Exercise And Bone Density - Healthy Bones Australia

1st Edition 02/21Exercise andBone DensityExercise is recognised as an effectivelifestyle strategy to build a strongskeleton and maintain bone strengththroughout life.

Exercise and Bone DensityRegular physical activity and exercise plays an important rolein maintaining healthy bones. Exercise is recognised as an effectivelifestyle strategy to build a strong skeleton and maintain bone strengththroughout life. Exercise also increases the size, strength and capacityof muscles. It is never too late to start exercising.Elements of a good exercise program for bone healthYou should not be intimidated by exercise if you have osteoporosis or osteopenia.In fact specific types of exercises are important for improving bone strength.Bones become stronger when a certain amount of impact or extra strain is placedon them, however it is recommenced that exercise is supervised especially whenfirst beginning an exercise program.Recommended types of exerciseThere are 3 types of exercises recommended in an exercise programto support bone health, including people with low bone density.1Weight Bearing Impact Loading2Resistance Training3Balance TrainingExercises that work against gravity to stimulate bone. It isthrough the weight of the body on the bones that the bonesbecome stronger over time.Moves that emphasis power and balance through the use ofadded weights to enhance strength and stability.Exercises that strengthen the muscles that keep you uprightsuch as your legs and core which helps to improve stabilityand assist in preventing falls.Exercises to avoidPeople with diagnosed osteoporosis should avoid exercises that compriseof twisting of the spine and hip motions such as golf, tennis or bowling. Alsoavoid extreme curving of the spine forward, such as toe touches and sit-ups.Disclaimer: Exercises shown in this brochure are a general guide only and do not replace medical adviceor health professional guidance on individual exercise needs. Exercises represented may be useful forsupporting bone health but do not account for personal limitations or other medical conditions. Pleaseconsult your GP, physiotherapist or exercise physiologist for individual exercise guidance.

Weight Bearing Impact Loading recommendationsThe goal is to jolt your bones rapidly and firmly through weight bearing (meaning your own weight or the use of weighted vestor ankle weights). These exercises are working the bones that are designed to support you such as the spine and lower body.Examples of beneficial impact loading exercises include:Jumping (vertical and multidirectional) and HoppingBoundingSkipping RopeBench Stepping (Step Ups)1Drop JumpsPlease Note: A combination of weight bearing exercise and resistance training is thebest way to protect your bones. Always land on an even surface to prevent ankle injuriesor overbalancing. Individuals with poor muscle strength or coordination should practiceimpact loading near a stable support rail or bench to steady themselves when they land.Avoid: Sudden jolts are not recommended for individuals with extremely low bonedensity due to higher risk of related fracture. Pain associated with advanced arthritiscan also make any jumping exercise inappropriate. For people in those situations,stamping the feet may be a manageable alternative. Stop any impact exercise thatcauses increased joint inflammation and discomfort for longer than two days.TIP:Progress the intensityof the exercise. This canbe done by raising theheights for activitiessuch as bounding anddrop jumping, by addingweighted vests, andchanging the directionsof your jumps morefrequently.

Resistance TrainingFor best protection of your bones combine weight bearing exercise with resistance training. This is done with free weights, elasticbands or gym equipment. The goal of resistance training is to increase loads on the muscle surrounding the bones that are moreprone to fracture such as hip, wrist and spine. Therefore these specific exercises can help improve strength and coordination.Examples of such exercises include:LungesHip Abduction/AdductionSquats2Shoulder ExtensionDorsiflexionTIP:Regular workouts for atleast 6-12 months assistbone density, and if youstop exercising youwill lose any benefitsgained.Give yourself a minimumof one day to recoverbetween resistancetraining bouts beforetraining again.

Back ExtensionAbdominal Exercises – BeginnersAbdominal Exercises – Intermediate2Abdominal Exercises – AdvancedTIP:It is recommendedto select 8 exercisesper session androtate throughdifferent ones eachtraining session.Please Note: If you have never lifted weights before, always consult an exerciseprofessional before you begin, to ensure you learn correct technique and preventinjury. Although lifting quickly (power lifting) can be effective muscle training forhealthy people, it may increase the risk of spinal fracture for people with low bonedensity therefore a measured lifting tempo is recommended instead.Avoid: Always avoid lifting in deep spine flexion (touching toes position). Avoidexercises with extreme curving of the spine forward, such as toe touches and sit-ups.TIP:You do not need to ‘pumpheavy iron’ to enjoy thebenefits of resistancetraining, select a weightthat is challenging butyou are able to repeat8-12 times. When you areready for more weightonly add up to 0.5kg.

General Balance TrainingThe goal of balance training is to improve balance and prevent falls. Balance can be challenged by exercises while standing still(static balance), when moving (dynamic balance) and when dual tasking (doing something else while you’re trying to balance).Static Balance ExerciseReducing your base of supportStanding only on one foot, standing with your feet closer together,one foot in front of the otherRaising your centre of gravityStanding as tall as possible, raising your arms above your headMoving your centre of gravity away from your base of supportLeaning forward, reaching, bending, then regaining your balance without using your arms3Dynamic Balance Exercise (done while moving)Walking in small circles and changes in directionStepping over obstacles

Walking on uneven or soft surfaces like foam matsWalking on your heels or toesWalking backwards, sideways or arms above headWalking on a beamYou can progress the difficulty of your balance training by increasing walking speed or stride length.Dual Tasking ExerciseStanding in tandem stance and doing a task that requires you to think, such as counting backwardsStanding on one leg while throwing and catching a ball3TIP:Balance trainingis recommendedfor 2 hours a weekto be effective.It can easily beincorporatedinto normal dailyactivities (e.g. staticexercise while doinghousehold chores).TIP:The exercises shouldchallenge you and onceyou achieve a milestone,try something harder.Structured activities canalso help for exampleTai Chi provides excellentstatic balance trainingor line dancing can bea fun form of dynamicbalance training.

Exercise RecommendationsStaying active helps support your bone health and is important throughout life. The benefits ofexercise far outweigh any risk and a supervised exercise program can help you gain confidence.People with osteoporosis should remain active and not avoid exercise. Please note exercise is nota replacement for osteoporosis treatment.Below is a summary of the 3 types of exercise recommendations. It explains recommendedexertion level, repetitions and frequency per week based on your level of ability. Thisinformation can be shared with a trainer. For high risk individuals supervision by an exercisephysiologist is recommended.A trainer can assist with determining your 1RM and RPE.123ModeComponentsLow-risk individuals 1Moderate-risk 2individualsHigh-risk individuals3Weight BearingImpact LoadingVertical and multi-directionaljumping, bounding, hopping,skipping rope, drop jumpsand bench stepping withprogressively increasingheightHigh impact activitiesModerate-High impactactivitiesModerate impact activities4-7 days per week50 jumps per session4-7 days per week50 jumps per sessionWork up to 50 repetitionsper session8 exercises per sessiontargeting major muscle groupsattached to the hip and spine.These include weighted lunges,hip abduction/adduction,knee extension/flexion, backextension, reverse chest fly’s,and abdominal exercises, orsmaller number of compoundmovements such as squatsand deadlifts2 days per week2 days per week2 days per week2-3 sets of 8 repetitions2-3 sets of 8 repetitions2-3 sets of 8 repetitionsSelect 8 exercises per sessionand rotate through differentones each training sessionSelect 8 exercises per sessionand rotate through differentones each training sessionSelect 8 exercises per sessionand rotate through differentones each training sessionTechnical Guide80-85% 1RM* 8 on RPE scale**Technical Guide80-85% 1RM* 8 on RPE scale**Technical Guide80-85% 1RM* 8 on RPE scale**Standing and moving exerciseswith a gradual reduction inbase of support to standingon one foot, perturbing thecentre of mass with leaningand reaching then regainingbalance with minimal use of theupper limbs, e.g. Tai Chi, andwalking on uneven surfacesChallenging tasks incorporatingbalance activities into strengthand impact elements wherepossibleChallenging tasks 4 sessionsper weekChallenging tasks 4 sessionsper week30 minutes of a variety ofbalance exercises; at least10 per steps forward andback for mobility exercises30 minutes of a variety ofbalance exercises; at least10 per steps forward andback for mobility exercisesResistanceTraining(Progressive)Balance TrainingLow risk – normal bone healthModerate Risk – low bone density (osteopenia)3High-risk – diagnosed osteoporosis (includes individuals who have previously fractured)12*1RM is the maximum weight you can lift with correct technique for certain exercise (training is then done at 80-85% of this weight)** Rate of Perceived Exertion (RPE) on a scale 1-10, 1 being easy and 10 taking all your effort to complete 1 repetitionFor more informationCall our national toll-free number1800 242 141Visit our websitehealthybonesaustralia.org.auTalk to your doctor4-7 days per week

exercise far outweigh any risk and a supervised exercise program can help you gain confidence. People with osteoporosis should remain active and not avoid exercise. Please note exercise is not a replacement for osteoporosis treatment. Below is a summary of the 3 types of exercise recommendations. It explains recommended