SIT AND BE FIT | Osteoporosis Information and Exercises

OSTEOPOROSIS AND YOU

What is Osteoporosis?

Osteoporosis (porous bones) is a disease of the skeleton in which the bones lose density and become thin, weak, and brittle. Bone tissue is actually lost over time, and the risk of fracturing the bone is greatly increased. Some bone loss is normal with advancing age, but if enough bone was not developed during youth, or if bone loss is excessive, osteoporosis results.

Osteoporosis itself has no symptoms; you can't tell if you have the disease or not based on how you feel or how you look. Often, one first finds out they have osteoporosis when a bone breaks. Currently, osteoporosis affects 8 million women and 2 million men in the US . Another 18 million women and men have osteopenia (lower than normal bone density) and are at risk of developing osteoporosis.

How Do I Know if I Have Osteoporosis?

Because osteoporosis exists without any symptoms, you can have the disease and not know it. An awareness of the risk factors for the disease will help you to determine if you may be at risk for having or developing osteoporosis.

female gender
low weight
Caucasian descent
family history
late onset of menstruation
early menopause
failure to menstruate
increased age
history of prior fracture
inactive lifestyle
low calcium intake
inadequate Vitamin D
excessive caffeine use
low estrogen levels in women
low testosterone levels in men
excessive thyriod hormone therapy
certain medications such as steriods
medical history of malabsorption
excessive use of alcohol
smoking cigarettes

If you think you might be at risk of having osteoporosis, check with your doctor. your doctor may prescribe a bone density test, which is a special low dose x-ray, and takes only a few minutes to complete. It is most common to test the bone density of the lumbar spine (bones of the lower spine) and the hip. A bone density test provides your doctor with a "t-score". If a person has a t-score of minus 2.5 or less, osteoporosis is present. If the t-score is between minus 1.0 and minus 2.5, osteopenia is present.

What are the Consequences of Osteoporosis?

Osteoporosis often results in multiple painful and disabling fractures. Bones affected by severe osteoporisis can fracture with normal, everday activities, such as picking up a bag of groceries or a child, rolling over in bed, stepping off a curb, or even sneezing. Falls are responsible for many osteoporotic fractures.

Compression fractures and wedge-shaped fractures of the bones of the spine (vertebrae) are the most common type of osteoporotic fracture. They result in decreased height, stooped posture, limited mobility, and disabling pain. The spine curves forward, and the lower ribs may even come to rest on the pelvis. Hip fractures are the most serious and expensive type of fracture. Nearly 25% of individuals who break a hip die within one year of their injury, and approximately 25% of survivors require expensive long-term care. Other commonly fractured sites are the wrist, the ribs, and the shoulder.

Can Exercise Help Osteoporosis?

Bones lose their strength if they are not used, just as muscles do. Bone is a living tissue and responds to the stresses placed upon it. If stress is minimal, bone strength and size will be less than if the bone is subjected to rigorous, high impact demands. Therefore, an active lifestyle is important throughout the lifespan to develop and maintain healthy bones. Weight-bearing, high impact exercises during youth (running, jumping, gymnastics, etc.) are important for the development of maximum bone density and strength.⁵ Weight-bearing exercises (walking, jogging) continue to be important throughout life to help prevent the loss of bone tissue. However, high impact exercises may not be appropriate later in life because of the risks of injury. Non-weight bearing exercises, such as swimming or cycling, do not help to strengthen bones.

Strengthening exercises slow the rate of bone loss with age, and over time, may even build bone strength. Standing leg strengthening exercises like lunges and squats are important in the prevention and treatment of osteoporosis. They increase bone density and strength at the hip joint and the spine, and improve balance, reducing falls and fractures.⁶

When osteoporosis is present, fall prevention is very important. Exercises and activities that challenge balance skills improve balance. Standing on one leg, weight shifting, reaching in various directions, standing with one foot in front of the other like on a balance beam, turning, and changing directions are examples of appropriate activities to improve balance. Balance exercises must always be done in a safe environment so falls do not occur.

Poor posture promotes osteoporotic bone fractures in two ways. First, poor posture increases pressure on the vertebrae, contributing to compression and wedge shaped vertebral fractures. Second, it interferes with overall balance, increasing the likelihood of fractures related to falls. The person with osteoporosis must learn what good posture looks like in the mirror and what it feels like so that proper postural alignment in various positions and with activity becomes a way of life.

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2. Holley T: Musculoskeletal system. FOCUS: Geriatric Physical Therapy. Section on Geriatrics, APTA; 2001

3. Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45:101-107.

4. Kelsey JL, Hoffman S. Risk factors for hip fractures. N Engl J Med. 1987;316:404-406.

5. McKay HA, Petit MA, Schutz RW, et al. Augmented trochanteric bone mineral density after modified physical education classes: A randomized school-based exercise intervention in prepubertal and early-pubertal children. J Pediatr 2000; 136:156-162.

6. Kahn K, McKay H, Kannus P, Bailey D, Wark J, Bennell K. Physical Activity and Bone Health.. Champagne, IL: Human Kinetics; 2001.