It is estimated that osteoporosis affects over 1.2 million Australians, with a slightly higher prevalence in women. Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes. This can lead to a decrease in bone strength that can increase the risk of falls and fractures.

During childhood and adolescence the goal is to build as much bone strength as possible, so that you can maintain this throughout adulthood. Then, in your older years, it’s important to reduce bone loss and maintain muscle mass, which maximises mobility and balance. This ultimately helps to reduce the risk of falls and subsequent fractures as we age.

Bone density can be measured through a DEXA scan and it primarily measures bone density of the hips and spine. A T-score of -1 to -2.5 indicates osteopenia (lower than normal bone density) and a T-score of -2.5 or below indicates osteoporosis.

The good news is exercise plays an important role in maintaining bone health and preventing the development of osteoporosis. When it comes to exercise and bone health, not all exercise has the same impact on bones. The best type of exercise for our bones is weightbearing impact-loading exercises, resistance training and balance training. A combination of all three types of exercise is even better!

What are weightbearing impact-loading activities?

Weightbearing impact-loading activities are those that produce a force on the bones that promote bone growth and strength. This force is commonly produced by impact with the ground. This would include activities like bouncing, jumping, skipping, jogging, dancing, climbing stairs, and many team sports. It is through the weight of the body on the bones that the bones become stronger over time. Weight slightly compresses the bone matrix and triggers the cells to create more calcium and other minerals which increases bone density. Depending on the status of your bone density, it is recommended to incorporate these types of activities slowly and consider other musculoskeletal issues.

How to do resistance training at home

Resistance training is where you increase your muscle and bone strength by making your muscles work against a weight or force. This doesn’t mean you need to join a gym or have copious amounts of equipment at home. There are lots of things that you can use around the house as resistance, including water bottles or cans of food and even your own body weight. Alternatively, hand weights, kettlebells or therabands can be purchased for a small price for added variety.

Some examples of resistance training exercises include bicep curls, bent over row, wall push-ups and sit to stands. Ideally, a resistance training program will include 8-10 different exercises, targeting the major muscle groups of the body (ie: chest, back, arms, legs etc). It is recommended to perform 10 repetitions of each exercise, have a rest and then complete a second set of those same exercises.

Balance training

Balance training is another a very important component in improving bone density and reducing the risk of falls. In fact, we rely on good balance every day to do things such as walking, bending over to tie our shoe laces and stepping to the side to avoid obstacles. A good balance training program will challenge you to build the muscles that help keep you upright, including your legs and core. This could be simply standing on one leg for a few seconds or walking heel to toe in a straight line. There is also lots of equipment you can use that forces your body to stabilise itself, like the Bosu (half circle stability ball), balance boards, foam pads and other unstable surfaces. Over time, you can increase the difficulty of your balance training by holding positions for longer, closing your eyes or letting go of your chair or other support.

How to get started

If you are looking to improve your bone density and you’re not sure where to start, you can reach out to your doctor for a referral to an Accredited Exercise Physiologist, under a diabetes care plan. They can assess your capabilities and limitations, review your medical history and formulate an appropriate exercise program tailored to you. If exercise is new to you, this is a great way to build your confidence under supervision so that you can participate safely on your own in the comfort of your own home. Remember, healthy bones means greater independence and a reduced risk of falls.

By Hayley Nicholson Exercise Physiologist, Credentialed Diabetes Educator

Resources:

Healthy Bones Australia

Australian Physical Activity Guidelines