Exercising with osteoporosis: Stay active the safe way

Osteoporosis is a major cause of disability in older women. So if you have osteoporosis, how can you reduce your risk of the spinal problems and broken bones that can result in loss of mobility and independence?

The answer: Exercise.

If you've always been physically active, good for you. Even though your bones may lose some density as you age, they're less likely to become brittle enough to break if you slip and fall. Plus by exercising, you strengthen your muscles and stronger muscles also help protect your bones.

Benefits of exercise

It's never too late to start exercising. After menopause, the pace of bone loss really picks up. Starting an exercise program can increase your muscle strength, improve your balance and help you avoid falls — and it may keep your bones from getting weaker.

For postmenopausal women, regular physical activity can:

• Increase your muscle strength
• Improve your balance
• Make you better able to carry out daily tasks and activities
• Maintain or improve your posture
• Relieve or decrease pain
• Improve your sense of well-being

Exercising if you have osteoporosis means finding the safest, most enjoyable activities for you, given your overall health and amount of bone loss. There's no one-size-fits-all prescription.

Before you start

Consult your doctor before starting any exercise program for osteoporosis. You may need some tests first, including:

• Bone density measurement
• Fitness assessment

In the meantime, think about what kind of activities you enjoy most. If you choose an exercise you enjoy, you're more likely to stick with it over time.

Choosing the right form of exercise

These types of activities are often recommended for people with osteoporosis:

• Strength training exercises, especially those for the back
• Weight-bearing aerobic activities
• Flexibility exercises
• Stability and balance exercises

Because of the varying degrees of osteoporosis and the risk of fracture, certain exercises may be discouraged. Ask your doctor or physical therapist whether you're at risk of osteoporosis-related problems, and find out what exercises are appropriate for you.

Strength training
Strength training includes the use of free weights, weight machines, resistance bands or water exercises to strengthen the muscles and bones in your arms and upper spine. Strength training can also work directly on your bones to slow mineral loss.

Osteoporosis can cause compression fractures in your spinal column. These fractures often lead to a stooped posture, increasing the pressure along the front of your spinal column, and result in even more compression fractures. Exercises that gently stretch your upper back, strengthen the muscles between your shoulder blades and improve your posture can all help to reduce harmful stress on your bones and maintain bone density.

Weight-bearing aerobic activities
Weight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening. These types of exercise work directly on the bones in your legs, hips and lower spine to slow mineral loss. They can also provide cardiovascular benefits, which boost heart and circulatory system health.

Swimming and water aerobics have many benefits, but they don't have the impact your bones need to slow mineral loss. However, these activities can be useful in cases of extreme osteoporosis, during rehabilitation following a fracture or for increasing aerobic capacity.

Flexibility exercises
Being able to move your joints through their full range of motion helps you maintain good balance and prevent muscle injury. Increased flexibility can also help improve your posture. When your joints are stiff, your abdominal and chest muscles become tight, pulling you forward and giving you a stooped posture.

Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example. They should be done gently and slowly, without bouncing. Avoid stretches that flex your spine or cause you to bend at the waist. These positions may put excessive stress on the bones in your spine (vertebrae), placing you at greater risk of a compression fracture. Ask your doctor which stretching exercises would be best for you.

Stability and balance exercises
Fall prevention is important for people who have osteoporosis. Stability and balance exercises help your muscles work together in a way that helps keep you more stable and less likely to fall. Simple exercises such as standing on one leg or movement-based exercises such as tai chi can improve your stability and balance.

Movements to avoid

If you have osteoporosis, don't do the following types of exercises:

• High-impact exercises, such as jumping, running or jogging. These activities increase compression in your spine and lower extremities and can lead to fractures in weakened bones. Avoid jerky, rapid movements in general. Choose exercises with slow, controlled movements.
• Exercises in which you bend forward and twist your waist, such as touching your toes or doing sit-ups. These movements put pressure on the bones in your spine, increasing your risk of compression fractures. Other activities that may require you to bend or twist forcefully at the waist are golf, tennis, bowling and some yoga poses.

If you're not sure how healthy your bones are, talk to your doctor. Don't let fear of fractures keep you from having fun and being active.

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