May 18, 2018

Staying Active With Osteoporosis

Training & Fitness
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An osteoporosis diagnosis doesn’t mean the end of an active lifestyle. In fact, exercise, together with proper nutrition, is often recommended as a way to help increase bone mass, therefore, preventing fractures in the future. As Dr. Leslie Morse, assistant professor in physical medicine and rehabilitation at Harvard Medical School and a physiatrist at Spaulding Rehabilitation Hospital, writes in Harvard Women’s Health Watch, “Bone tissue responds to day-to-day signals, and when you stop moving, it gets the signal to start removing bone, so it’s important to stay as active as you can.”

So you know your diagnosis and understand you need exercise and nutrition to help improve your health, but where do you start? Here we break down exercise and nutrition ideas to help you stay active.

Consultation

An osteoporosis diagnosis in a patient can range from someone who is disabled with severe bone fractures, to an otherwise healthy individual that has a low bone density test score. It is therefore important to first consult your physician on what is correct for your health before implementing a new exercise or nutrition routine.

Types of Activities to Avoid

The National Osteoporosis Foundation recommends avoiding high-impact weight-bearing activities that may add a large amount of stress on bones, therefore, contributing to fractures. Weight-bearing activities work by having you support your own weight against gravity. High-impact activities can include (but are not limited to) the following types of exercise:

  • Racket Sports
  • Certain types of high impact dancing
  • Certain types of high impact aerobics
  • Hiking
  • Running
  • Jumping Rope
  • Stair climbing
  • Skiing
  • Figure skating
  • Bowling

Types of Activities to Try

Low-impact weight-bearing activities are important in preventing fractures from osteoporosis. The following are good options to try:

  • Stair machine
  • Elliptical machine
  • Walking
  • Free Weights
  • Tai Chi
  • Low-impact dancing
  • Swimming

Specific Exercises to Try

In addition to continuing with your favorite weight bearing, low-impact activity, it is important to work on exercises in certain key areas. These include resistance, core strength, flexibility, and balance. These types of exercises can be done at a gym, or, in the comfort of your own home.

Resistance- In resistance exercises, your muscles contract from a force that can come from weight from exercise machines, free weights, elastic bands, or your body weight. These types of exercise are especially helpful for strengthening muscles that attach to your spine and hips, such as your back and legs. However, be careful to avoid machines that twist or bend your spine as these do not help your core strength and may put too much stress on your back. Specific resistance exercises to try include:

Butt-Tap Squats– For a squat that does not put extra pressure on your knees, try standing in front of a chair with your hips about feet-width apart. Position your arms straight out in front of you, bend your knees until your butt lightly touches the chair, and then return to a standing position. Repeat five to eight times.

Seated Rows– Place a resistance band on a secure object and then sit a couple of feet away with your arms straight in front of you. Keep your shoulders straight, and your back relaxed and pull the band towards you. There should be very little tension on the band. Repeat five to eight times.

Chest Raises– Lie facedown with your arms by your sides. Slowly raise your chest, head, and arms for a few seconds at a time, then rest for two seconds and repeat until you feel tired.

Core Strength- Core muscles help you to maintain good posture and stand upright. These muscles attach to your shoulders, pelvis, and spine. With a strong core and legs, you are less likely to incur a bad fall. However, similar to resistance exercises, avoid ones that unnecessarily bend or twist your spine to prevent fractures in that area. Good core strength exercises include:

Forearm plank– Lie on your stomach with your forearms underneath you at a 90-degree angle with your waist touching the floor. Raise your hips off the floor and tighten your abs, keeping your body in a straight line. Do this for 10-20 seconds and then rest. Work your way up to a minute at a time. Repeat two to four times.

Dead bug– Lie on your back with your feet on the floor, knees bent, and arms down by your side. Now tighten your abs and bring your knees to a 90-degree angle above your hips. While doing this, raise your arms until your fingers point to the ceiling. Now stick your left arm back to almost lying down above your head, along with your right leg down, so it hovers just above the floor. Alternate by swapping your right arm and left leg. Try two or three sets of eight to ten repetitions.

Flexibility- Maintaining good range of motion in your joints will also help to avoid falls. Try an exercise such as:

Reclined leg stretch– Lie on your back with your feet on the floor and knees bent. Slowly bring one foot up at a time and straighten the leg as far as it can go until you feel a stretch in the back of your leg. Use a towel or band to help as necessary. Hold the stretch for about 15-seconds.

Balance- Balance helps the body to understand better its perception of where it is as well as helping to strengthen muscles. By improving your balance, you are also improving your self-confidence that you will not fall, which has actually been proven to make falls less likely. Exercises include:

Arm and leg extensions– Get down on your hands and knees. Slowly raise your right arm and left leg extending them out as far as is comfortable and then hold for two seconds. Be sure to keep your torso straight and abs tight. Do ten repetitions on each side.

One-leg balance– Hold onto the back of a chair on one foot for 30-seconds trying to maintain balance. Afterward, swap to your left. Try to work up to one minute on each foot.

Heel and toe raises- Hold onto the back of a chair for this exercise as well. Stand on your toes for a second and then lower them down to rest on your heels. Try two sets of eight to ten repetitions.

Nutrition

In addition to exercise, be sure that you are receiving the proper nutrition in order to help manage your osteoporosis and help you stay active. Two of the most critical nutrients for those who have osteoporosis are Calcium and Vitamin D. While a one meta-analysis study calls Vitamin D into question, a deeper analysis finds merit.

Calcium helps to build bones and keep them healthy, all while also helping our heart to beat, blood to clot, and our muscles to contract. Vitamin D, meanwhile, helps your body to absorb calcium and supports your muscles to avoid falls. While the best source of these nutrients is food itself, supplements can help if you do not think you are getting adequate nutrition.

Calcium is predominately found in dairy products. Some green vegetables contain small amounts of calcium as well. These days certain foods are fortified with it too (meaning it is not naturally occurring but is added). Items like cereal, juices, bread, soymilk, etc. sometimes have it added.

Meanwhile, the best ways to obtain vitamin D are through fortified food (like milk), supplements, and sunlight. Vitamin D occurs naturally in fatty fish such as tuna, salmon, and mackerel. It is also added as a supplement to a lot of the same foods as calcium, such as juice, soymilk, cereals, etc.

Vitamin D is also produced by your skin in reaction to the sunlight and stores it in fat. A lot of seniors do not spend enough time outdoors to get the amount of sunlight they need, so try going for a walk, swimming outside, or other doctor recommended exercise. (Always remember to protect your skin with sunscreen, however!)

Supplements

Calcium is the main mineral but not the main component of your bones; by volume, your bones are about 50% protein. Unsurprisingly, the effect of dietary protein on bone health has been the subject of many randomized controlled trials and prospective cohort studies.

The consensus is that higher protein intakes can help maintain bone mineral density, or at least slow its decrease, especially in the presence of enough calcium. Luckily, higher protein intakes also enhance calcium absorption in the intestines (as does vitamin D) – Examine.com

In addition to talking to your doctor about a quality bone supplement, be sure to read labels, and consider which ingredients are included. If your diet and supplement don’t include enough of them, consider adding Protein, Vitamin K, and Magnesium.

As described above, protein is the main component of your bones. The U.S.  Recommended Daily Allowance (RDA) is 0.8 g per kilogram of body weight (0.36 g/lb/day). Most studies have observed positive effects by increasing to 1.4 g/kg/day (with a minimum of 90 g/day). Digest protein throughout the day, and target intake levels based on desired weight if you are over a 30 BMI (Body Mass Index).

Vitamin D is important – especially during the darker months of the year. The most stable and bioavailable form of vitamin D is D³. Recommendations for bone supplementation are 2,000 IU (50mcg). It’s most effective when taken with a meal containing fats. When supplementing calcium, it can be helpful to have vitamin D and Vitamin K – both increase (individually and synergistically) the uptake of minerals like calcium and magnesium for your bones.

Vitamin K is contraindicated for people that take anticoagulants such as warfarin or Coumadin. These products are used as a blood thinner, which may be hindered by the blood-clotting assistance in vitamin K.

Calcium is one of those supplements where more isn’t necessarily better. A target of around 500/mg per day should include your dietary sources, and factor your biological gender and age. Excess calcium can also cause constipation (and other problems). Consider adding K or D instead of overloading calcium.

Magnesium deficiency is more pronounced among athletes, as it is lost through sweat. There is a correlation between levels in the blood with greater or lower bone mass in old age. Magnesium can impair the absorption of some medications including antibiotics, and may have a sedative effect – often recommended before bed. Calcium, iron, magnesium, and zinc compete for absorption. Do not take high doses in concert. A standard dose of magnesium is 200 mg.

Conclusion

Osteoporosis can be a scary diagnosis, but do not let it limit you. Together with the guidance of your doctor, proper exercise and nutrition can help you remain as active as ever, all the while helping to improve your osteoporosis condition by making your bones more resilient and lowering your risk for falls and fractures.

References*

“Exercise/Safe Movement”. National Osteoporosis Foundation. 4 May 2018. <https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/>.

Somers, Dixie. “The Best Ways to Stay Active When Living with Osteoporosis.” American Fitness Professionals & Associates. 4 May 2018. <https://www.afpafitness.com/blog/the-best-ways-to-stay-active-when-living-with-osteoporosis>.

“Staying Active Despite Osteoporosis”. Harvard Health Publishing. 4 May 2018. <https://www.health.harvard.edu/staying-healthy/staying-active-despite-osteoporosis>.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61647-5/abstract

https://www.nal.usda.gov/sites/default/files/fnic_uploads//589-768.pdf

*Links to sources do not constitute endorsement of others’ conclusions, products/services, or ours. This information doesn’t constitute medical advice. We hope to jumpstart your own research. Always consult your doctor before beginning any diet, supplement, or exercise plan.

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