World Osteoporosis Day is on October 20th this year and we are being encouraged to “say no to fragile bones” and to “move for your bones.” Osteoporosis (porous bones) is a condition where the bones become brittle and weak and it can affect any bone in the body. People with this condition can suffer broken bones from a minor impact or accident (most common fracture sites are the spine, wrist, hip). Osteoporosis is rarely diagnosed before a fracture occurs; therefore, it is likely to be under diagnosed. Based on data from the AIHW in 2022, there was an estimated 853,600 (3.4%) Australians diagnosed with either Osteoporosis or Osteopenia. Osteopenia refers to lower than normal bone-mineral density but is not low enough to be classified as osteoporosis.
Additionally in 2022, the prevalence of osteoporosis and osteopenia collectively:
- increased substantially with increasing age, from 0.7% of people aged 35–44, to 17% of people aged 75 and over
- was highest for women aged 75 and over (26%)
- was higher among women compared with men (5.5% and 1.1%, respectively)
Osteoporosis has no obvious symptoms so it is often not diagnosed until after a fracture occurs. Diagnosis of osteoporosis requires an assessment of bone mineral density. The most commonly used method for diagnosis is a specialised X-ray known as a ‘Dual energy X-ray Absorptiometry scan’. Assessment is often repeated 1-2 years after starting or changing osteoporosis medication to evaluate treatment outcomes. Alternatively, it might be repeated in 1-2 years if close to a treatment threshold (osteopenia scores) but not receiving treatment, with subsequent testing varying according to your individual situation.
Risk factors associated with the development of osteoporosis include:
- family history of the condition
- increasing age
- being female
- low vitamin D levels
- low intake of calcium
- low body weight
- smoking
- excess alcohol consumption
- long-term corticosteroid use
- physical inactivity
- reduced oestrogen level
Exercise is important for women across all stages of life and as such is recognised as an effective lifestyle strategy to shape a strong skeleton and preserve bone strength. For example, during menopause, the hormonal changes (particularly decreased oestrogen – a hormone that regulates bone metabolism and is essential to bone health because it promotes the activity of osteoblasts, which are the cells that make new bone) means that the risk of developing osteoporosis is significantly greater. This is where strength-based training is particularly vital to prevent or slow the progression disease. Just like muscles, bones can adapt to the loading put on them from exercise and leads to an increase in bone density. Other benefits of exercise can include: improved balance, better lower extremity neuromuscular function and increased muscle strength – all playing a major role in falls prevention.
When appropriately prescribed, exercise can be an effective and safe treatment for most people with Osteoporosis. Accredited Exercise Physiologists (AEPs) are university qualified professionals equipped with the knowledge to design safe and effective exercise programs for people living with, or at risk of developing Osteoporosis. Impact training, aerobic weight bearing, balance and resistance exercise can be beneficial for those with Osteoporosis, the goal should be to start small and gradually build up time and intensity from there.
Thorough evidence-based pre-screening and relevant fitness testing is conducted onsite at our state-of-the-art functional rehabilitation facility to gain an understanding of all the health conditions you are living with, how they impact your life and your current level of fitness. Exercise prescription is individualised based on this information in addition to what your goals are.
It may be recommended to start with supervised sessions at our facility under the experienced eye of our Accredited Exercise Physiologists, Nathan Walker or Scott Howard, or your program can be designed to be performed from home. We utilise a free exercise software program called Physitrack, which can be downloaded to your smart phone or tablet, which gives you the ability to message your therapist directly with feedback about your exercises.
If you want to exercise or know someone who does but aren’t sure how to get started, please book an appointment with one of our AEP’s today. They can help show you how to use exercise to keep your body and mind, happy and healthy in the management of Osteoporosis.
Sources:
https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview
https://www.worldosteoporosisday.org/
https://exerciseright.com.au/ebooks-and-magazines/
https://healthybonesaustralia.org.au/resource-hub/fact-sheets/
