Low bone density is commonly associated with ageing. But recently we have seen an increase in younger people being diagnosed with it. Some even before they turn 50 years old. So why is the density of our bones important? It’s important because our bone density tells us how strong our bones are. It is also linked to the risk of fracturing a bone in people who have osteoporosis.
Osteoporosis is a common disease. In Australia there are 1.2 million people estimated to have osteoporosis. There is a further 6.3 million people with low bone density. Osteoporosis is a condition where bone tissue has been lost. This means the weakened bones are more likely to fracture. Women are at greater risk of this due to the rapid decline in oestrogen levels during menopause. When oestrogen levels decrease the bone loses calcium and other important minerals faster. Men can also develop low bone density, although it is far less common.
Many factors can influence our bone health:
Your medical history
- Corticosteroids – these are commonly used for asthma, rheumatoid arthritis and other inflammatory conditions.
- Low hormone levels – in women this is associated with early menopause and in men low testosterone.
- Thyroid conditions – such as an over active thyroid or parathyroid.
- Conditions that cause mal-absorption. These conditions include coeliac disease and inflammatory bowel disease.
- Chronic diseases – such as rheumatoid arthritis, as well as chronic liver or kidney disease.
- Some medicines for breast cancer, prostate cancer, epilepsy and some antidepressants.
- Low levels of physical activity
- Excessive alcohol intake
How is bone density measured?
Bone density is measured by dual energy x-ray absorptiometry (DXA). This is considered the gold standard in Australia, as it is fast and highly accurate. The scan provides a T-Score. This T-Score compares a patient’s bone density to the peak bone density of young adults. The score is then classified according to the following spectrum:
How can exercise help improve bone density?
Regular exercise plays an important role in maintaining or improving bone density. Exercise exposes our bones to greater than normal loads. In turn the bones adapt and this helps protect us from injury. The level of impact or strain placed on a bone determines how much it adapts. In other words, certain types of exercise are more beneficial for our bone density. Research shows that strength-based exercises are the most helpful. In fact they are as beneficial as prescription drugs in preventing osteoporotic fractures.
The classification of bone density is important. It helps health professionals know what type of exercise to prescribe. For example, those with osteoporosis are managed more conservatively than those with osteopenia.
Osteopenia is the precursor for osteoporosis. If you have osteopenia you can tolerate greater load bearing exercises. These greater loads help prevent further bone loss. If you already have osteoporosis you will be given lower loading exercises. This is because you are at higher risk of fracturing your bones.
A quick example of exercises for each condition include:
Osteopenia: Running, jumping, skipping, hoping, high-weight resistance exercise, and other high impact sports.
Osteoporosis: Moderate weight resistance, step ups, balance, tai chi and Pilates.
So how much exercise is recommended?
To a degree this depends on your past and current physical activity levels. But research recommends that men and women with osteopenia should aim for 4 x 30 minute sessions per week. If you have osteoporosis it is slightly different. Research recommends you aim for 5 x 40 minute sessions per week.
How can an Exercise Physiologist help?
Exercise Physiologists prescribe exercise programs that are specific to your needs.
An initial assessment is the first step. We look at your medical history, current activity levels and exercise capacity. From this information we put together an exercise program to help you achieve your goals.
If you are concerned about your own bone density, and would like to have an exercise program to help improve the strength of your bones, please contact any of our Exercise Physiologists at Physiotas.
About the Author:
Laura completed her Bachelor of Exercise Science degree in 2013, and then went on to complete a Bachelor of Exercise Physiology (professional honours) in 2014. Laura has since worked primarily in chronic disease management, before making the change to private practice in early 2016.
Laura’s current role is diverse with a combination of preventative health, community exercise programs, chronic disease management and musculoskeletal rehabilitation. Her professional interests include; strength and conditioning programming, preventative health, pre-and post-cancer treatment.