Osteoporosis is a ‘silent’ disease where bones have become fragile to the point that fractures may occur with only minimal trauma. Osteoporosis affects around two thirds of women and one sixth of men. Unfortunately, the silent nature of the disease tends to lead to late diagnosis – often with a fracture being the first sign of bone weakness.

So what causes osteoporosis?

♦  Primary causes include family history and the tendency to lose bone as we age. Our bone density peaks in our 20s, gradually weakening from around 30 years of age. Bone loss accelerates in post-menopausal women, who are at highest risk of osteoporosis.

♦  Certain medical conditions and their treatments (Eg. Corticosteroids) can increase bone loss, as does immobilisation with injury.

♦  Lifestyle behaviours, including inactivity, inadequate vitamin D and low calcium intake increase risk of the condition.

Many osteoporotic fractures occur as a result of a fall, including over 90% of hip fractures. Poor balance and reduced lower limb strength with aging are both risk factors for falls.

Research shows that strength training programs increase muscle strength, muscle mass, dynamic balance and reduce the risk of falls. The studies suggest all individuals, especially older adults, engage in resistance training exercises 4-5 times per week to receive maximum benefits for fall prevention.

One study indicated that the most frequent cause of falls among older adults was not slipping or tripping, but problems with weight shifting. Inability to get in a stable, final position while rising, or difficulty stopping their forward momentum after taking a misstep were the main causes of falls. The study also showed that falls were just as likely to occur when people were lowering themselves into a seat or even when standing, due to being bumped or losing balance while turning or reaching.

Falls are a major cause of injury and hospitalization to older adults, but most falls are preventable. Here are some tips for falls prevention:

♦  Engage in a regular exercise program targeting balance and strength.

♦ Talk to your doctor. Review your medications to make sure they are not increasing your risk of falling. Taking multiple medications has been shown to increase falls.

♦  Get your vision and hearing checked, your eyes and ears help keep you on your feet.

♦ Keep your home safe by removing tripping hazards, increasing lighting, and installing grab bars. Be sure to wear appropriate footwear.

Engaging in a wide range of high-impact activities throughout life can reduce your chances of osteoporosis. A person with severe weakening of the bones, however, is at high risk of minimal trauma fracture. They should perform lower impact exercises such as Tai Chi, light weight training and low-moderate impact aerobic exercise. This is less likely to enhance bone strength, but will improve muscular strength and balance with the goal of preventing fractures through falls prevention. Avoiding rapid movements or excessive twisting are important for the frail skeleton and minimizing time spent sitting or lying down is also beneficial.

When initiating any new exercise program, it is essential to take care and progress gradually. For specific advice on exercise for osteoporosis, it is advised to see an Exercise Physiologist.

Melissa Brodie

Accredited Exercise Physiologist

Cao, Z.-B., et al.,The Effect of a 12-week Combined Exercise Intervention Program on Physical Performance and Gait Kinematics in Community-dwelling Elderly Women.Journal of PHYSIOLOGICAL ANTHROPOLOGY, 2007.

http://exerciseismedicine.org.au/wp-content/uploads/2014/05/2014-Osteoporosis-FULL.pdf