How Exercise can Help Osteoporosis from the Point of View of Exercise Physiology

Osteoporosis is the reduction of bone mass/ bone mineral density (BMD), the bones become increasingly porous which leads to a predisposition of fractures. In Australia, approximately 20% of people over 75 years old have osteoporosis, with women being at a greater risk than men. It is diagnosed by an estimation of the BMD using an x-ray machine called a DEXA. A t-score of 1 to -1 is considered normal, -1 to -2.5 is osteopenia (low bone mass), and -2.5 or more is osteoporosis. It can be found anywhere in the body but commonly in the hip, spine, and wrists.

When you think of osteoporosis you may think exercise could make it worse, but in fact, it does the opposite. Participating in exercise creates loading on your bones, which actually helps prevent the loss of bone density, by creating new bone growth and strengthens the surrounding muscles. Some exercises create greater osteogenic effects compared to others. Research has shown that moderate-high impact weight-bearing activities, high-intensity progressive resistance training (PRT) and balance training have the best outcomes. Although, other types of exercise may have a positive influence on overall fitness they do not alter BMD significantly. 

Decreasing the risk of falls, increasing BMD or preventing BMD loss is the main focus for individuals with osteoporosis. This is because if a 

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person with osteoporosis falls this can result in fractures, even if the fall is only minor. As their bones have become brittle and they cannot withstand the force of the fall, a loss of functioning, mobility and independence becomes an issue. For individuals to be able to maintain their independence and be able to perform their usual activities o

f daily living is critical. Exercise aids in regenerating their bone density and/or preventing even further loss. At the same time building strength of surrounding muscles creates stable structures, which in turn reducing the risk of falls.

References

Australian Institute of Health and Welfare 2019. Osteoporosis. Cat. no. PHE 233. Canberra: AIHW. Viewed 22 April 2020, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis

Beck BR, et al. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport (2016), http://dx.doi.org/10.1016/j.jsams.2016.10.001 

Turner, C. H., & Robling, A. G. (2005). Exercises for improving bone strength. British journal of sports medicine39(4), 188-189.

https://www.osteoporosis.org.au/exercise
https://exerciseright.com.au/osteoporosis/