Move It or Loose It

Apr 3, 2020 | Teacher's Corner

The case for exercise in preventing and reversing Osteoporosis and Osteopenia.

Bones consist of a calcium mineral embedded in a protein mesh of collagen and have a honeycomb structure. This living tissue renews itself continuously, that is, there is a continual breaking down of old bone tissue and the making of new and this bone turnover not only allows fractures to be healed but also allows bones to gain strength.

However, to do this they need regular stimulation from physical activity – bones respond to “loading” by getting stronger, but they become weaker if there is no load inflicted upon them. This is seen when astronauts are in a gravity-free environment for a long time. Their muscles start to atrophy and their bones lose mass. This reverses when they once more enter a weight bearing environment.

Unfortunately, as people age their bones begin to deteriorate – they begin to get thinner and weaker and this leads to Osteopenia (weakened bones), and finally Osteoporosis (severely weakened bones). Women especially suffer from this after menopause due to less Oestrogen being produced but men over 65 can also get it. Osteoporosis can cause hip and other fractures in the body and cause the vertebrae to crumble resulting in a bent- over spine (kyphosis).

There are many factors leading to Osteoporosis but just in the last 20 years healthcare professionals have come to realise that one of the best ways to build and maintain healthy bones is through exercise. Just like muscles, bones respond when they are stressed – that is forced to bear more weight than they are used to – so weight bearing or impact exercises such as running, lifting weights, pulling bands, jumping and dancing will have an effect on them. Swimming and cycling, which are not weight-bearing, will not have such an effect on bones.

Exercise is very important for bones no matter what one’s age. In children it will build bones, in adults it will build and maintain bones, and, in the elderly it will maintain bone health. A study, done in the USA and Japan, found that when post-menopausal women used small weights to strengthen their back muscles over a period of two years, they had far stronger back muscles than their peers who did not exercise.  More importantly it reduced their chances of getting a vertebral fracture, and wedged vertebrae, by three-fold.

While exercise plays a major role in preventing Osteoporosis it can also be a part of the rehabilitation process in those who have developed it.  Kyphosis is often seen in older women.  This severe curvature of the spine is almost always due to fractures of the vertebrae caused by Osteoporosis – when vertebrae are weakened they can no longer support the weight of the body and they begin to get compressed and this leads to the curvature.  

Women suffering from this suffer chronic severe pain and can also have trouble breathing.  Exercise can help relieve the pain and some of the symptoms of kyphosis – by strengthening the muscles in the back the spine can be brought to a more upright position, mobility is increased and pain relieved. Again, with women who have had a hip replacement recent studies have shown that intensive exercise training after (and before if it is an elective procedure) can lead to improvement in strength and function.

While lack of balance does not have all that much to do with Osteoporosis, it is linked to muscles that are unused and it does increase the chances of falling and having a fracture of a weak bone.  If muscles are used less and less, the control our nervous system exerts over those muscles begins to decline and this means that reflexes are not as good as they should be and the risk of stumbling and falling increases.  Exercise builds strong muscles which in turn builds strong bones and exercise also improves muscle control, balance and coordination and these together reduces the risk of falling and having a fracture.

It is important that older women understand the value of exercising in preventing and reversing Osteopenia and Osteoporosis.  While more and more of our elderly population are going to exercise and dance classes there are still too many who think they should protect their bodies or who think a little walking is enough. Older women need to jump and dance and run more, lift weights and extend themselves and in this way protect their bones and their health.

(Terry Hodson)