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We all know that exercise is on any short list of “essential actions” to treat or even reverse osteopenia or osteoporosis. But why is that the case? And what kind of exercise is best? Some recent research is beginning to answer those questions.
Bone is made mostly of collagen and is living, growing tissue. Throughout life, bone is constantly renewed through a two-part process called remodeling: resorption and formation. During resorption, old bone is broken down and removed. During formation, new bone replaces the old bone tissue. The rate of bone remodeling depends largely on response to nutrition, hormones, exercise, sunlight and age. When the bones are not adequately supported by the proper nutrients, bone resorption occurs faster than bone formation; the result is low bone mass and ensuing disease such as osteopenia and osteoporosis.
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Osteoporosis Exercises: Studies Show the Benefits
A recent study, to be published in the Endocrine’s Society’s Journal of Clinical Endocrinology and Metabolism, shows that physical activity boosts new bone formation in several different ways. Another study, this one from the Mayo clinic published in June 2012, revealed that healthy muscles equal healthy bones. The study found that improved muscle mass is associated with bone strength at particular places in the body.
In women, muscle mass was strongly connected to the health of load-bearing bones such as the hip, lumbar spine and tibia. Researchers also found that improved muscle mass benefitted the trabecular bone in women’s forearms, a non-load-bearing site that is at higher risk of fracture following menopause. These revelations begin to give us a clue as to which type of exercise works best to improve bone health.
Best Types of Exercises for Osteoporosis and Osteopenia
For people who have already been diagnosed with osteoporosis or osteopenia, there are two types of exercise that are important for building and maintaining bone density: Weight-bearing exercises and muscle-strengthening exercises. Weight-bearing exercises include walking, swimming, using elliptical machines or stair machines, and low-impact aerobics.
Muscle-strengthening exercises include lifting light weights and balance or flexibility exercises. Attention should also be made to help strengthen the abdominal muscles to stabilize the back because osteoporosis commonly results in compression fractures in the spinal column; however, the back should always be supported while performing these exercises.
Abdominal exercises for osteoporosis or osteopenia are best done on the floor, as it provides a hard surface for the back to keep it straight. One exercise that strengthens the abdominals is straight leg lifts. To perform leg lifts, follow these steps:
Step 1: Lie with your back on the floor and your legs stretched out on the floor straight in front of you.
Step 2: Bend the knees. Raise your legs slowly–all the way up.
Step 3: Straighten your legs slowly so that your feet point to the ceiling. Then, lower your legs, while keeping them straight, back to the floor.
Repeat these steps at least five times (or longer as tolerated) and then take small breaks.
Important! People with Osteopenia or Osteoporosis Should Avoid Certain Exercises
It is critically important for people who already have a diagnosis of osteopenia or osteoporosis to completely avoid certain positions or exercise routines, particularly yoga postures. Because the bones are frail, you need to be very cautious to prevent fractures. Remember if you have very low bone density, sometimes a fracture can occur with something as simple as sneezing or a deep cough.
Therefore, if you have low bone mass and are thinking about beginning a new exercise routine, you should avoid the following activities:
- Exercises that require you to bend forward from the waist, such as standing-forward bend, head-to-knee pose and seated-forward bend (sit-ups). These movements can cause fractures in the spine bones (vertebrae).
- Activities that involve rounding or hunching of the back.
- Twisting your spine to a point of strain, especially when in a standing or seated position.
- Sudden jerking or rapid movements.
- Poses that bear weight directly on the neck, such as headstand and shoulder-stand positions.
- Lifting heavy weights.
- Activities such as jumping, dancing, tennis, or high-impact aerobics.
Remember, if you’re trying to strengthen your bones and head off the debilitating effects of osteoporosis, exercise is truly an essential ingredient. And as you get started, make sure that both weight-bearing exercises and muscle-strengthening exercises are part of your routine; yet, take care that the exercise routine you choose is something your body can handle. If you’re uncertain if you can perform an activity safely, talk with a chiropractor or a physical therapist to help you learn which exercises are safe and appropriate for you.
For more motivation, consider how exercise protects your memory, fights depression, and even improves digestion. How does exercise benefit you? And how do you stay motivated? Tell us about it in the comments section below.
 Mohammed-Salleh M. Ardawi, Abdulrahim A. Rouzi, and Mohammed H. Qari. Physical Activity in Relation to Serum Sclerostin, Insulin-Like Growth Factor-1, and Bone Turnover Markers in Healthy Premenopausal Women: A Cross-Sectional and a Longitudinal Study. Journal of Clinical Endocrinology and Metabolism, 2012; DOI: 10.1210/jc.2011-3361
 Journal of Bone and Mineral Research, Mayo Clinic, June 20, 2012.
 National Osteoporosis Foundation.
Originally published in 2012 and updated.