Osteoporosis affects just under 1 million Australians with approximately 66% of Australians over 55 being affected. It is also estimated that 180,000 fractures yearly can be attributed to poor bone health. These numbers are both scary and sobering. Especially considering how dangerous fractures such as hip fractures can be.
If you suffer from bone mineral density diseases, or you have a family history of these conditions it is important that you are managed effectively by a doctor to ensure that you are medically managing it as best as you can. But did you know that physiotherapy and exercise physiology are also a cornerstone of effective management of these conditions?
The Gold Standard:
Bones grow where there is load and pressure applied to them. It is one of the roles of a cell type called an osteocyte to detect mechanical load applied to a bone and to signal to other cells (osteoclasts and osteoblasts) to repair and strengthen the bone.
This mechanism is already used to our advantage when healing fractures and also not to our advantage during conditions such as hip impingements where bone is grown in areas that affect our mobility. We can leverage this condition to allow us to increase the bone mineral density in populations that are affected or could be affected by conditions such as osteoporosis and osteopenia.
The way we do this is by loading the bone to stimulate bone growth in those tissues. This means we need to apply a substantial force while exercising by performing resistance training and by including impact exercises such as running, jumping, and stomping.
Is walking enough?
People hear ‘impact exercises’ or ‘weight-bearing exercises’ and may think that walking is sufficient for bone growth. While walking is a phenomenal exercise that can and should be performed regularly due to the health benefits it provides, both mental and physical, it is generally considered that walking alone is not sufficiently impactful to stimulate bone growth.
What can you do instead?
There are initiatives in practice all over the world that include a myriad of exercises. Things like dance classes, boxing classes, strength and balance exercises, and running programs. All of these can be beneficial and can be used to strengthen bone tissue.
A good starting point can be a general strengthening program. This would be a program that is progressive – it continues to be challenging as you participate in it – and targets many areas in the body. This may include exercises using bodyweight exercises, free weights (dumbells or barbells), or machines to apply load to the muscles
If you are new to exercising and exercise programs it may be a good idea to consult a physiotherapist or an exercise physiologist at this point. The reason for that is there are so many options in a gym or even with bodyweight exercises at home that it can be daunting to try to put together a program that seems safe and also loads all the affected and necessary areas.
Final thoughts
While you may be a little apprehensive about including high-impact or heavy exercises into a program if you are worried about fractures, it is important to note that if you safely build up to high-impact exercises, you will in fact stimulate the most bone growth. Think: the more you load the bone, the more the bone will grow.
