Firstly, what is Osteoporosis?
Osteoporosis is a bone condition characterised by low bone mass and changes to the internal structure of the bone. These changes lead to increased bone fragility and therefore, increased susceptibility to fracture. A recent report from Healthy Bones Australia indicated that 67% of Australians aged 50yrs and older, have either osteoporosis or osteopenia.
Osteoporosis is typically diagnosed following a bone density test at the hip and spine. The resulting ‘T score’ from this test indicates whether osteoporosis or osteopenia is present. Osteopenia is the pre-cursor to osteoporosis, where bone density scores are lower than the average adult, but not yet low enough to be diagnosed as osteoporosis.
Risk Factors
The primary risk factors for osteoporosis and osteopenia are;
- female sex, particularly post-menopausal women
- age (>50 yrs)
- sedentary lifestyle
- malnutrition (specifically inadequate calcium and vitamin D)
- smoking and excessive alcohol consumption
Exercise for Bone Health
Bone is adaptable and responds to appropriate forces placed on it. Current evidence indicates the most effective exercise to promote bone remodeling / strengthening is progressive resistance training and impact activities. A combination of both these forms of exercise have been shown to be the most effective for bone loading. Additionally, regular balance training is recommended to minimise falls risk and subsequently fracture risk.
Recommendations
Resistance Training
- 2-3 days per week
- 2-4 sets of 5-8 repetitions
- Focus on multi-joint exercises, targeting large muscle groups
Impact Exercise
- 3 days per week
- Gradual progression of jumping/landing impacts
- Approx 50 impacts per session
Balance
- 3 days per week
- Progressively challenging exercises
- Including dynamic balance and reactive balance components
It’s important to note that the above recommendations represent a ‘best case’ scenario, which will not be applicable or achievable for everyone straight away. The starting point and progressions for each exercise will always be individual specific, in order to be achieve a safe and effective program.
