Are Your Bones Strong Enough?

Are Your Bones Strong Enough?

The Power of Resistance Training in Maintaining Healthy Bones

Osteoporosis and osteopenia are prevalent conditions affecting the bone health of many Australians, especially as we age. Statistics taken between the years 2012-2022 revealed that 66% of people over 50 years of age have poor bone health. Specifically, 22% of Australians over the age of 50 had osteoporosis, and 78% had osteopenia, with an estimated 31% increase projected in the ensuing years. Comparing these statistics to those taken back in 2001 and 2007, what we can be clear about is that little progress has been made in preventing and managing osteoporosis in Australia.

We can define Osteoporosis with a relatively simplified explanation: new bone creation doesn’t keep up with old bone removal, resulting in bones that become weak and brittle, or porous and fragile, making them prone to fractures from minor falls or injuries. There can be many reasons for this, but ageing is one of the risk factors. One problem with osteoporosis is that many people have no symptoms until they have a bone fracture. Osteopenia is the stage before osteoporosis – a warning that your bone health is starting to deteriorate.

Our body is constantly absorbing and replacing bone tissue. This is a very natural, and constant, physiological process in our body ensuring that bone continues to adapt and respond to stress, becoming stronger and more resilient in the process. It is when this fine balance between bone absorption and bone production is compromised that our bones become vulnerable.

Risk Factors for Poor Bone Health

There are several factors that contribute to the development of osteoporosis and osteopenia, including:

1. Age: Bone density decreases with age.
2. Gender: Women are more prone due to lower peak bone mass and postmenopausal hormonal changes.
3. Family History: Genetics play a crucial role.
4. Nutritional Deficiencies: Lack of calcium and vitamin D.
5. Sedentary Lifestyle: Physical inactivity contributes to bone loss.
6. Chronic Diseases: Conditions like rheumatoid arthritis and hyperthyroidism.
7. Medications: Long-term use of corticosteroids and other drugs.

The Role of Exercise in Bone Health

Regular physical activity is essential for maintaining bone health and preventing osteoporosis and osteopenia. We have always thought that weight-bearing exercises (like walking and running) are the keys to staving off osteoporosis and osteopenia, but we now have some very solid evidence that these activities alone are not sufficient to optimize bone health. This is where resistance training comes into play.

Why Resistance Training is Crucial

Resistance training, also known as strength training, involves exercises that cause muscles to contract against an external resistance. This type of exercise can include free weights, resistance bands, body-weight exercises, springs (eg Pilates) or even household items like a bottle of water. The benefits of resistance training for bone health are enormous:

1. Stimulates Bone Formation: Resistance training exerts stress on bones, stimulating osteoblast activity (bone-building cells). This stress prompts bones to become denser and stronger over time.
2. Improves Muscle Strength: Stronger muscles support and protect bones, reducing the risk of fractures. These stronger muscles can exert greater stresses on bone, further stimulating osteoblast activity.
3. Enhances Balance and Coordination: This reduces the risk of falls, which are a primary cause of fractures in older adults.
   Increases Bone Mineral Density (BMD): Studies have shown that resistance training significantly increases BMD, particularly in the spine and hips, which are common sites for osteoporotic fractures.

Resistance Training vs. Weight-Bearing Exercise

As mentioned, in the past we thought that weightbearing exercise was the key to healthy bones. While weight-bearing exercises are beneficial, they primarily target the lower body and may not provide sufficient stimulus to those osteoblasts to increase bone density throughout the entire skeleton. For instance, activities like running primarily benefit the legs and do not significantly impact bone density in the spine or arms.

Similarly, weightbearing exercises do not necessarily have the same muscle strengthening effects as specific resistance training does. Resistance training can help overcome the effects of sarcopenia (the natural loss of muscle mass, strength and function that happens with age, and accelerates from the age of 50) and can be tailored to target all major muscle groups, providing a comprehensive approach to bone health.

Very interestingly, some studies in endurance runners (who do loads of weight bearing exercise) have shown that their bone density is no better than their sedentary peers. Basically, these studies have shown that lower impact, repetitive, high frequency, uniplanar (same direction) loads (which is basically what running is) are not as effective at increasing bone mass as higher impact, irregular, and multi directional loads! This is why the physio’s at SSPC will always be encouraging our running athletes (and more mature clients) to add resistance training to their walk/run programs!

Implementing a Resistance Training Program

Starting a resistance training program doesn’t have to be daunting. Here are some tips for getting started:
1. Consult our Physio’s: Before beginning any new exercise program, it’s essential to consult with a healthcare provider or physiotherapist, especially if you have existing health conditions or are new to exercise.
2. Start Slow: Begin with lighter weights and gradually increase the resistance as you become more comfortable with the exercises. Stop if you get any pain or discomfort.
3. Add some higher impact load: Another aspect that needs to involve consultation with your health professional. Sometimes higher impact load can be as simple as step ups, but for some we have the goal of working up towards some gentle jumping type activities.
4. Incorporate Variety: Include exercises that target different muscle groups to ensure comprehensive bone strengthening. Add variation of direction, and speed, and force, and you’ll be stimulating those osteoblasts!
5. Consistency is Key: Aim for at least two to three resistance training sessions per week.
6. Join A Class: at SSPC we run over 60 classes per week that involve resistance training – there’s a class for everyone! Take a look at our class timetable at sspc.physio

Conclusion

Resistance training is a powerful tool in maintaining healthy bones and reducing the risk of osteoporosis and osteopenia. By incorporating this type of exercise into your routine, you can significantly enhance bone density, improve muscle strength, and reduce the risk of fractures. For older adults, particularly those at higher risk of bone conditions, resistance training should be a cornerstone of a comprehensive bone health strategy.

For more detailed information and personalized guidance, don’t hesitate to reach out to our physiotherapy clinic. Together, we can develop an exercise plan that supports your bone health and overall well-being.

Anthony Lance
SSPC Physiotherapist
References available on request