Exercising With Osteoporosis- Improving Bone Health Through Strength Training
Osteoporosis is a degenerative disorder that effects a persons’ bone mass, increasing bone fragility and the risk of fractures after a minor trauma (1). According to the Australian Bureau of Statistics (ABS) in 2020-21, approximately 3.6% of the population were affected by osteoporosis, with females being more likely to be diagnosed than males (5.9% compared to 1.1%) (10).
Osteoporosis poses a major clinical problem, particularly amongst the older population (2), with the above ABS report finding the rate of osteoporosis diagnosis rising from 5.6% of 55-64year old’s, to 20.1% of people aged 75 years and over (10).
Diagnosing Osteoporosis
Formal diagnosis is done at recommendation from your GP through performing a bone mineral density (BMD) test, which shows what quantity of calcium and other minerals are in an area of your bone (5). Usually measured in the hip or spine, the BMD score will allow doctors to assess a patient’s future risk of fracture (9).
When you go for a BMD scan, you will receive a T-score which represents the density of your bone. This T-score classification index is as below:
-1 or above. Bone density is normal.
-1 – -2.5. Bone density is moderately low and may represent osteopenia (early stages of osteoporosis).
-2.5 or above. Bone density is low, highlighting the presence of osteoporosis.
I Have Osteoporosis- How Do I Manage My Condition?
Whilst osteoporosis is commonly thought of as a debilitative condition, with nine out of ten people over the age of 18 with osteoporosis experiencing bodily pain (10), there are many health and lifestyle changes -alongside medical intervention recommended by your doctor- that can keep you doing what you love with minimal pain.
Balanced nutrition, appropriate calcium and vitamin D intake, and a well-balanced exercise program are all well studied and essential elements in achieving normal peak bone mass, which is a crucial factor in prevention and management of osteoporosis (1).
There is a general misconception that exercising with osteoporosis can cause unnecessary strain and potential damage on the bones and muscles, but research shows that this is, in fact, the opposite of the truth. Current research tells us that through strength-training and resistance-based exercises, people can both reduce the risk of future osteoporosis and combat the existing condition by building muscle mass and strength, in turn preserving bone density (6).
One of Absolute Health & Performance’s resident Exercise Physiologists, Adam Luther, has advice on managing osteoporosis through exercise. “Seeing a qualified professional in regard to exercise advice when managing osteoporosis is a fantastic first step, as performing a general program may not be the best way to start your strength training.” Adam says, “Having an individualised strength program that is based on you will be extremely beneficial to your osteoporosis.”
A 2017 study conducted by the American Society for Bone and Mineral Research into the efficacy of high intensity resistance and impact training (HiRIT) to reduce the risk for fractures in people with low bone mass, found that “contrary to current opinion, HiRIT was efficacious and induced no adverse events under highly supervised conditions” (3). This is further supported by a study from Otero et al, which demonstrates that a program based on strength exercises is capable of significantly improving both strength and balance in patients with osteoporosis (4).
Adam Luther recommends working alongside your coach to establish suitable resistance training loads, allowing you to perform strength training safely and effectively, by progressively overloading your skeletal system to improve muscular strength.
“The key is to start slowly and progressively overload under guidance of an expert,” Adam advises. “This applies to both weight and resistance training, as well as plyometric training.”
When utilised in combination with a resistance-based exercise program, plyometric training (e.g. jumping) has been shown to stimulate greater improvements in BMD than just strength training alone (8). In fact, in 24 separate studies conducted by Alejandro et al, subjects in intervention groups subjected to consistent plyometric exercise showed higher bone mineral density, bone mineral content, and bone structure improvements than controls, without side effects to bone structural properties (7).
Adam recommends a healthy balance of strength based and plyometric training to his clients with osteoporosis. “This should be based on client goals and training status, and when supervised by your coach or EP, is a great tool to add into your training plan,” he adds.
The Next Steps
Exercising with osteoporosis can be an intimidating concept, but with the right knowledge under your belt, and in consultation with your GP and exercise physiologist or performance coach to allow maximal safety and effectiveness, it can be the turning point for living with this condition.
“If you have osteoporosis and are looking for ways to help manage your symptoms, an exercise program can be a beneficial part of your treatment,” Adam Luther says.
To learn more about training with osteoporosis, and finding your way to a stronger you, you can book in with Exercise Physiologist Adam Luther HERE.
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1. Australian Bureau of Statstics. (2022, 03 21). Health Conditions Prevalence Key findings on 1. Lane, J M et al. “Osteoporosis.” Clinical orthopaedics and related research ,372 (2000): 139-50. doi:10.1097/00003086-200003000-00016
2. Srivastava, Manish, and Chad Deal. “Osteoporosis in elderly: prevention and treatment.” Clinics in geriatric medicine vol. 18,3 (2002): 529-55. doi:10.1016/s0749-0690(02)00022-8
3. Watson, Steven L et al. “High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial.” Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research vol. 33,2 (2018): 211-220. doi:10.1002/jbmr.3284
4. Otero, Montserrat et al. “The effectiveness of a basic exercise intervention to improve strength and balance in women with osteoporosis.” Clinical interventions in aging vol. 12 505-513. 14 Mar. 2017, doi:10.2147/CIA.S127233
5. Bone Health & Osteoporosis Foundation. (2022). Evaluation of Bone Health/Bone Density Testing. Retrieved from BHOF: Bone Health & Osteoporosis FOUNDATION: https://www.bonehealthandosteoporosis.org/patients/diagnosis-information/bone-density-examtesting/
6. Seguin, Rebecca, and Miriam E Nelson. “The benefits of strength training for older adults.” American journal of preventive medicine vol. 25,3 Suppl 2 (2003): 141-9. doi:10.1016/s0749-3797(03)00177-6
7. Gómez-Bruton, Alejandro et al. “Plyometric exercise and bone health in children and adolescents: a systematic review.” World journal of pediatrics : WJP vol. 13,2 (2017): 112-121. doi:10.1007/s12519-016-0076-0
8. Hinton, Pamela S et al. “Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial.” Bone vol. 79 (2015): 203-12. doi:10.1016/j.bone.2015.06.008
9. Australian Institute of Health and Welfare. (2014). Estimating the prevalence of osteoporosis in Australia. Canberra: AIHW.
10. Australian Bureau of Statstics. (2022, 03 21). Health Conditions Prevalence Key findings on selected long-term health conditions and prevalence in Australia. Retrieved from Australian Bureau of Statistics: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/latest-release
