osteoporosis is a disease characterized by loss of bone that increases the risk of fracture particularly in the wrist spine and hip. exercise can have a positive effect on bone mineral density and the strength of bone but it is a complicated relationship because of many factors including genetics age gender hormone and menopause status activity level and nutrient deficiencies. age applies to everyone when it comes to the effect of exercise on building bone strength. in youth the time of peak bone mineral content velocity (the time around puberty when bone rapidly forms) is an important time for children and early teens to be exercising because: 1. research shows that increases in estrogen in girls helps bone form (puberty is when estrogen rises) and exercise added during this time enhances the effect on bone density. 2. research shows that active youth have higher bone density than inactive children. 3. research suggests that denser bone formed during childhood may track into adulthood. that is if children and teens exercise enough to create denser bones than their sedentary peers then they may have thicker bones as adults. as for young adults it is generally believed that peak bone density is reached by the time we reach our late 20s or early 30s and research suggests that athletes in this age group have higher bone mineral density than sedentary individuals. for middle-aged and older adults bone density decreases by about 5% per decade after the age of 40. some scientists believe that during these times of life it may not be realistic to expect substantial increases in bone density but rather we should expect a reduction or attenuation of the loss of bone that we experience as we age. these scientists may be right because there is little evidence that walking weight lifting or any other type of exercise substantially increases bone density in older adults. what you can say with some certainty is that active individuals in these age groups do maintain their bone density while their sedentary peers do not. and that's a good thing. equally important for older adults in terms of osteoporosis is the effect of exercise on the risk of falling. when individuals with osteoporosis fall they typically break bones and in fact sometimes the bones are so brittle that they break before the person hits the ground; for example just stepping off a curb could break a brittle bone in the hip and then the individual falls as a result. people fall for many reasons including poor balance poor vision decreased strength and range of motion and cognitive impairments like dementia. exercise can't help every factor but studies show that exercises such as balance training (e. g. tai chi) leg strengthening and flexibility training (e. g. yoga) can reduce the risk of falling in older adults. as for which exercises are best for people with osteoporosis the simple answer is: 1. weight-bearing exercises that cause force on the bones like jogging stair climbing and walking briskly. 2. resistance exercises that involve the bones you are concerned about. 3. balance exercises if you are an older adult. research is clear that you need some force-loading or weight-bearing on bones to have any effect on density and strength but caution should be taken with exercise when you have osteoporosis. you should avoid: 1. exercises that might increase the risk of falling. 2. movements like twisting of the spine and bending from the waist. 3. high-impact activities like high-intensity aerobics or jumping. 4. excessive weight during resistance exercise. the american college of sports medicine recommends the following exercises for bone health for different age groups: for children and teens: type: impact activities such as gymnastics jumping (sometimes called plyometric training) and moderate-intensity resistance training; participation in sports that involve running and jumping like soccer and basketball (although they concede that research to prove this is lacking). intensity: high in terms of bone-loading forces; for safety reasons resistance training should be moderate equivalent to 60% of the maximum lift. frequency: at least three days per week. duration: 10-20 minutes (two times per day or more may be more effective). for adults: type: weight-bearing endurance activities (tennis; stair climbing; jogging at least intermittently during walking) activities that involve jumping (volleyball basketball) and resistance exercise (weight lifting).
which exercises are best for people with osteoporosis?