Bone Health
Bone Health is a crucial topic for older adults, as many are at risk of developing fractures related to osteopenia or osteoporosis. Fortunately, bone health can be maintained throughout the lifespan using exercise, diet, and other lifestyle factors.
This blog compiles strategies and research for older adults to promote bone health across the lifespan.
1. Yoga to Support Bone Health
Osteoporosis and osteopenia are diseases of decreased bone mineral density (BMD) that primarily affect older individuals, especially post-menopausal women. These conditions put individuals at risk for spinal and hip fractures, which can drastically affect the trajectory of one’s life.
Peak BMD is usually achieved around age 25-30, at which point it begins to lower for the rest of the lifespan. Many strategies can promote bone health into older age, such as managing nutrition, hormones, medications, and activity.
Yoga presents an exercise-based approach by exposing bones to forces or loads that can help enhance bone mineral density.
This study examined the effects of 12-pose sequence performed by 227 subjects nearly every day for two years, comparing bone mineral density before and after the program. They found the program helped to improve bone quality and reverse bone loss in the spine and femur.
Yoga can be a useful tool along with other exercise and fall prevention measures to ensure bone health across the lifespan.
2. High Intensity Resistance Training & Impact Training to Improve Bone Mineral Density
Heavy resistance training has been previously viewed as dangerous for individuals with osteoporosis or osteopenia, but recent research into this area, guided by the aptly named LIFTMOR trials, demonstrate that higher-intensity training is both safe and effective for this population.
This study guided postmenopausal women through an 8 month, 2x weekly exercise program, with the high intensity group performing compound lifts (such as squats and deadlifts) with heavy loads, as well as impact training composed of controlled jumps.
They found that the high intensity group outperformed the low intensity exercise group in bone mass, bone density measured at the femur, and physical function. Also, they found no fractures or major adverse events in the high intensity group, providing evidence of the safety of high intensity exercise.
This is fantastic news for individuals at risk of fractures, as high intensity exercise provides a helpful stimulus for bone health.
3. Exercises for Individuals with Osteoporosis
One of the more common areas for fracture in people with osteoporosis is in the spinal vertebrae. Vertebral compression fractures can result from major trauma (i.e. car accidents or falls) or minor trauma in individuals at high risk for fractures (due to osteoporosis, cancer, infection, long-term steroid use, vitamin D deficiency, smoking, or hyperthyroidism).
What strategies can be used to prevent these fractures and their negative downstream effects? This study outlined an exercise regimen containing elements that can be especially beneficial in preventing compression fractures.
Exercise programs should be:
Individualized - to match the goals/needs of the patient
Comprehensive - addressing flexibility, muscle strength, cardiovascular fitness, and balance.
In particular, this study notes the importance of spinal extensor strengthening, lower extremity strengthening, and balance!
Remember that movement is one of your best tools for bone loss management and prevention. Check out our exercise library for more ideas to keep you moving and living well.
4. Determining Osteoporosis Risk
Your risk of developing osteoporosis depends on a several key health and lifestyle factors, such as age, sex, medical conditions, and other lifestyle factors.
This risk calculator by the UK Royal Osteoporosis Society accounts for each of these factors in a series of questions that educates rationale for each question and compiles your overall risk at the end.
We recommend checking in with your individual provider with specific questions involving your osteoporosis risk, but you can enter this conversation already informed with common risk factors using this free online tool.
Article References:
Lu, Yi-Hsueh PhD; Rosner, Bernard PhD; Chang, Gregory MD, PhD; Fishman, Loren M. MD, B Phil (oxon.). Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Topics in Geriatric Rehabilitation: April/June 2016 - Volume 32 - Issue 2 - p 81-87. doi: 10.1097/TGR.0000000000000085
Watson, S.L., Weeks, B.K., Weis, L.J., Harding, A.T., Horan, S.A. and Beck, B.R. (2018), High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. J Bone Miner Res, 33: 211-220. https://doi.org/10.1002/jbmr.3284
M. Sinaki. Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention PM & R : J Injur Funct Rehabil, 4 (11) (2012), pp. 882-888 https://doi.org/10.1016/j.pmrj.2012.10.008
