Exercising with Osteoporosis.

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Exercising with osteoporosis: Stay active the safe way

If you have osteoporosis, you might mistakenly think exercise will lead to fracture. In fact, though, using your muscles helps protect your bones.

Osteoporosis is a major cause of disability in older women. So what can you do to prevent the condition? Or if you have it, how can you reduce your risk of the spinal problems and broken bones that osteoporosis makes you susceptible to?

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.

But it's not too late to start exercising after menopause, when the pace of bone loss really picks up. Even then, exercise will increase your muscle strength, improve your balance and help you avoid falls — and it may keep your bones from getting weaker.

Other possible benefits include:

Increasing your ability to carry out daily tasks and activities Maintaining or improving your posture Relieving or lessening pain Increasing your sense of well-being

The key to exercising with osteoporosis is to find the safest, most enjoyable activities you can do, given your overall health and degree 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 a bone density test and a fitness assessment first.

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

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Choosing the right form of exercise

Three types of activities are often recommended for people with osteoporosis: strength training exercises — especially those for the back — weight-bearing aerobic activities and flexibility exercises.

Because of the varying degrees of osteoporosis and the risk of fracture, certain strength-training, aerobic and flexibility exercises may be unsuitable. 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 trainingStrength 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.

Compression fractures resulting from osteoporosis often lead to a stooped posture and increase pressure along your spine, resulting in even more compression fractures. Exercises that gently stretch your upper back, improve your posture and focus on strengthening the muscles between your shoulder blades can all help to reduce harmful stress on your bones and maintain bone density.

Weight-bearing aerobic activitiesWeight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics 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 aerobic benefits, such as reducing your risk of cardiovascular disease.

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

Flexibility exercisesThese exercises help increase the mobility of your joints, another key component of overall fitness. Being able to bend, extend and rotate your joints helps you 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. Chest and shoulder stretches may be helpful, as may prone push-ups.

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. Relax and breathe deeply while you stretch. 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.

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Slide show: Exercises for osteoporosis Slide show: Balance exercises improve stability, help prevent falls

Movements to avoid

Mild bone deterioration without osteoporosis shouldn't interfere with recreation. In fact, activities such as golf and bowling may be beneficial. But 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. Try to move in a slow and controlled manner. Exercises in which you bend forward and twist your waist, such as touching your toes, doing sit-ups or using a rowing machine. These movements also compress the bones in your spine. 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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Nov 13, 2007