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  • Carol Michaels


This Osteoporosis exercise and education two part series will be helpful to those interested in learning about the prevention, treatment and management of osteoporosis through exercise. If you have a client with osteoporosis or osteopenia you should this understand how to teach them how to exercise properly and safely in order to decrease the risk the progression of this disease. According to the National Osteoporosis Foundation, 1 out of 2 women and 1 out of 4 men over 50 will have a wrist, hip, or spine fracture due to osteoposorosis. Effective and safe exercise can improve your quality if life, overall health, and keep your osteoporosis under control.

Topics to be covered include:

1. What is osteoporosis and osteopenia?

2. Who is at risk and why is it increasing?

3. Effects of osteoporosis

4. Protecting your bones through exercise

a. Why exercise improves bones

b. How to start a strength training program

c. Which exercises increase bone density

d. The exercise that should be avoided and potentially cause fractures

5. Balance and preventing falls

6. Posture and body mechanics

7. Guidelines for daily life activities to prevent fractures

Osteoporosis means porous bone and is a disease that weakens the bones.It is a serious health issue with 44 million people at risk for this debilitating disease. Bone density decreases and the bones become fraglie and break easily. The disease can cause the bone to fracture or break easily. The most common sites for breaks are the hips, spine and wrist, although it can cause a break in any bone. A broken hip or spine usually require a hospital stay or surgery so they are of particular concern. It can lead to permanent pain, disability,or death.

Our bodies are always braking down bone and replacing it with new bone. In the reabsoption stage, the old bone is broken down and in the formation stage, new bone is built. It is constantly being renewed throughout our lives. As we age the replacement process slows down. Bone is a living issue which has little spaces which get larger as we lose bone density. To make matters worse, the outside of the bone thins as well. Calcium and phosphate are essential for bone formation. If you do not get enough calcium or your body does not absorb enough calcium, it will hurt bone production.

Bone loss occurs in everyone as we get older. Bone forming cells begin to slow down which causes bone to be lost at a faster pace then it is formed. Osteoporosis occurs as a result of an acceleration of this process which is called primary osteoporosis. Secondary osteoporosis is caused by some medications and disease processes. Half of the women and men older than age 70 may have this disease. It may occur in older people and women after menopause. The leading causes of osteoporosis are a decrease in estrogen in women at menopause and a drop of testosterone in men.

It is a silent disease because it progresses without symptoms.There are no symptoms in the very early stages. Most people do not know that they have it until a bone breaks. It can be from a fall or something as slight as a bear hug. A sneeze or sudden movement can be enought o break a bone in someone with severe osteoporosis. Later in the disease you can notice kyphosis or a stooped posture. A dowager’s hump becomes appearant. There can be neck or back pain due to fractures or bone tenderness. Loss of height can occur even up to 5 or 6 inches.

Reduced bone density can be seen on a DEXA scan. Your clients over 50 have this routinely done to test bone mineral density. A score of –1 to –2.5 standard deviations indicates osteopenia which indicates the beginning of osteoporosis. A standard deviation of more than- 2.5 is considered osteoposrosis . This number is called a t score which compares bone density to a 25 year old. This test focus on the lower spine and hip. Many times osteoporosis begins in middle age as hormone levels change or at an older age associated with a vitamin D deficiency

Who is at risk?

There are risk factors-some are controllable and some are not.

Women are at higher risk than men. They have smaller bones and there may be issues which increase risk such as: late menarche, amenorrhea, and hysterectomy at young age. Older people are at risk as there bones get thinner. Osteoporosis seems to run in families and those that have had a fracture after 50 are considered to be at higher danger. Caucasions and Asians are at higher risk as are smokers and and alcohol use ,being thin, doing little exercise, and a diet without sufficient vitamin D and calcium. Other risk factors: rhumatoid arthtitis, type 1 daibetes, anorexia, premature menapause, asthma,muliple sclerosis, lupus,some antacids,cancer treatments,and thyroid,gastrointestinal, blood and renal disorders.

Why is osteoporosis increasing?

A very large percentage of your cleints over 50 probably have osteopenia or osteoporosis.

I have been noticing along with other fitness professionals that a larger percentage of our clients have this disease. Some of that increase can be attributed an increase in testing at age 50. Lack of physical activiy and poor diet is increasing the prevalance of osteoporosis. A small percentage of us have jobs that involve physical activity and most people have sedentary lifestyles.Osteoporosois is increasing for many of the same reasons as the increase in our obesity problem.

There are medications which help control this disease but there can be side effects. The best advice that you can give your clients is to have them participate in weight bearing exercise and follow a bone healthy diet. Our goal is to keep the bones dense; strength training not only increases mucsle mass it also can stimulate the bone. We want to increase the muscle mass so there is more of it pulling on the bone. The specific exercises that are necessary for bone health and guidelines for daily life activity to prevent factures will be covered in part two. As a fitness professional you can play an invaluable role in the bone health of your clients by noticing the early signs of osteoporosis and teaching them how to manage this disease through exercise, diet, and healthy lifestyle.

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