Physical activity is an important factor in the risk reduction and treatment of osteoporosis.
Physical activity improves balance and coordination, which reduces the risk of falling or consequent fractures. In addition to improving strength, flexibility and posture, physical activity can reduce pain and enable people with osteoporosis to perform activities of daily living.
Physical activity places an increased “load” or force on our bones. Bones respond by forming new bone and remodeling the existing bone to become stronger. Bones need to be stimulated by physical activity; it is necessary to be active in different ways in order to “load” or “stimulate” these bones and maintain their structural competence and strength.
In 2013, Dr. Lora Giangregorio from the University of Waterloo and a group of international experts developed the ‘Too Fit to Fracture exercise recommendations’ for individuals with osteoporosis or osteoporotic vertebral fracture.
The key points from this research is to develop multicomponent exercise programs that combine aerobic physical activity with balance and strength training to prevent bone loss and falls for individuals with osteoporosis, or those with osteoporotic spine fractures. These recommendations include expert opinions on how to move safely during every day activities, to avoid the risk of falls or spine fractures.9
There are four types of exercise and activity integral to the management of low trauma fracture and osteoporosis.
Your routine should include:
- Back Extensor Strengthening
- Strength training
- Posture training
- Balance training
- Weight-bearing aerobic physical activity
- Activities of Daily Living, Adaptation/Spine Sparing Strategies
Key Messages: Exercise and Osteoporosis
- Changes in posture, combined with changes in bone strength, can increase the risk of spine fracture. Poor alignment can be improved with exercises that target muscles important for posture.
- Poor alignment during daily activities may contribute to falls and fractures.
- In fact, spine fractures in older adults can occur during daily activities, like bending forward when putting on shoes.
- Aerobic physical activity, such as walking or dancing, has many health benefits. However, evidence suggests that balance and strength training should be emphasized as having the most benefit with respect to preventing falls, and bone loss. Aerobic physical activity should be combined with strength training and balance training to achieve the greatest health benefit.
- Performing exercises that challenge your balance daily can help prevent falls – even just a few exercises a day.
- Performing strength training exercises challenging most muscles of the body at least twice a week is recommended. With age, posture or body alignment can change, such that the spine is “hunched” or the head sits further forward than the shoulders. Individuals with osteoporosis can incorporate postural awareness into their daily life. Poor alignment can be improved with exercises that target muscles important for posture. Individuals with osteoporosis could consider practising exercises that target “back extensor muscles” daily.
- The individuals at high risk of fracture should consider consulting a physical therapist with expertise in osteoporosis in order to design and execute an exercise program that reduces the risk of fracture.
Further detail on exercise and physical activity will be covered in Module 3