“I have osteoporosis and my GP said I need to improve my bone density, but I’m scared that exercise will damage my bones”
Osteoporosis is a condition that develops slowly over several years; it weakens your bones, making them fragile and more susceptible to fracture. Osteopenia may be diagnosed if bone density tests show you have a reduced bone density, but not low enough to be classed as osteoporosis.
Bone is a living tissue that continues throughout life to respond to increased loads by growing stronger. Younger active people naturally produce more new bone than they lose, so their bone density increases and peaks at around 30 years. However our bones naturally become thinner as we get older because, from our 30’s onwards, we start to produce less bone than we lose. This happens to everyone, but some people lose bone density much faster than normal and develop osteoporosis. This means they’re at greater risk of a fracture.
Osteoporosis develops when the degree of bone loss causes the structure of the bone to become thin and fragile, this can result in the weakened bone fracturing from even minor bumps and falls. The most common fractures seen with osteoporosis are in the wrists, hips and spine; spinal fractures can also cause loss of height and curvature of the spine.
What causes it?
Losing bone is a normal part of the ageing process, but some people lose bone density much faster than normal, this means they’re at greater risk of osteoporosis and fracture.
Osteoporosis can affect both men and women although women are more at risk because the hormone changes that occur at menopause directly affect bone density; a woman’s bone loss is usually most rapid during the first few years after menopause.
Osteoporosis is more common in older people, but it can also affect younger people.
Many other factors can also increase the risk of developing osteoporosis including: having a family history of osteoporosis (especially with parental history of hip fracture); being underweight; long-term use of some corticosteroids; other medical conditions such as inflammatory conditions, hormone-related conditions; digestive mal-absorption problems; long periods of inactivity, such as long-term bed rest; heavy drinking and smoking
Exercise, healthy eating and other lifestyle changes can slow the bone loss that usually occurs as we age and may help to reduce the risk of our bones breaking.
What type of exercise should I do?
Bone is a living tissue that reacts to increases in loads and forces by growing stronger. It does this all the time, so exercise will only increase your bone strength if it increases the loading above normal levels. Not all activities increase bone density, for example swimming (although very good for cardiovascular fitness) is not weight bearing and therefore will not stimulate your bone production.
The following 4 types of exercise are important to minimise bone loss and help reduce the risk of broken bones:
Weight-bearing: this is exercise where you support your own body weight through your feet and legs, or hands and arms. Weight-bearing exercises can be high-impact or low-impact. High-impact weight-bearing exercises help build bones and keep them strong, however if you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises.
Muscle strengthening: this type of exercise strengthens bone because it requires your muscles to generate large forces in the tendons that attach muscle to bone. Your bone responds to this extra stress by becoming stronger. Exercises that improve the strength of your leg, back and stomach muscles also help to reduce the risk of falling and breaking bones.
Balance: this is the ability to maintain your body in its upright position while moving, and is essential for normal daily activities. Good balance is also essential to avoid falling if you trip – falling is the leading cause of accidental injury in people over 65; falling commonly causes fractures, particularly if you have osteoporosis.
Flexibility: Being able to move your joints through their full range of motion helps you to maintain good balance and prevent muscle injury. Increased flexibility also helps improve your posture.
Applied Pilates – how can we help?
Using the Applied Pilates method we have created a safe way for you to combine weight bearing, muscle strengthening, balance and flexibility exercise designed to improve bone density and reduce the risk of falls. But every individual arrives with different degrees of strength, fitness, flexibility, balance depending on age, genetics, type of daily activities, and these cannot be improved by giving everyone a generic routine. This is why Applied Pilates is different.
We help clients across a wide range of ages and with varying degrees of osteopenia and osteoporosis:
– Those with osteopenia or with a high risk of developing osteoporosis due to family, medical or other reasons
– Those with an osteoporosis diagnosis who need to increase bone density and strength to reduce the risk of future fractures
– Those with an osteoporosis diagnosis and fragile bones who have easily broken bones in the past and who need to focus on stability and balance to reduce risk of falls and future broken bones
It is essential that only clinically appropriate exercises are applied, therefore it’s important to make sure you attend a form of clinical pilates, such as Applied Pilates. Any generic pilates routine, or classical pilates, or fitness pilates (whether mat based or reformer based) is inappropriate as a tool for management of osteoporosis because many standard pilates exercises are not safe if you have been told you have fragile bones and you have broken bones easily in the past. For example, exercises that require you to bend forward may increase the chance of breaking a bone in the spine if you have already had a compression fracture of the spine, or have been advised you are at high risk of fracture.
Osteolates – how can we help?
Osteolates soft tissue treatment techniques can prepare the muscles so they are able to respond to and maximise the benefits of doing the right Applied Pilates exercises. During a bone strength improvement programme it is essential for us to get the correct balance between flexibility and strengthening to achieve stability at each major joint. For example tight hamstrings hamstrings can result in pelvic instability and back pain, but trying to stretch tight hamstrings inappropriately will also create back problems. Osteolates treatments provide a controlled way to resolve muscle, tendon and ligament issues that become apparent as your exercise programme progresses. We have found over the years that clients who combine Applied Pilates exercises with occasional Osteolates treatments improve strength and flexibility more quickly.
Other advice we provide for you
Osteoporosis is a long-term condition, we can assist you to set realistic goals, help you understand the cause of pain and/or dysfunction, and give you the confidence to keep you moving at an appropriate pace for your age and ability.