Osteoporosis and Fitness


Osteoporosis is low bone density or bone mass and deterioration of the bone that increases skeletal fragility and risk of fracture. It often goes undetected because early stages lack clear symptoms and is called the "silent disease". This disease affects almost one out of every two women at some point in their lives. There are two classification for osteoporosis, primary and secondary. Primary osteoporosis is age related and secondary is due to other factors such as drug regimens for treating other diseases that can decrease bone at any time during the lifespan. The female athlete triad is an example of secondary osteoporosis and begins with an eating disorder followed by amenorrhea and can result in early-onset osteoporosis.


Recent evidence indicates that exercise can delay the onset of osteoporosis and reduce fracture risk. The benefits of exercise on bone health occurs in both children and adults and are due primarily to the increases in bone density, volume, and muscle strength. It can also help with balance and reduce falls and fractures due to falls. Because osteoporosis often leads to fractures, it may result in loss of workdays or employment and increased hospitalization. The economic burden has been estimated to be $20 billion in the US and $30 billion in Europe. Besides the financial burden you may incur, it also leads to loss of independence for the older population.


Peak bone density is achieved in the 20's and loss of bone density begins around the age of 25-30 years old. Recent data indicates that bone loss begins earlier in men (25-39 years) than women (40-44 years). Men and women lose bone at about the same rate until women begin to approach menopause.


There are several pharmacological agents to increase or preserve bone or reduce bone loss such as Calcium and Vitamin D, SERM, HRT, and Calcitonin. But the best way to reduce bone density it to incorporate exercise. The exercise guidelines for individuals with Osteoporosis from ACSM is below:


Aerobic

Frequency - 4-5 days a week

Intensity - Moderate Intensity at 40-59%

Time - Begin with 20 min, but progress to 45-60 minutes

Type - Walking, cycling, or other aerobic activity


Resistance

Frequency- Start with 1-2 non-consecutive days a week, can progress to 2-3 days a week

Intensity - Adjust resistance so that last 2 reps are challenging to perform. High intensity training is beneficial in those that can tolerate it.

Time - Begin with 1 set of 8-12 reps, and increase to 2 sets of 8-10 reps

Type - Machines, free weights, bands, and body weight


Flexibility

Frequency - 5-7 days

Intensity - Stretch to the point of tightness or slight discomfort

Time - Hold static stretch for 10-30 sec, 2-4 reps

Type - Static stretching of all major joints

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