What is osteoporosis?
Osteoporosis is a disease that is characterized by low bone mass, deterioration of bone tissue, and disruption of bone microarchitecture: it can lead to compromised bone strength and an increase in the risk of fractures. Osteoporosis is a risk factor for fracture just as hypertension is for stroke.
It was estimated that the number of patients worldwide with osteoporotic hip fractures is more than 200 million. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime.
Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality (article).
Fortunately, a well designed exercise program can help to counterbalance the losses in bone density that occur with age and may even allow people to slightly increase their bone density.
What is the best exercise to get my bones stronger?
The best exercises to improve your bone density are weight training and weight-bearing exercises (eg. walking, jogging, etc.). We need to feed our bones with load. When a bone is loaded, this activates the production of bone building cells (osteoblast), which are responsible for the synthesis and mineralization of bone.
Exercise to promote bone and muscle strength (link):
- Frequency: at least 2-3 times/week (non-consecutive days)
- Duration: aim for 20-30 minutes on exercises that target legs, arms and spine
- Intensity/Time: 1-3 sets of 8-12 repetitions of each exercise
- Type: 1 exercise per body part
Weight bearing exercise with impact
The recommendations are:
- For people with osteoporosis but without fractures: about 50 minutes moderate impacts on most days (jumps, skips, jogs, hops, etc.)
- For people who have spinal fractures or are unable to do moderate impact: 20 minutes lower impact exercises on most days (walks, brisk walking, marching, stair climbing, etc.)
Balance exercise is also recommended, up to 20 minutes per day. Balance needs to be challenged in order for it to be effective and balance exercises must be maintained as balance can decrease quickly.
What about cycling and swimming?
These activities are not weight-bearing and don’t provide impact. They may strengthen muscles to some extent but because the weight of your body is held by the water or your bike, there isn’t much force going through to your bones. It is probably not enough to promote bone strength.
What about walking?
Walking is a form of exercise such as cycling and swimming, and it doesn’t provide enough of a loading stimulus to stimulate bone growth.
With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Therefore, increasing awareness among healthcare workers, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic (link).
- An overview and management of osteoporosis – Tumay et al., European Journal of Rheumatology, 2016;
- Royal Osteoporosis Society, http://www.theros.org.uk