Training your bones – Bone Talk

Train your bones
By Rebekah Rotstein, NCPT

You have been diagnosed with osteoporosis or osteopenia and told that exercise can help. But what kind of exercise should you do? How do you know you won’t hurt yourself? What if you’ve never exercised before – how do you even get started? Or if you’re already an exercise enthusiast, what else can you do that you may have overlooked before?

Let’s start by identifying how exercise can benefit your bones. Your bones are living tissue that change thickness, mass and shape with use, just like your muscles. If you wanted to strengthen your muscles, you would use them by pulling objects (like lifting weights) and pushing things (like push-ups). You can strengthen your bones in much the same way.

Your bones adapt and respond to loads by strengthening and strengthening themselves to be able to bear that same load again in the future. When you resist external forces like gravity or weights, your bones reap the reward. On the other hand, not using your bones results in a weakening of their structure and composition. Ever seen the wrist of someone whose cast has just been removed? The wrist size has generally become smaller compared to the other wrist due to its immobility and lack of use. Similarly, NASA research has shown how the absence of gravity in space, which also limits the ability of muscles to pull on bones, causes reductions in bone mass.

To know which type of exercise to engage in, you need to understand that bone is built from three sources when it comes to activity:

1–Weight load

Every time you stand upright, you are working against gravity and supporting the weight of your body. When you crawl or exercise on the floor and support your body with your hands and wrists, you similarly support your weight through your forearm bones.

2–Resistance

Your muscles facilitate movement against additional forces such as weights, bands or pulleys when you exercise. They also contract during daily activities such as carrying objects and moving furniture.

3–Effect

Your bones respond to compressive forces and receive further stimuli to become stronger when a greater force is added that increases the gravitational effect. You’re probably familiar with the term “high impact,” which refers to activities like running and jumping that some people find uncomfortable on their joints as they get older. High impact may not be recommended if you have osteoporosis, and especially if you have had a fracture, but it is important for building maximum bone mass in younger individuals. Low impact can be achieved by repeatedly stomping your feet or dropping your heels.

Knowing which exercises to perform – and even which type of exercise (strength training, Pilates, yoga, HIIT, aerobics, to name a few examples) – depends on your physical capacity, history of physical activity and history of fractures . (If you have had a fracture, you should get permission from your doctor to begin an exercise program.)

To actually increase bone density through exercise after menopause, you probably need high-intensity exercise (lifting heavy weights with a load of at least 80% of the maximum you can lift in a single repetition, along with a high impact). That assumes you don’t have any comorbidities (other conditions) or safety concerns that could make it contraindicated, and you have access to a gym and a trainer to supervise you.

You can also aim to maintain the bone density you have, train for strength and power, and absorb impact at lower loads. No matter what, to avoid injuries, maintain good form by mastering basic movements and training for mobility to achieve the necessary range of motion in your joints.

So when the question arises as to what is the one form of exercise you should be doing for osteoporosis, there is not ONE! The three bone-strengthening elements mentioned above are essential in addition to mobility training, but as the 2014 consensus document ‘Too Fit to Fracture’ pointed out, the best strategy is a multimodal approach that also combines balance and posture training (which we will discuss in this article). a future part of this series.)

A few important things to keep in mind as you begin your training journey:

• Be consistent. As with any activity or skill, consistency is key to experiencing results and promoting motivation

• Keep challenging yourself. Your bones and muscles are both adaptive organs. So to continue to reap the benefits of exercise, you need to continually and gradually make things harder so you don’t plateau.

• Make it fun. If you find it annoying, you’re more likely to procrastinate and avoid it! The best exercise is the one you are going to do.

Sometimes getting started is the biggest hurdle you have to overcome. Know that exercise affects more than just your bones and muscles, joints and soft tissues. It is multisystemic and can improve other systems of your body, such as your digestion, your circulation and your cognition. Furthermore, the more physically active you become, the stronger you feel. One of the often overlooked aspects of osteoporosis is the emotional difficulty that patients experience, regardless of whether they have suffered a fracture. Taking charge of your health through exercise can be one of the best actions you can take to transform yourself from a sense of fear and vulnerability to a sense of confidence and capability.

Stay tuned for the next part of this series demonstrating specific posture training exercises that you can incorporate into your daily life. The smallest change in body position can make a big difference in the experience and effects of your exercise program.