Osteoporosis

What is Osteoporosis?

Osteoporosis is a medical condition diagnosed in individuals with low bone mineral density. The current definition is those with bone mineral density that is greater than 2.5 standard deviations below the average young adult mean value. Those who are 1-2.5 standard deviations below are characterised as having osteopenia. Both conditions can be problematic as they predispose individuals to low impact fractures. These fractures occur with mechanical forces that would not normally lead to a fracture. This can then lead to an impaired quality of life, long lasting disability, and increased mortality in those who suffer from them.

Age is the number one risk factor for this condition with 70% of those over 80 years of age being affected.

Risk Factors for Osteoporosis

Osteoporosis is more common in females than males with around 1 in 3 females over the age of 50 suffering from an osteoporotic fracture compared to 1 in 5 males. This is due to the protective effect oestrogen has on bone health and the loss of this during menopause. It is also more commonly seen in those individuals who are less physically active or with a vitamin D or calcium deficiency.

Therefore, it is important to ensure that you are physically active as certain exercises have been shown to maintain and even improve bone mineral density. Having a sufficient dietary intake of appropriate vitamins and minerals is important as these play a role in the remodelling of bony tissue. When combined, a sufficient diet, appropriate medication and exercise can all be utilised to reduce the risk of developing osteoporotic fractures and maintain or improve bone mineral density.

Managing Osteoporosis with Exercise

Current management guidelines for osteoporosis aim to categorise exercises for different problem areas and to allow safe and effective messaging between clients and healthcare practitioners.

Three main categories of exercises were identified:

Strong

• These exercises are focused on promoting bone strength and preventing fractures.
• Weight bearing/impact training is advised on most days, this can be a range of activities and will vary in terms of impact levels.
• Lower impact activities such as stair climbing or brisk walking.
• Moderate impact activities such as low jumps, skipping, jogging.
• Those with osteoporosis should aim to get up to moderate impact activities for optimum benefit.
• These exercises can be completed on most days.
• In those with identified vertebral fractures, only lower impact activities are recommended.
• This category also chooses resistance-based exercises. These are used for both upper and lower body.
• These are advised to be completed 2-3 days per week with 3 sets of 8-12 on each exercise using weights or bands for resistance lifting until you fatigue.

Steady

• These are exercises that aim to reduce falls risk.
• The steady exercises should include a variety of surfaces, a reduced base of support and different balance strategies.
• The aim is to complete these exercises 2-3 days of the week in those over 65 and who are less steady.
• In those who have had multiple falls, a challenging balance program may be required and this should be created with input by a qualified professional.
• The ‘Strong’ exercises will help to strengthen the lower limb which will help with balance as well.

Straighter

• These are designed to reduce risk of vertebral fractures, improve posture and manage symptoms of vertebral fracture.
• These exercises are focused on strengthening the muscles of the back and creating safe moving and bending techniques.
• These should be completed most days with a focus on endurance-based repetitions.
• In those experiencing pain from vertebral fractures, these would be beneficial to complete daily.

If you have recently been diagnosed with osteoporosis or osteopenia and would like help setting up a structured exercise program, book with one of our physiotherapists and they can do this for you. https://malvernphysio.janeapp.com/

 

Published July 29, 2022