Preventing Osteoporosis and Osteopenia

Recommendations on how to avoid bone loss have changed quite a bit over the last few decades. Doctors used to view a person with osteopenia (a precursor to osteoporosis) or osteoporosis (porous, weak bone) as fragile and often recommended that they not engage much in exercise, fearing that it could injure them.

Now we know more about the illness and how to prevent it. Exercise recommendations have changed too: now we know we should be doing more rather than less exercise but it needs to be the right kind and we should be starting earlier.

How to Prevent Osteoporosis at Various Ages/Life Stages:

• Elementary school age. Given the obesity pandemic, young girls are reaching puberty very, very early, highlighting the need for them to start paying attention to building bone mass. Encouraging them to explore many different sports and movements, such as moving back and forth, left and right, and jumping as in basketball and soccer, are good for boosting bone mass and strength. Repetitive movements are not as good for a growing child than having the child explore with different types of movement. It is important to teach a love of movement at this young age.

• Teenagers/adolescents. Looking at the difference in bone building between gymnasts and swimmers; gymnasts always win out. While swimming is great for cardio and building muscles, it is not great for bone density, so swim but also lift weights. At this age, kids need walking/running but also strength training. They need to be putting bone in the bank for when the door closes at 30 and they start withdrawing bone from bank. Try to get teenagers into the weight room, which will also resurrect confidence in their bodies, something that is often lost as they go through puberty.

• 20s-30s. At this age, young adults are often attending college, eating poorly and drinking too much alcohol. At this age they get busy and stressed and often don’t take the time for exercise anymore. Exercise is important not only to avoid the freshman 15-20 pounds but also for bones. This is the age to find those exercises that can be practiced long into adulthood. It is better to start really focusing on bone building and strength in young adulthood rather than when you are in your 50s and much of your bone mass has diminished.

• 30s-40s. At this age, women particularly are super busy, balancing work, kids, and household duties. They also spent a lot of time driving kids to/from sports, social, doctor appointments etc. The positive thing is that often at this point, people have a bit more financial resources so they can afford to join a gym. If only they can find the time to go! With such hectic lives, it is tough to stay regular with exercise. Choose strength over cardio though when you do find the time.

• 40s-50s. Now is the time, in perimenopause, where bone loss gets more urgent. Focus on losing weight and prioritizing protein. Cardio burns fat well but strength training is the most beneficial for bones. Start doing less and less cardio and more and more strength training to muscular fatigue. Besides building bone mass and density, you will also end up with more energy.

So, what type of exercise should you do? You need both weight bearing and weight resistance. If bad knees are preventing you from weight bearing exercise, you need to do even more weight resistance.

• In weight bearing, bounding side to side is really important, as in tennis, basketball, and soccer. This hopping left to right, and forward to back stresses the bone in all different angles.

• For weight resistance try bands and tubing, suspension tool, machine weights, or dumbbells. Best for building bone density is lifting or pushing something heavy.

Walking is good for your health but it is not enough. A walking program is good start but don’t stop there. We need strength training; even lifting for 10-15 mins a couple times a week you can really get the benefit of stimulating those muscles and bones.

• You can try yoga which is proven to increase bone density and puts stress on the wrists and upper body.

• Walking 10,000 steps is not building better or more bone density than 6,000 steps given that you have the same heal strike. It is best to break it up with a little jogging, sprinting, jumping rope, and jumping up and off a box.

Contraindications/Cautions:

• If you’ve got osteopenia/osteoporosis, be careful not to combine bending, lifting and twisting in one move. Examples would be revolved triangle pose in yoga, shoveling snow, and grabbing heavy groceries from your trunk where you are twisting. Either one of those on their own is ok but not all together.

• Another questionable move is forceful forward flexion, such as in sit ups and crunches. Pilates is great form of exercise but some of the moves are not ideal for those suffering with bone loss. Avoid rolling up and back down on the ground.

**Content provided for educational and informational purposes only. It is derived from an interview between Kevin Ellis, the Bone Coach, and Debra Atkinson of Flipping 50. It is not to be considered medical advice.**