Osteoporosis is a condition that causes bones to become weaker and more fragile, increasing the risk of fractures. While it can affect people of all ages, it becomes more common as we get older, particularly in women after menopause.
What happens to the bones in osteoporosis?
Our bones are living tissue and are constantly being remodelled. Osteoclasts break down old or damaged bone, while osteoblasts build new bone. When these processes are well balanced, bone strength is maintained.
As we age, however, the rate of bone breakdown can begin to exceed the rate of new bone formation. This leads to a gradual reduction in bone mineral density and changes to the internal structure of the bone, making it more fragile and susceptible to fractures.
Osteopenia refers to bone density that is lower than normal, but not low enough to meet the diagnostic criteria for osteoporosis. It can be thought of as a stage between healthy bone density and osteoporosis, although not everyone with osteopenia will go on to develop osteoporosis.
Having osteopenia is an important opportunity to focus on modifiable factors such as regular resistance exercise, adequate nutrition and fall prevention. A physiotherapist can help develop an appropriate exercise program to maintain strength, balance and physical function.
Why are women more commonly affected?
Women are more susceptible to osteoporosis, particularly after menopause, largely because of changes in oestrogen levels.
Oestrogen plays an important role in maintaining healthy bone by helping regulate the activity of bone-remodelling cells. During and after menopause, oestrogen levels fall significantly. This accelerates bone resorption, meaning that bone can be broken down faster than it is replaced. As a result, women can experience a relatively rapid reduction in bone density during the years surrounding menopause.
Women also tend to have a lower peak bone mass and smaller bones compared with men, providing less overall bone reserve as bone density naturally declines with age. Men can certainly develop osteoporosis too, particularly with increasing age or in the presence of other risk factors, but the condition generally occurs later and at a lower rate than in women.
Why is strength training important?
When muscles work against resistance, they place healthy levels of load through the bones. Over time, this can help maintain or improve bone strength, while also improving muscle strength and function.
As physio’s, we can develop an individualised strengthening program based on your current abilities, health and fracture risk. This might include exercises such as:
Sit to stand exercises
Squats or supported squats
Step ups
Free weights or gym-based resistance exercises
The right exercises and level of resistance will depend on the individual, particularly if you already have osteoporosis or have experienced a previous fracture.
Don't forget about balance…
Strong muscles are only part of the equation. Good balance can help reduce your risk of falls, which is particularly important when bones are more vulnerable to fracture.
What about walking?
Walking is a great way to stay active and support general health. However, for people with osteoporosis, walking alone may not provide enough stimulus to maintain bone and muscle strength. A well-rounded exercise program generally includes progressive strengthening, balance training and other weight-bearing activities, tailored to your needs.
How can we help?
Exercise with osteoporosis doesn't have to be intimidating. We can help to assess your strength, balance, mobility and individual risk factors before developing a safe and achievable exercise program. For more information on the classes we run, take a look here.
Whether you're newly diagnosed with osteoporosis, have osteopenia, or simply want to stay strong and active as you age, the right exercise program can help you maintain independence and confidence in everyday life.