According to The Mayo Clinic, “Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone.” Osteoporosis is a bone disease where bone mineral density is reduced. It most commonly occurs in women over the age of 50, but it can affect anyone. It causes bones to become brittle which increases the risk of fractures. Our bones not only support our body’s structure, but they also protect vital organs, play a role in blood cell production, our immune system, the storage of calcium, the release of essential hormones, among other functions.
Our bones are made of living tissue and mainly contain bone marrow, cartilage, membranes, nerves, blood vessels and three different types of cells. Like other cells in our body, the cells in our bones are constantly being broken down and subsequently replaced. This process in our bones is called bone remodeling or bone-rebuilding. The bone remodeling process allows the body to repair broken bones, reshape the bones as we grow, and regulate calcium levels. Many factors contribute to bone remodeling. Some of these factors are the parathyroid hormone, vitamin D, estrogen, and testosterone. This bone remodeling process of breaking down old bone and increasing our bone mass when new bone is made, slows down as we age. The process starts to slow as early as our 30’s and as we continue to age it’s possible that bone mass is lost faster than new mass can be created.
This is not a complete list of the potential causes of osteoporosis, but it can help us identify ways to help maintain or increase our bone mineral density and let us know who might be most at risk.
There are no typical symptoms in the early stages of bone mineral density loss. Once you have osteoporosis, you might experience signs like; back pain (caused by a fractured or collapsed vertebra), loss of height over time, a stooped posture or a bone that breaks easily.
A bone density test is the only way for doctors to determine if you have osteoporosis or osteopenia. Osteopenia is a loss of bone mineral density, which means your bones are weaker but not yet to the point of osteoporosis which is a more severe loss of bone mineral density (bones are brittle or almost brittle). There are not usually any symptoms of osteopenia. It may be helpful to know if your bones have weakened to this point so you can work with your doctor to determine a treatment plan to prevent it from worsening to osteoporosis.
To help prevent osteoporosis, Johns Hopkins Medicine suggests; limiting alcohol consumption, stopping smoking if you smoke, consuming adequate amounts of calcium and Vitamin D as well as having an adequate protein and vegetable intake. They also mention that weight bearing exercise can help build strong bones and slow bone loss.
Just like our muscles break down under stress (like resistance training) and then repair themselves to become stronger, our bones have a similar process. If a bone comes under increased stress over time, for example during weight bearing exercise, the parts of the bone under the most pressure will become thicker over time. Exercise helps maintain or increase bone density no matter when you start, but if you start exercising regularly when you are young and continue throughout your life you will reap the most benefits.
If you have osteoporosis or osteopenia, ask your doctor or physical therapist before starting a new exercise routine about what exercises are right for you.
In general, with osteoporosis, it is recommended to avoid excessive bending or twisting of the spine and to be careful of high impact activities like running or jumping.
In 2022, the British Journal of Sports Medicine (2022; 56 [15]) published exercise guidelines for people with osteoporosis. A multidisciplinary group of experts met in 2017 to create these guidelines based on their review of research and expert opinions. They wanted to clear up any uncertainty about what types of exercise and how much physical activity are safe and effective in individuals with osteoporosis. We know that physical activity and exercise can optimize bone strength, reduce fall, and fracture risk but they wanted to create these guidelines to be more specific on the type and duration of exercise as well as how to minimize any potential risks of exercise.
They concluded the following recommendations for all people with osteoporosis:
They also found that “There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.”
Activities that can help prevent bone loss, maintain bone density and are safe for those with osteoporosis:
Complete 10-12 repetitions of each exercise before moving to the next. Then repeat each exercise three more times, resting in between each set.
Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life. Regardless of age or osteoporosis risk or osteoporosis status, exercise has a positive impact on strength, mobility, and bone density in addition to improving overall health. It’s never too late to start. Regular exercise can help to prevent and even reverse some bone loss. It also can improve balance and flexibility which is key for preventing falls which are the most common reason for bone fractures.