15 Jan Osteoporosis and Bone Density: How important is exercise for bone health?
Osteoporosis is a widespread condition characterised by low bone mass or density. It is primarily a metabolic disorder related to age and general health with a variety of risk factors and causes. The most common and well-known consequence of osteoporosis or low bone density is weakened bones that can break more easily from small forces that would usually be harmless.
In osteoporosis, both the matrix of the bone (similar to scaffolding) and the density of the bone are affected. While bone seems like a static part of our body, bone is actually continuously laid down and removed by our bodies particularly in higher loading areas of the body. In osteoporosis, there is an imbalance between the growth and reduction in the bone where the bone becomes progressively weaker. As such, it generally worsens with age, and while the disease process might begin much earlier, symptoms are usually only noticed over the age of 50.
What are the signs and symptoms?
Often called a silent disease, many people with osteoporosis will have no idea that they have the condition, as there are no visible symptoms. Sometimes the first sign that a person has osteoporosis is when the first bone breaks/fractures. Unfortunately lower bone density and osteoarthritis causes these bones to heal at a much slower rate than that of a healthy individual and therefore can lead to more complications. However, broken bones are not the only symptom of osteoporosis, as bones lose density and strength, they can also become compressed and develop wedge fractures under the weight of the body.
When the spine is affected by osteoporosis, people may develop a hunched or stooped posture, which can itself lead to respiratory issues and places pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have a distressing impact on their overall quality of life.
What causes it?
As a metabolic disorder, osteoporosis can be caused by any process that interferes with the body’s ability to maintain bone density. This includes post-menopausal hormones, gastrointestinal conditions that prevent adequate absorption of calcium, required for bone growth, lack of dietary calcium or low levels of vitamin D, which are essential for the absorption of calcium. Some medications can contribute to bone loss as an unfortunate side effect, especially if they are taken for a long time or in high doses. A well-known example is the long-term use of steroids which are prescribed for long periods to reduce inflammation.
Inactivity can also predispose a person to low bone density or osteoporosis as bones respond to load and force by building stronger. Having a sedentary lifestyle or choosing activities with low levels of impact can mean that without the weight-bearing stimulus to make bone, bones are less dense over time. Osteoporosis is a common issue for elite cyclists and swimmers, who are more likely to develop the condition if they don’t also include weight-bearing activities such as jogging in their training program.
Exercise and bone density throughout life
The specific goals of exercising for bone health change throughout life; from building maximum bone strength in childhood and adolescence, optimising muscle and bone strength in young adulthood, to reducing bone loss in old age. Exercise has a large effect on our bone health throughout our entire life. For the elderly, the focus is on prevention of muscle wasting and addressing risk factors for falls, particularly difficulties in balance and mobility.
How can physiotherapy help?
Physiotherapy can help you to improve your overall bone health, avoid or recover from fractures. It is important that you are doing the correct type of exercises to build bone strength. Physiotherapy exercises can direct you to safely increase your weight-bearing, which can help build bone mass. Balance training is also an important factor as this can reduce your risk of falls. Your physiotherapist can also help you to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.
None of the information in this blog is a replacement for proper medical advice. Always see a professional for advice on your injury.