Total Nutrition Technology
Monday, September 9, 2013

At any age, exercise is essential for maintaining healthy bones. If you exercised regularly as a child and young adult, you probably helped maximize your bone production, most of which occurs by age 35. If you continued to exercise into middle age and beyond, you probably helped reduce your risk of developing the bone-thinning disease osteoporosis.

Still, it's never too late to start a bone-healthy exercise program, even if you already have osteoporosis or are at high risk of developing osteoporosis.

For years, we've thought we understood osteoporosis: it's a disease in which the bones become more and more fragile as they lose density, usually due to aging, menopause, and other factors like lack of calcium and vitamin D in the diet. But today, advances in research are shedding new light on osteoporosis, which is predicted to affect as many as half of all Americans over age 50 by the year 2020. From diagnosis to prevention to osteoporosis treatment, new research is turning our old understanding...

Although people with osteoporosis may believe that exercise increases the risk of injury from broken bones, the truth is quite the opposite. A regular, properly designed exercise program may actually help prevent the falls and fall-related fractures that so often result in disability and premature death. That's because exercise strengthens bones and muscles, and improves balance, coordination, and flexibility, which is especially important for older adults and people who have been diagnosed with osteoporosis.

According to the National Osteoporosis Foundation, the best exercises for building and maintaining bone density are:
Weight-bearing exercise, such as walking, that makes you work against gravity while staying upright.
Muscle-strengthening exercise, such as weight lifting, that makes you work against gravity in a standing, sitting, or prone position.

Nonimpact activities such as balance, functional, and posture exercises also may benefit people with osteoporosis. Although these exercises don't build or maintain bone density, they may increase muscle strength and decrease the risk of falls and fractures.

Medical Evaluation Is Key

If you have osteoporosis or are at risk of osteoporosis, most experts believe that supervised weight-bearing exercise and strength training exercise is safe and effective. Studies of postmenopausal women report that aerobic, weight-bearing, and strength training exercise can increase bone mineral density in the spine, and that a simple walking program can increase bone mineral density in the spine and hip.

Before beginning any exercise program, it's important to undergo a thorough medical examination to determine which activities are safe for you.

There is no single exercise regimen that's best for everyone with osteoporosis. Each regimen should be specifically tailored to the individual patient based on a medical evaluation of:
fracture risk
muscle strength
range of motion
level of physical activity

During the evaluation, your doctor also will consider any other chronic conditions that can affect your ability to exercise, such as obesity, high blood pressure, and heart disease. If you're at risk for osteoporotic fracture, the National Osteoporosis Foundation recommends that your doctor refer you to a specially trained physical therapist for a through physical assessment and exercise prescriptions that focus on body mechanics and posture, balance, gait and transfer training, resistance weights, and progressive aerobic activities.

Weight-Bearing Exercises for Osteoporosis

If your doctor determines that it's not safe for you to perform high-impact weight-bearing exercises, he or she may recommend low-impact weight-bearing exercises that are less likely to cause fractures and also build and maintain bone density. These include:
elliptical training machines
low-impact aerobics
stair-step machines
walking (either outside or on a treadmill machine)

If you're new to exercise, or haven't exercised for awhile, you should aim to gradually increase your level of weight-bearing exercise to 30 minutes per day on most days of the week.

Muscle-Strengthening Exercises for Osteoporosis

Programs that maintain muscular strength can slow the loss of bone mineral density associated with osteoporosis, and may help prevent fall-related fractures. Examples of muscle-strengthening exercises include functional movements such as standing and rising on your toes, lifting your own body weight, and the use of equipment such as:
elastic exercise bands
free weights
weight machines

Experts recommend performing strength-training exercises two to three days per week.

Nonimpact Activities for Osteoporosis

Certain nonimpact activities can improve your coordination, flexibility, and muscle strength and reduce your risk of falls and fractures while increasing your mobility and overall quality of life.

Balance exercises such as Tai Chi can strengthen your leg muscles, and help you stay steadier on your feet. Posture exercises can improve your carriage, reduce the "sloping" shoulders associated with osteoporosis, and decrease your risk of fractures, especially in the spine. Functional exercises can improve your ability to perform everyday activities such as getting in and out of bed and chairs, and climbing stairs.

Balance, posture, and functional exercises can be performed daily.

Nonimpact programs such as yoga and Pilates can improve strength, balance, and flexibility in people with osteoporosis. But some of the movements associated with these programs -- including forward-bending exercises -- can increase the risk of fracture. If you're interested in such programs, ask your physical therapist to tell you which movements are most likely to be beneficial or harmful.

Although exercise can benefit almost everyone with osteoporosis, it's important to remember that it's only one component of an overall treatment program. Other essential lifestyle recommendations include a diet rich in calcium and vitamin D, maintaining a normal body weight, and avoiding tobacco use and excessive alcohol consumption. You also may require osteoporosis medications to either build or maintain bone density. By working with your doctor, you can develop an osteoporosis treatment program that's right for you.

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