26 Jun Bones as brittle as chalk? Exercise can help!

Throughout the lifespan our bones are constantly changing. In later life this change often leads to bones becoming brittle and weak, termed as osteopenia or osteoporosis. Currently 4.74 million Australians over the age of 50 have poor bone health. In 2012 there were over 140,000 fractures in Australia that were due to osteopenia or osteoporosis. However, a diagnosis of osteopenia or osteoporosis need not be a life-sentence to never-ending breaking bones. There are many types of exercise which can help turn back the hands of time for the age of your bones. Better yet – if you are a young adult you can utilise exercise now to reduce your risk of poor bone health later in life!

Our bones across the lifespan

As we develop from children into teenagers and young adults, our bones are constantly growing, changing and becoming stronger. Through early adulthood our body continues to deposit calcium and other minerals into our bones to increase their strength, with bone strength being highest during our 20’s and 30’s. From the age of 40 onwards our bones progressively lose strength over time. The onset of osteopenia or osteoporosis can be delayed by up to 13 years if we can maintain or improve our bone mass by 10% during these earlier stages of life. This is just one area where exercise has a big role to play.

During our 50’s, 60’s and beyond some Australians will have bone density testing completed called a DXA scan. In these tests the strength of your bones is assessed by looking at your bone mineral density and then given a T score. A T-score of 0 represents the average bone strength achieved by young healthy adults, whereas a T-score of -1 to -2.5 is defined as osteopenia and a score of -2.5 or lower as osteoporosis. The strength of your bones is important when looking at your risk of breaking or fracturing a bone, as fractures occur when the force applied to a bone exceeds its strength. Whilst post-menopausal women are most commonly affected by osteopenia and osteoporosis, 30% of osteoporotic fractures occur in men.

How does exercise help?

Whatever our age, when we move and exercise there are forces placed upon our bones. In response to these forces our bodies deposit additional calcium and minerals in our bones to strengthen and protect them from future forces. Moreover, the weaker or more bendy our bones are the greater the benefit exercise can have, as the more our bones bend during an exercise the more our body will strengthen that bone. There is a constant cycle of bone remodelling and reformation occurring in our bodies, so it’s never too late to start. Exercise can also improve your balance. Whilst this doesn’t increase the strength of your bones, having good balance plays an important role in preventing falls and subsequently fall-related fractures.

What type of exercise is best?

Regardless of whether you are aiming to maintain your bone strength or improve it the same type of exercises are beneficial. Basically, any type of exercise which places a strain upon your bones is best. High impact or plyometric activities such as running/jogging, jumping/hopping, step aerobics and resistance training provide the greatest benefit to bone health. You should also complete a variety of different exercises or activities, as the more varied the stimulus applied to your bones the more they will adapt. Subsequently, you should aim to complete a mixture of jogging or step aerobics and resistance exercise at a minimum of twice per week though preferably four times per week. It must be noted low impact exercises such as walking, swimming and cycling can’t be used to improve bone health but can certainly still be completed to improve your general health and fitness. For balance training the start point depends on your existing level of balance. Balance training will often begin with static stationary activities and then over time progress to dynamic moving activities with a mental task added to increase complexity. Generally, balance training should be completed on most, if not all, days of the week.

Regardless of your age or fitness level, Accredited Exercise Physiologists can design an exercise program specific to your capabilities and then safely progress the program over time. Therefore, if you are older or feel you can’t complete anything too intense, you can begin with a gentler program as this will still provide good benefits to your bone health. For many older adults osteopenia or osteoporosis co-exist with osteoarthritis or other forms of arthritis. Whilst many people are often fearful exercise will exacerbate their arthritis, often the opposite occurs. Accredited Exercise Physiologists are well trained to develop exercise programs which will both assist with improving your osteoarthritis and osteopenia or osteoporosis.

Where to from here?

Contact your local Accredited Exercise Physiologist to have an individualised exercise program designed specific to your stage of osteopenia or osteoporosis and your ability level. If you are currently inactive and have any pre-existing cardiac, respiratory or other major health conditions it is advised you see your GP prior to beginning any exercise program.

References

Osteoporosis Australia – a new burden of disease summary 2012 – 2022 https://www.osteoporosis.org.au/sites/default/files/files/BofD_Exec_Sum_for_print.pdf

Troy, K.L., Mancuso, M.E., Butler, T.A., & Johnson, J.E. (2018) Exercise Early and Often: Effects of Physical Activity and Exercise on Women’s Bone Health. International Journal of Environmental Research and Public Health. Doi: 10.3390/ijerph15050878