You’ve been diagnosed with osteoporosis or osteopenia and told that exercise can help. But what type of exercise should you do and how does it help? How do you know you won’t be hurting yourself? What if you’ve never exercised before – how do you even begin? Or what if you’re already an exercise devotee – what else can you do in your regimen that you may have previously overlooked?
Let’s start by identifying how exercise can benefit your bones. Your bones are living tissue which change in thickness, mass and shape through use, just like your muscles. If you wanted to strengthen your muscles, you would use them – you’d pull on objects (lifting weights in a gym or you lift grocery bags in daily life) and you’d also push on objects (doing push ups as exercise or pushing open doors in daily life). You can strengthen your bones in much the same way – through using them.
Your bones adapt and respond to load by reinforcing and strengthening themselves to sustain that same load again in the future. So when you use your muscles and resist external forces like gravity, your bones reap the reward. On the flip side, not using your bones and muscles results in weakening of their structure and composition. Think of the wrist of someone whose cast has just been removed – the wrist size has diminished compared to the other wrist because of its immobility and lack of use. Similarly, NASA (National Aeronautics and Space Administration) research has demonstrated how the absence of gravity in space, which also limits the ability of muscles to pull on bones, causes reduction in bone mass.
In order to know what type of exercise to engage in, you need to know that bone tissue builds from three methods:
1. Weight bearing: any time you are standing and upright you are working against gravity and bearing your body’s weight. When you crawl or do exercise on the ground supporting your body through your hands and wrists, you are weight-bearing through your forearm bones.
2. Resistance: where your muscles facilitate movement working against additional forces such as weights, exercise bands or pulleys.
3. Impact: where your bones respond to additional compressive forces and receive further stimulus to strengthen. You’re probably familiar with the term ‘high impact’ referring to activities like running and jumping which many people find uncomfortable on their joints as they age. High impact may not be recommended if you have osteoporosis, and especially not if you’ve experienced a fracture, but it’s important for building of peak bone mass in younger individuals.
To know which exercises to perform and even what form of exercise (weight-training, Pilates, aerobics, as a few examples) depends on your medical history, level of physical activity and capacity and your physician’s clearance, which you should always obtain first. But your course of exercise should be enjoyable, since if you find it tedious, you will likely avoid it. And it must be consistent for you to experience results. You’ll also find that the longer you continue your path of exercise over weeks and months, the easier the exercises will become as your body adapts and grows stronger, which will also be gratifying and rewarding. Where you may have previously felt weak or even frail, especially if you were informed that your bones were ‘frail’, you will soon feel more empowered and capable emotionally in addition to physically.
Stay tuned next month for specific bone-building exercises you can integrate into your daily life. Even if you’re accustomed to certain movements, you may be surprised how the smallest shift in positioning makes a significant difference in the outcome.
This article, authored by Rebekah Rotstein, is the first of a three part series on exercise.
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Rebekah Rotstein is an international exercise presenter and movement educator and the creator of the award-winning DVD and workout Pilates for Buff Bones®. She runs her own studio in New York City and teaches courses on a variety of topics including bone health, functional anatomy and rehabilitation. Her ongoing study of the body includes annual cadaver dissections, somatic studies and visceral manipulation. Rebekah is a partner of the U.S. Department of Health & Human Services and she has been frequently interviewed in the media.