Can Osteoporosis Be Prevented With Exercise?

Bone health is a crucial aspect of overall well-being, often overlooked until issues arise. Maintaining strong bones is vital for physical function, healthy ageing, and overall quality of life. 

This article delves into the topic of osteopenia, explores how exercise improves bone health, and provides a detailed workout routine to enhance bone density.

What is Osteopenia?

Osteopenia is a condition characterized by lower-than-normal bone mineral density (BMD), which is not low enough to be classified as osteoporosis but still indicates a higher risk of developing osteoporosis. BMD is a measure of the amount of minerals (mainly calcium) in a specific volume of bone. Osteopenia serves as a warning sign that bones are becoming weaker and may fracture more easily.

Osteopenia can be detected through a dual-energy X-ray absorptiometry (DEXA) scan, which measures BMD. The results are given in the form of T-scores:

- A T-score of -1.0 and above is considered normal.

- A T-score between -1.0 and -2.5 indicates osteopenia.

- A T-score of -2.5 and below is diagnostic of osteoporosis.

BMD Scale, displaying T-scores and their subsequent diagnosis outcomes

Several factors contribute to the development of osteopenia, including ageing, hormonal changes (such as reduced estrogen levels in post-menopausal women), nutritional deficiencies (especially calcium and vitamin D), sedentary lifestyle, smoking, excessive alcohol consumption, and certain medical conditions and medications.

How Does Exercise Improve Bone Health?

Exercise is a powerful tool in maintaining and improving bone health. It stimulates bone formation, slows down bone loss, and enhances overall skeletal strength. 

Here’s how exercise positively impacts bone health:

1. Weight-Bearing Exercises:

Weight-bearing exercise encapsulates any physical activity performed whilst on our feet and legs,  which requires your body, particularly your muscles and bones, to work against gravity. 

These activities stimulate bone-forming cells called osteoblasts, promoting bone growth and formation. The impact and resistance provided by these exercises create stress on the bones, encouraging them to produce more bone tissue, which leads to denser and strengthened bones.

2. Resistance Training:

Resistance training, including activities like lifting weights, resistance band exercises, and body weight exercises, increases muscle strength and mass, which exerts additional pressure on bones. 

This pressure puts stress on the bones, which triggers bone remodelling, enhancing bone density and reducing the risk of fractures.

3. Balance and Coordination Exercises:

Exercises that improve balance and coordination help prevent falls, which are a common cause of bone fractures. Focussing on strength development in muscle groups which keep you upright, such as your legs and core, help to prevent instability and improve mobility.

These activities also promote flexibility and joint stability, contributing to overall musculoskeletal health.

4. High-Impact Exercises:

High-impact exercises, such as jumping, running, and plyometrics, provide significant stimulation to bones, particularly in weight-bearing areas like the hips, legs, and spine. 

These exercises are particularly effective in the preventative stages of osteopenia; however, they should be managed with guidance for those already experiencing osteoporosis.

5. Non-Impact Exercises:

While non-impact exercises like swimming and cycling do not provide the same bone-building benefits as weight-bearing activities, they are excellent for maintaining cardiovascular health, muscle strength, and joint mobility, which indirectly support bone health by enhancing overall fitness and preventing injuries.

A Workout You Can Do to Improve Your Bone Density

An effective bone-strengthening workout should incorporate a mix of weight-bearing, resistance, balance, and flexibility exercises. 

Here is some  sample workout ideas spread across a week designed to improve bone density, noting that individual history and experience will vary, and this should not be viewed as a one size fits all approach. Please seek advice for your situation from a qualified coach or practitioner:

Warm-Up for each:

- 5-10 minutes of brisk walking, light jogging, or off feet cardio like a bike to increase heart rate and prepare muscles for exercise.

Weight-Bearing Exercises:

1. Walking or Jogging:

   - Duration: 30-60 minutes

   - Frequency: 2-3 times per week

   - Intensity: Moderate (walking) to vigorous (jogging)

2. Stair Climbing:

   - Duration: 10 minutes

   - Frequency: 3 times per week

   - Intensity: Moderate to vigorous

3. Resistance Training:

- Duration: 30-45 minutes

- Frequency: 2-3 times per week

- Intensity: Moderate to vigorous

Sample program:

A. Squats:

   - Sets: 3

   - Repetitions: 6-10

B. Lunges:

   - Sets: 3

   - Repetitions: 10-12 per leg

C. Push-Ups:

   - Sets: 3

   - Repetitions: As many as you can do close to failure

   - Modifications: Perform on your knees or against a wall if needed.

D. Bent-Over Rows:

   - Sets: 3

   - Repetitions: 12-15

   - Tips: Can use variety of barbells, dumbbells or resistance bands

E. Standing Leg Lifts:

   - Sets: 3

   - Repetitions: 10-15 per leg

   - Frequency: Daily

   - Tips: Hold onto a chair or wall for support if needed.

Cool-Down:

- 5-10 minutes of gentle stretching to improve flexibility and relax muscles.

Additional Tips:

- Hydration: Drink plenty of water before, during, and after exercise.

- Nutrition: Ensure adequate intake of calcium and vitamin D through diet and supplements if necessary.

- Consistency: Regularity is key; aim for at least 30 minutes of bone-strengthening activities most days of the week.

- Progression: Gradually increase the intensity and duration of your exercises as your strength and endurance improve.

Improving bone health through exercise is a proactive approach to preventing osteopenia and osteoporosis, ensuring long-term skeletal strength and overall health. Understanding osteopenia and how exercise can positively impact bone density empowers individuals to take charge of their health. 

By incorporating weight-bearing and resistance exercises into a regular fitness routine, one can significantly enhance bone health and reduce the risk of fractures and other bone-related issues. Adopting these practices not only strengthens bones but also contributes to a healthier, more active lifestyle.