Osteoporosis and Exercise

What is Osteoporosis?
Osteoporosis is a disease in which the mass of bones is low and bone structure is altered, leading to a higher likelihood of breaking. According to the World Health Organization, it is currently estimated that there are 1.66 million hip fractures each year worldwide, and this number is estimated to increase four-fold by 2050. Risk factors include aging, family history, medication, being a Caucasian or Asian woman, having a small and thin body frame. Lifestyle, including diet and exercise habits, has a role in both the development and prevention of the disease.

Preventing Osteoporosis with Exercise
Physical activity, particularly weight bearing exercise and resistance training, is widely recommended to help increase bone mass and prevent osteoporosis.^1,2,3 Weight bearing exercise includes activities like jogging, hiking, aerobics and sports like soccer, basketball and volleyball.

Regular physical activity during adolescence, specifically weight bearing exercise, is critical for optimizing peak bone mass.⁴ In a study of teenage girls, it was found that over a seven year period, the girls with the highest levels of physical activity had a bigger increase in bone mass when compared with those with the lowest levels.⁵ Maximizing bone mass during the early years of life has sustained benefits in adulthood.⁶ Adults who participate in moderate-intensity physical activity during their early years are likely to have higher bone mass and a lower risk of developing osteoporosis as the decades go by.

Exercise for bone health is not limited to the young, however. The Australian and New Zealand Bone and Mineral Society states physical activity may lower the rate of bone loss, improve muscle strength, and fitness can help lower the risk of fractures and falls among the elderly.⁷ Research performed in postmenopausal Japanese women supports that regular physical exercise can positively impact maintenance of bone mass and help prevent bone loss.^8,9

There is also some evidence that working on balance, coordination and posture, such as Tai Chi Chuan exercises can help delay bone loss in postmenopausal women,¹⁰ however more thorough studies are needed to confirm this finding.

Improving Symptoms of Osteoporosis with Exercise
Including weight bearing activity during the later years of life can help improve symptoms of osteoporosis. Results from a study performed in postmenopausal women with osteoporosis found that participating in an exercise program with moderate-intensity weight-bearing aerobic activities and resistance exercises with free weights, stabilized both height and bone mineral density of the lumbar site. In addition there was a reduction in fractures over the 5-year study period.¹¹

Bottom Line
A comprehensive activity plan that includes weight bearing, resistance, and balance training is an effective way to maximize bone mass in the early years and delay bone loss during the adult years, thus preventing the development of osteoporosis.

This content is reviewed regularly. Last updated December 17, 2011.

FOOT NOTES

¹ Chan KM, Anderson M, Lau EMC. Exercise interventions: defusing the world’s osteoporosis time bomb. Bulletin of the World Health Organization. 2003;81(11):827-830.

² Wolman RL. Education and debate ABC of sports Medicine: Osteoporosis and Exercise. BMJ. 1994 August;309:400.

³ Ullom-Minnich P. Prevention of osteoporosis and fractures. AAFP. 1999;60:194-202.

⁴ Karlsson MK. Does exercise during growth prevent fractures in later life? Med Sport Sci. 2007;51:121-136.

⁵ Rautava E, Lehtonen-Veromaa M, Kautiainen H, Kajander S, Heinonen OJ, Viikari J, Mottonen T. The reduction of physical activity reflects on the bone mass among young females: a follow-up study of 142 adolescent girls. Osteoporos Int. 2007 Jul;18(7):915-22.

⁶ Rideout CA, McKay HA, Barr SI. Self-reported lifetime physical activity and areal bone mineral density in healthy postmenopausal women: the importance of teenage activity. Calcif Tissue Int. 2006 Oct;79(4):214-22.

⁷ Forwood MR, Larsen JA. Exercise recommendations for osteoporosis. A position statement of the Australian and New Zealand Bone and Mineral Society. Aust Fam Physician. 2000 Aug;29(8):761-4.

⁸ Shimegi S et al. Physical exercise increases bone mineral density in postmenopausal women. Endocr J. 1994 Feb;41(1):49-56.

⁹ Hatori M. et al. The effects of walking at the anaerobic threshold level on vertebral bone loss in postmenopausal women. Calcif Tissue Int. 1993 Jun;52(6):411-4.

¹⁰ Qin L, Au S, Choy W, Leung P, Neff M, Lee K, Lau M, Woo J, Chan K. Regular Tai Chi Chuan exercise may retard bone loss in postmenopausal women: A case-control study. Arch Phys Med Rehabil. 2002 Oct;83(10):1355-9.

¹¹ Walker M, klentrou P, Chow R, Plyley M. Longitudinal evaluation of supervised versus unsupervised exercise programs for the treatment of osteoporosis. Eur J Appl Physiol. 2000 Nov;83(4-5):349-55.