Exercise for Osteoporosis and Osteopenia

If you have been diagnosed with osteoporosis or osteopenia, it is imperative that you exercise your muscles to help protect your bones. A major cause of disability, especially in middle-aged and older women, these conditions can result in fractures of the hip and spine, which can be devastating to your mobility and independence. However, exercise can help strengthen muscles and bones and improve your balance to prevent falls.

It’s never too late to start exercising! If you have osteoporosis or osteopenia, talk to your doctor before you begin. The goal is to find exercises that will be safe and enjoyable. You want to think about what you will stick with for the long-term. Ask your doctor what exercises are recommended and which are contraindicated.

Especially important forms of exercise, as recommended by the Mayo Clinic, are:

1) Strength training, especially for the upper back

2) Weight-bearing aerobic/cardiovascular activities

3) Flexibility exercises

4) Stability and balance exercises

Strength training uses external resistance (bands, free weights, machines, etc.) or your own body weight to strengthen all the major muscle groups and can help maintain bone density. Be cautious with exercises or machine adjustments that cause you to twist your spine. 

Resistance training should be tailored to your physical ability and not cause or increase pain. Talk to your physical therapist or personal trainer to help you develop a strength training routine. Proper form and technique are crucial to prevent injury and allow you to get the most benefit from your workout. Avoid exercises that use excessive forward flexion, such as crunches.

Weight-bearing aerobic/cardiovascular activities that will be the most beneficial involve using your body weight with your feet contacting the ground to support your bones. Examples are walking, dancing, low-impact aerobics, hiking and stair-climbing. These exercises work directly on the bones of your legs, hips and lower spine to slow mineral loss. They also benefit heart, lung and circulatory health. 

Swimming and cycling have many benefits, but don’t provide the weight-bearing load your bones need. However, if you enjoy these exercises, feel free to rotate them in, returning to weight-bearing activity as much as possible.

Flexibility exercises help you move your joints through their full range of motion and keep your muscles, tendons and ligaments working well. Static stretches should be done after a warm-up, or at the end of your session. Do them slowly and gently, without bouncing. Avoid stretches that cause you to flex forward excessively. (Bending backward may be okay if it is cleared by your doctor and does not cause pain.) 

Stability and balance exercises help with fall prevention, which is especially important if you have mineral loss in the bones. These exercises work together to keep you more stable and less likely to fall. You can start with simple exercises such as standing on one leg or ask your physical therapist or personal trainer for other balance exercises that will challenge you, but still be at the appropriate level. Tai chi is another form of exercise that can improve your stability and balance.

Movements to avoid with osteoporosis or osteopenia include the following.

High-impact exercises 

Jumping, running or jogging have the potential to cause fractures in weakened bones. Chooses exercises with slow, controlled movements. If you are generally fit and strong, you may be able to engage in somewhat higher-impact exercises than someone who is more frail.

Bending and twisting 

Exercises where you bend forward at the waist or twist at the waist, such as toe touches or sit-ups, can put you at risk for compression fractures in your spine. Other exercises to be cautious of due to twisting and bending forcefully include golf, tennis, bowling and some yoga poses.

If in doubt, talk to your doctor about the health of your bones. There is no reason why someone with these conditions can’t continue to have fun, be active and get stronger and more capable. Plus, exercise has so many overall physical and mental health benefits. Happy exercising!

Lori Vance

Body Image Fitness, LLC


Exercise for Osteoporosis and Osteopenia

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