest research shows that, on the contrary, exercise can reap huge benefits for someone with osteoporosis by strengthening the bone structure and, if done accordingly, decreasing the risk of fractures and disease progression.

Osteoporosis is a bone-decimating disease that predominantly affects women, including four out of five of the 10 million U.S. adults over 50 who are diagnosed with the condition. According to data from the National Institutes of Health, one in two women over 50 will experience a fracture related to osteoporosis in her lifetime. As the perception of the bone disease has changed from an unavoidable deterioration of bones due to age to a preventable occurrence largely predicated on lifestyle choices, exercise has been recognized as a central preventive strategy. Bone is a living organism, and exercise—weight-bearing exercise in particular—helps develop bone mass until a person’s late twenties, when growth of new bone naturally begins to stabilize or decrease. By middle age, both men and women experience a decline in bone mass, and women specifically see a sharp decline in the years following menopause. But as the medical community now acknowledges, that declines is far from the static, inevitable progression so often perceived.

Bone Deposits, Now and Later

When Dr. Adam Bright, an orthopaedic surgeon at Sarasota Memorial Hospital in Florida, was in medical school, he and his fellow students were stumped by an anomalous X-ray of a man’s right-arm bone structure. They offered conjectures, assuming the patient had some type of cancer. But the truth was much more simple: the man made his living as a rodeo rider, and the super bone structure in his arm was a result of the strain the limb endured in his profession. “He developed bone in response to strain. And the strain is really exercise,” says Bright, a member of the American Academy of Orthopaedic Surgeons and a fitness guru who maintains information on replacement surgeries on his website www.abrightmd.com.

The medical community has long known that exercise can help a person amass bone density, and do so in a “depositing” kind of way. That is, the more bone mass a person builds up, the less rapidly that person will lose bone mass when age starts to lead to the path of deficits. Weight-bearing exercise, like running, walking or weight-lifting, confers the most benefits by providing the “strain” to which Dr. Bright refers.

However, as important as physical activity is to prevention, that is not its sole benefit. Recent research shows that exercise confers benefits on the bone health of those already diagnosed with the condition. According to research from the Mayo Clinic, the benefits derived from physical activity in those with osteoporosis include increased muscle strength and improved balance, which together can decrease falls that result in injuries like hip and wrist fractures. A study from the Florida State College of Medicine found that physical activity could replace hormone therapy as an effective way to retain bone mineral density in postmenopausal women. Another study from Brazil found that weight-training in postmenopausal women with osteoporosis helped maintain bone density compared to women who did no such exercise.

While weight-bearing exercise is the most effective way to increase bone mass, rigorous forms are discouraged for those already diagnosed with osteoporosis. An overstrain of such exercise can itself lead to fractures in those with vulnerable bones. Such exercise may include jumping, running or jogging. Instead, low-impact weight-bearing exercise is recommended for those with the condition (see Building Stronger Bones above).

Overall, Dr. Bright refers to three key aspects of bone health—calcium, vitamin D and exercise—that show the control a person has over the potential progression, or lack of progression, of the disabling condition. Of these three components of bone health, exercise has proven to be an indispensable part of the bone health relationship. And it is an effective antidote to age-related frailty in key sequences: both before and after.

Building Stronger Bones

Those with osteoporosis must take special care of their bones, particularly in the problem areas of the spine, hip and wrist. While exercise can provide huge benefits, not all exercise is OK. Those with osteoporosis should focus on the following three types of activities.

Strength training. This will help build muscle strength and also can directly improve bone strength. Examples include free weights, weight machines and resistance bands. Exercises focusing on the back muscles can help improve posture and prevent spinal compression.

Weight-bearing aerobic activities. Such exercise directly strengthens bones and can impede mineral loss. Exercises include low-impact aerobic exercise, dancing, elliptical training, gardening, stair climbing and walking. While swimming confers cardiovascular benefits, it does not directly impact bone strength.

Flexibility exercise. Being flexible improves balance and can prevent injury. Flexible joints help improve posture, which can lessen harmful strain on the spine. Exercises include stretching, though stretching exercises that force a person to bend at the waist are not recommended for those with osteoporosis.     (Source: Mayo Clinic