Physicians are constantly encouraging their patients to exercise. We all know it helps our hearts, joints, and muscles. But can exercise really benefit someone with osteoporosis? Truth is, it can!
Osteoporosis is a disease characterized by significant loss of bone mass, quality, and strength. It can affect bones throughout your body and can increase the risk fracture. Osteoporosis affects more than 200 million people worldwide. It is normal and natural for our bones to become thinner and weaker as we age, so it is no surprise that this disease is predominantly found in those of advanced years. Postmenopausal women are particularly susceptible to developing osteoporosis. There are several factors that explain this discrepancy. One such factor is the falling estrogen levels after menopause, as estrogen normally has a protective effect on bone strength.
A bone density test, or DEXA scan, is the method used to diagnose osteoporosis. This test compares the subject's bone mineral density with that of a young-adult reference population producing a value called a T-score. The World Health Organization defines osteoporosis as a T-score two and half times lower than the reference value. There are no clinical manifestations of osteoporosis until a bone fractures. Some people mistakenly think if they feel fine they must not have osteoporosis. Others assume the pain in their bones or joints indicates the presence of osteoporosis. Neither of these assumptions is accurate, thus emphasizing the need for appropriate and timely screening. Unfortunately a fracture is too often the first indication of underlying osteoporosis. The most common bones fractured in osteoporosis are the spinal vertebrae. Hip fractures are also common in osteoporosis, affecting up to 15% of women by age 80.
So now we know the definition of osteoporosis. The bigger question remains, what are the treatments? While pharmacological therapy (medications) is still a mainstay of treatment, lifestyle interventions are being recognized as increasingly important in the management of osteoporosis. Examples of lifestyle interventions include optimization of calcium and vitamin D levels, smoking cessation, and exercise.
General guidelines for exercise in healthy persons include:
- At least 150 minutes of moderate intensity aerobic exercise per week
- Muscle strengthening exercise targeting 8 to 10 muscle groups at least two non-consecutive days per week
- Flexibility exercise twice a week for at least 10 minutes
For those who have been diagnosed with osteoporosis, more specific recommendations are as follows:
- Greater emphasis on weight-bearing and strengthening exercise
- Fall prevention or balance training (such as Tai Chi)
The benefits are measurable. Studies suggest that bone mass density can increase, falls can be reduced by up to 40%, and strength can improve 25% with these simple exercise interventions.
If you would like to learn more about how exercise can benefit your osteoporosis and overall health, set up an appointment with Dr. Carfagno at your earliest convenience.
Bryce Kirkman, MS-IV
David Carfagno, D.O., C.A.Q.S.M.
Rosen HN, Drezner MK. Overview of the management of osteoporosis in postmenopausal women. UpToDate. Last updated: 12/10/2015.
Palombaro KM, et al. Effectiveness of exercise for managing osteoporosis in women postmenopause. Journal of the American Physical Therapy Association. 2013:93(8), 1021-5.
Moreira, LDF, et al. Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. Brazilian Archives of Endocrinology & Metabolism, 2014:58(5), 514-22.
Morey MC. Physical activity and exercise in older adults. UpToDate. Last updated: 09/01/2015.
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