Skeleton showing the spinal column

Healthy Bones: What is Osteoporosis?

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Osteoporosis is a skeletal disease characterised by low bone mineral density and changes in the microarchitecture of bone that increase its susceptibility to fracture1. The underlying mechanism involves an imbalance between bone resorption and bone formation, leading to low bone mass and deterioration of bone tissue, with a consequent increase in bone fragility.

How Common is Osteoporosis?

A diagram explaining how common osteoporosis is in Australians

According to the Australian Institute of Health and Welfare2:

  • An estimated 924,000 Australians have osteoporosis.
  • It is more common in women than men – 29% of women aged 75 and over vs 10% of men.
  • Over 1 in 4 women aged 75 years and older have osteoporosis.

How is Osteoporosis Diagnosed?

Osteoporosis is diagnosed by assessing bone mineral density (BMD), which is most commonly done using a specialised X-ray test called a ‘dual-energy x-ray absorptiometry’ (DEXA) scan. Scan results are expressed as T-scores which compare a person’s BMD with the average of young healthy adults2,3:

NormalOsteopeniaOsteoporosis
T-Score1 to –1–1 to –2.5–2.5 or lower

What are the Benefits of Exercise?

Activities that put stress on bones stimulate extra deposits of calcium and stimulate bone-forming cells. The tugging and pushing on bone that happens during strength and power training provides this stress and leads to stronger, more dense bones4.

According to the American College of Sports Medicine (ACSM)1, regular exercise has a number of benefits, including:

  • Increased bone density, volume, and strength
  • Increased muscle strength
  • Improved balance
  • Reduced risk of falls
  • Reduced risk of bone fracture
  • Delayed onset of osteoporosis
  • Improved cardiovascular and metabolic health

What are the Physical Activity Guidelines for Osteoporosis?

The physical activity recommendations for individuals with osteoporosis are:

  • Complete moderate-intensity weight-bearing exercise that does not cause or exacerbate pain, including:
    • Aerobic exercise on 4-5 days per week, starting with 20-minute bouts and increasing to 30-60 minutes, and
    • Resistance exercise on 1-3 non-consecutive days per week, and
    • Flexibility exercise on most days, completing static stretching of all major joints.
  • Higher impact, velocity, and intensity exercise is recommended for individuals with low to moderate risk for fracture.
  • Complete balance exercises to reduce fall risk

What Exercise Should be Avoided?

For individuals with a high risk of fracture, the following should be avoided:

  • Exercises that cause or exacerbate pain
  • Explosive movements or high-impact loading
  • Excessive twisting, bending, or compression of the spine

The information in this article is general in nature and should not replace the advice of a qualified health professional. Please consult an appropriate health professional prior to commencing exercise to ensure you receive information tailored to your individual needs.

References

1 American College of Sports Medicine. (2022). ACSM’s Guidelines for Exercise Testing and Prescription (11th Ed.). Wolters Kluwer.

2 Australian Institute of Health and Welfare. (2023). Chronic musculoskeletal conditions: Osteoporosis. Retrieved from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis.

3 Finkelstein, J.S., Yu, E., Rosen, C.J., & Rubinow, K. (2023). Patient education: Bone density testing (Beyond the Basics). Retrieved from: https://www.uptodate.com/contents/bone-density-testing-beyond-the-basics.

4 Harvard Health Publishing. (2021). Slowing bone loss with weight-bearing exercise. Retrieved from: https://www.health.harvard.edu/staying-healthy/slowing-bone-loss-with-weight-bearing-exercise

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