Condition guide
Osteoporosis is when bones lose density and their inner structure weakens, so they break more easily. It often causes no symptoms until a bone breaks. The good news: the right exercise, preventing falls and, when needed, medication can lower your risk of a fracture.
Bone is living tissue that is constantly being broken down and rebuilt. With age, and in women especially after the menopause, breakdown gets ahead of rebuilding: bone density falls and the inner structure becomes thinner. As a result, a simple fall or a strain such as bending forward to lift something can cause a fracture. The spine, hip and wrist are the bones that break most often.
It is diagnosed with a bone density scan (DEXA). Your doctor decides who should have a scan, and when, based on risk factors.
A noticeable loss of height, or an upper back that is becoming more and more rounded, may be a sign of spinal fractures that have gone unnoticed.
The expert consensus statement from the UK's Royal Osteoporosis Society groups exercise around three goals: strengthening bone, preventing falls and protecting the spine.
Whether you need medication, calcium and vitamin D varies from person to person; your doctor will decide on these. Stopping smoking and limiting alcohol also protect your bones.
Exercises at home
These exercises work on strength, balance and safe movement together. If you have had a spinal fracture, or the exercises cause pain, plan your programme with a physiotherapist. Hold on to something sturdy for the standing exercises.
Sit in a sturdy chair with armrests and move your feet back a little. Keeping your back straight, lean forward from your hips and stand up, then sit back down with control. As it gets easier, cross your arms over your chest or hold a weight in your hands.
8–12 reps, 2–3 setsStand upright, holding on to the counter. Lift both heels together to rise up onto your toes, hold for 2 seconds, then lower slowly. If it is suitable for you, letting your heels drop gently to the floor adds small impacts that give your bones extra stimulus.
10–15 repsStand with your feet hip-width apart and your knees slightly bent. Keeping your back straight, bend your body forward from your hips, then squeeze your buttocks to stand back up. Use this movement, rather than rounding your lower back, when you pick something up from the floor or lift a load.
10 repsLie on your front with your arms by your sides. Looking down at the floor, lift your chest and head a few centimetres off the floor, hold for 3 seconds, then lower slowly. This strengthens your back muscles and supports an upright posture.
8–10 repsStand upright in front of the kitchen counter, holding on lightly with one or both hands. Lift one foot off the floor by bending the knee back, and keep your balance. As it gets easier, hold on with one hand, then with just your fingertips.
10–15 seconds, 3–5 times on each footStand or sit up straight. Without lifting your shoulders towards your ears, draw your shoulder blades back and slightly down towards each other. Hold for 5 seconds, then relax.
10–15 reps, twice a dayMoving safely does not mean avoiding movement; it means moving the right way.
Video
From the YouTube channel of US physical therapists Bob Schrupp and Brad Heineck.
Movements to avoid and exercises that are recommended.
Movements that can strain the spine, and safe alternatives.
Yes; exercise is one of the most important parts of bone health. The expert consensus statement from the UK's Royal Osteoporosis Society recommends muscle strengthening, impact exercise for people it suits, and balance training. The type and intensity of exercise should be adjusted by a physiotherapist to your fracture history and general health.
The advice is to modify movements that bend your spine forward for long periods, as far as it will go, or while carrying a load, or to replace them with other movements. For example, rather than doing sit-ups, bending down towards the floor with your knees straight, or lifting a load by rounding your back, it is safer to bend from your hips and bend your knees.
Walking is very good for your general health, but on its own it is usually not enough for your bones. Muscle-strengthening exercise 2–3 days a week is recommended; if it is suitable for you, about 50 moderate impacts (light jogging steps, small jumps) can be added on most days. People over 65 and anyone with balance problems should also include balance exercises in their programme.
Yes, but the programme should be adapted to you. It is recommended that people with a painful spinal fracture are given reassuring information early on and are referred to a physiotherapist. At first, the focus is on strengthening, balance and learning to move safely rather than on impact exercise.
Yes, when it is done under expert supervision. In a study of 101 postmenopausal women with low bone density, 30 minutes of high-intensity strength and impact training twice a week significantly increased bone density in the lower (lumbar) spine over 8 months compared with a control group. However, programmes like this must always be planned for the individual and carried out under supervision, building up gradually.
See a doctor without delay if you have any of the following:
Sources
İhsan Eren