Women sometimes contact me on their way home from a doctor’s appointment. Their bone density scan has shown bone loss and their doctor wants to put them on medication. They’ve also been told to strength train, do weight-bearing exercise, and change their eating habits. It can be overwhelming, dealing with a bone loss diagnosis and figuring out what to do first.
Whether a person needs osteoporosis prevention exercise, already has osteoporosis, or is taking medication, here are 10 tips for developing a safe exercise plan. Always get your healthcare provider’s guidance before trying new exercises to make sure that they are right for you, individually.
1. Learn to strength train and keep it up for life! You’re never too old to start strength training. It can be done with equipment such as dumbbells, ankle weights, resistance bands, or body weight. From the very first workout, muscles begin getting stronger. I’ve had women over sixty come up to me after their third strength training class saying, “I already feel stronger. Is that possible?” Giving your muscles a little bit of an overload, week after week, brings significant increases in strength. All of your other physical activities will then be easier, more effective, and fun.
For decades, university studies have repeatedly shown that strength training (also called resistance training) can help slow down or halt bone loss, plus build balance, in only two workouts a week. Strength training has an effect on bone because skeletal muscles are attached to your bones. As you get stronger during strength training, your stronger muscles give a harder pull on your bones when they contract, stimulating the bone building cells, the osteoblasts, to increase their activity. When dormant muscles are activated with strength training, balance also improves because the nerves attached to the muscle fibers are re-enlivened, renewing their neural pathway to the brain and back.
2. Balance training. Most fractures occur from a fall. If you simply don’t fall down, you can avoid 90% of hip fractures and 30-50% of spinal fractures, with or without osteoporosis. It’s recommended to fit 15-20 minutes of balance training in throughout your day to significantly improve your balance.
To reduce your risk of falls and build your balance, start with stationary stances and progress to standing on one foot in a variety of positions. Work up to being able to stand on one foot for at least 30 seconds. Use support, like a counter or sturdy chair, at first and always have support available as you progress to not holding on. Look for the many opportunities in your day to work on balance.
3. Weight-Bearing Exercise. Walking, hiking, stair climbing, elliptical trainers, treadmills, and sports done on your feet are all considered weight-bearing. The more vigorous the activity, the better the effect on bone strength.
The Too Fit to Fracture exercise recommendations emphasize that only doing weight-bearing aerobic exercise, such as brisk walking, may not be enough to prevent falls and fractures.
Strength and balance training are considered of equal or greater benefit for bone health, so be sure to include them along with your weight-bearing aerobics. Swimming and cycling are excellent for heart health and fitness, but aren’t weight bearing, so they have little effect on bone density. But, if you love them like I do, be sure to add some on-your-feet aerobic exercise and strength training to compensate.
4. Agility training. Practice being quick on your feet. Dancing and stepping in different directions, helps create the quicker reactions and muscle memory needed to catch yourself if you trip or get caught off balance.
5. Stay flexible. Tight chest muscles contribute to poor posture. Tight hip flexors at the top of your thigh make it harder to fully straighten up and stand tall. Stiff ankles reduce your agility. Be sure to take time to gently stretch after weight-bearing exercise, strength training, and anytime during your day when your muscles are warm and flexible.
6. Heel thumps. Coming up on your toes and dropping back down on your heels gives a gentle, beneficial “thump” that is considered helpful for your bones. It’s important to be easy on your joints by hinging back with the hips and giving with your knees as you come down on your heels.
7. Get up often. Since your body is always trying to save energy, it will get rid of tissues that aren’t used. Remind your body that it needs your muscles and bones by standing up often during the day. It’s more important to stand up for one minute 30 times a day than it is to stand continuously for 30 minutes. For an added boost to your metabolism, walk in place and swing your arms during the one-minute stands.
8. Keep your head over your spine. Your head weighs around 12 to 15 pounds and can help strengthen your upper back muscles and spine if it’s properly positioned and not pitched forward. Maintain upright posture and slide your chin back if it’s jutting out to get your head into proper alignment. Yes, I know, you’ll get a few double chins, but we’re going for health and beautiful posture here!
9. Stand tall. Stand as if you’re showing off a beautiful necklace. See if you can hold yourself upright enough to keep some space between your ribs and pelvis. Standing tall always makes you look good!
10. Have a zero tolerance slouch policy. Pay attention to your posture to protect the bones and discs of your spine and not compress your internal organs by slouching. Strong back muscles make all the difference in being able to maintain good posture, so be sure to include back strengthening in your strength training routine. When you’re not able to maintain good posture while sitting, use back support instead of slouching. Your back muscles will gradually get stronger if you consistently use them to keep good posture and body alignment.
Some physical activities may have risks that outweigh the benefits. The National Osteoporosis Foundation (NOF) advises taking the following precautions if you have bone loss and are at higher risk of fractures.
- Avoid very high impact, rapid, or jolting moves.
- No forward bending at the waist or compressive forces on the spine, such as toe touches, abdominal crunches, shoulder stands, and yoga plows.*
- No twisting to the point of strain or in combination with a forward bend.
- No deep side bends.
- When you need to bend down, keep a neutral spine by hinging back with the hips, using your legs and knees for support, not your back. Making small adjustments to your body alignment can make a big difference in exercising and moving safely.
To make your exercise plan work, pick physical activities that you enjoy and stick with it! All of the wonderful gains in muscle and bone tissue will be lost if you stop exercising. Find exercise buddies to help you stay active for life. Schedule your physical activity and make it a priority. Build your fitness now so that you have strong muscles and bones for an active and independent second half of your life.
Questions? Ask in the comment section below! –Susie
Also, see the Bone Safe Yoga Sun Salutation modifications by Sherri Betz, PT, on YouTube.
This article first appeared in the Iowa Source magazine’s October 2014 issue.