What is osteopenia/What is osteoporosis?
Osteopenia and osteoporosis are very similar issues. They are both conditions that mean you have a lower than normal bone density. Bone density is a good measure of bone health. Lower bone densities mean you are more at risk of fracture. What’s the difference? Osteopenia means having a bone density score of -1 to -2.5. A bone density score lower than -2.5 is classed as osteoporosis.
Do you suffer from osteopenia or osteoporosis?
Coming into the winter months is when most of the issues with osteopenia and osteoporosis arise. Why? Well for one during the winter months people are generally less active as the rain and darkness set in. When you have osteoporosis or osteopenia weight-bearing exercise is essential. Also, the issue in winter is the increased likelihood of falling. Falls are more likely because of reduced visibility, wet weather, or even ice.
Falls account for 80% of hospitalized injuries. Many of these are patients with osteoporosis or osteopenia. If you suffer from osteoporosis or osteopenia you are more likely to have a fracture following a fall.
Osteoporosis and osteopenia are not life sentences. It does not mean you are now frail and old. They do not mean you need to stop exercising. In fact, exercising is very beneficial for osteoporosis and osteopenia.
In the clinic most people with osteoporosis or osteopenia are scared. They are scared because they believe that they are fragile. When you are given a diagnosis of osteoporosis or osteopenia generally very negative language follows.
This negative language can come from doctors or nurses. The negativity with a diagnosis of osteoporosis or osteopenia can even come from friends and family. In Ireland, far too often the phrases “mind yourself” or “be careful” or “take it easy” are said to somebody with osteoporosis or osteopenia.
When you have osteoporosis or osteopenia you should not be taking it easy, being careful, or minding yourself! Instead, you should be working to strengthen your bones. Whether you get your osteoporosis or osteopenia medication in tablet form or via IV exercise can still be used to complement this treatment and make you more robust.
What factors make it more likely for me to develop osteoporosis or osteopenia if I don’t have either?
There are many factors that can contribute to the development of osteoporosis or osteopenia. Some of these factors cannot be changed. For example, 80% of bone is determined by genetics. If you have a family history of osteoporosis or osteopenia then you are more likely to develop it. The same goes if you have a family history of hip fractures then you are more likely to develop osteoporosis or osteopenia.
Another contributing factor to osteoporosis and osteopenia is age. You are more likely to develop osteoporosis or osteopenia as you get older. But, much like frailty, arthritis, or dementia getting old doesn’t mean you definitely will get osteoporosis or osteopenia.
Race can also determine if you will develop osteoporosis or osteopenia. In general, Caucasian and Asian individuals are at a higher risk. But, all races can develop osteoporosis or osteopenia.
Other factors that determine your risk of developing osteoporosis or osteopenia can be changed. For example,
- Consuming too much caffeine, too much fiber, or too much alcohol increases the risk.
- Smoking can mean you are more likely to have poor bone health or be at risk of getting osteoporosis or osteopenia.
- If you over-exercise and under eat you may also increase your risk.
- If you do not get enough calcium or vitamin D, this may contribute to osteoporosis or osteopenia.
The final factor that may increase your risk of getting osteoporosis or osteopenia is an illness. Many illnesses decrease bone density. Some examples are stroke, MS, cystic fibrosis, or lactose intolerance. There are too many to name all here. For more information check out irishosteoporosis.ie or consult your doctor
Other illnesses don’t affect bone density directly. But, their treatments will decrease your bone density. Decreased bone density will make you more susceptible to osteoporosis. Corticosteroids, chemotherapy, radiation therapy, warfarin/heparin therapy, and many more all contribute to an increased likeliness of developing osteoporosis or osteopenia.
If you are suffering from any illness to which either the illness or the medication may increase your chances of getting osteoporosis or osteopenia then it is likely that your doctor will have informed you of this. But, if not, it is advisable to ask your GP if you are unsure.
What’s the best way to treat osteoporosis or osteopenia?
The treatment for osteoporosis or osteopenia is not just one thing. In order to treat osteoporosis or osteopenia properly there needs to be a multi-faceted approach. Osteoporosis and osteopenia need medical treatment. They need pharmacological treatment for pain if necessary. They need lifestyle modifications. And, osteoporosis and osteopenia need to be treated with exercise.
Our area of expertise is in treating osteoporosis or osteopenia with exercise. Exercise as a treatment is extremely underrated. Exercise for osteoporosis or osteopenia will help you not only fight the issue but it will also help to keep you fit and healthy enough to keep doing the things you love even if you have bone health issues.
What’s the best exercise for osteoporosis or osteopenia?
The best exercises for osteoporosis and osteopenia are strength training, weight-bearing exercises, and balance.
Strength training as little as 1 hour a week can help reduce the effects of osteoporosis and osteopenia. That hour does not have to be done all in one go. It can be split up into bite-sized chunks. Two 30 minutes are probably best. But, if you can manage three 30 minute bouts that would be extra beneficial. Strength training as a treatment for osteoporosis or osteopenia should include exercises that target the whole body.
Balance exercises can be beneficial for helping osteoporosis or osteopenia. Balance exercises as part of your treatment won’t drastically increase your bone health. But, what they will do is reduce your chances of falling. Falls are dangerous for people with osteoporosis or osteopenia.
This is because they have a greater likelihood of getting a fracture from a fall compared to somebody with a higher bone density. Balance exercise as a treatment for osteoporosis or osteopenia is preventative rather than a cure. Balance exercise though is only recommended if you have poor balance. If you have a good balance, then it is better to focus on strength training and weight-bearing exercise to treat your osteoporosis or osteopenia.
When it comes to aerobic exercise as a treatment for osteoporosis or osteopenia you are best to choose something that is weight-bearing.
What does weight-bearing mean?
Weight-bearing means actually being on your feet for the exercise. For example, walking or running. Swimming on the other hand is not weight-bearing. Swimming is great exercise but it’s better for somebody with osteoarthritis. As it is not weight-bearing it takes the pressure off the joints and allows you to work the muscle and aerobic system with less chance of irritating the joints. Weight-bearing is the type of exercise you need for osteoporosis and osteopenia as it helps to build up bone health and reduce bone reabsorption.
Are osteoporosis or osteopenia preventable?
Yes. Osteoporosis is largely preventable. As I mentioned above, there are contributing factors that can’t be changed. But, there are many that can. It is never too early to start either. If you are a smoker, or, if you’ve never exercised. Then starting now is more beneficial than waiting for the osteoporosis or osteopenia diagnosis before you give up the smokes or start weight training.
Many of the factors that contribute to reduced bone health are there before you start to develop osteoporosis or osteopenia. Take for example women who enter early menopause or even had their periods late (after 15). They are more likely to develop osteoporosis or osteopenia. Rather than waiting until you’ve been diagnosed it is best to start working on prevention as early as you can. If either of these issues affected you or somebody you know then it may be advisable for them to adapt to any lifestyle changes necessary to be healthier. Being healthier may prevent the development of osteoporosis or osteopenia.
“I don’t have time to do physical activity”.
Having enough time to do anything is always a barrier. You will need to prioritize two 30 minute slots weekly for formal strength training as treatment for osteoporosis or osteopenia. Even if you are very busy it is important to set aside these two 30 minute blocks. They will help improve your bone health. Make you more robust. And, reduce the chances of you picking up a fracture or being in pain because of your osteoporosis or osteopenia.
On top of this then you need to do weight-bearing exercise a part of your treatment for osteoporosis or osteopenia. Weight-bearing exercise as we’ve really helps to increase bone density and improve bone health. The good thing about this is it can be done anywhere. Walking is a great form of weight-bearing exercise. The current guidelines for physical activity is 150-300 minutes weekly. That’s 30-60 minutes five days a week.
300 minutes seems like a lot but the great thing is it doesn’t have to be done in one go. Getting off the bus a stop early. Walking to work if possible. Taking the stairs. Even if it’s just taking the stairs on the way down. These are all ways to increase your levels of weight-bearing activity.
Your 150-300 minutes of physical activity in the week can be split into 300 one-minute bouts. It doesn’t have to be going from doing nothing to running for five hours a week. In fact, doing little and often bouts of exercise is more beneficial than one big bout for many things, not just osteoporosis or osteopenia.
“I don’t have the motivation to do formal exercises”.
Motivating yourself to start is the hardest part. But, there are a number of things you can do to help.
- Get a buddy. It’s easier to let yourself down than it is to let a friend down. Having a training partner can help motivate you to do more. Weather it’s a walking buddy or somebody that comes to the gym with you.
- Pick the right facility. Often what’s actually more of a barrier to strength training or exercising is the type of gym you join. You can often feel lost in a big commercial gym. If this is the case then try out a private training facility like ours in Lucan. We have 1 to 1 or 4 to 1 classes lead by physiotherapists. This may suit you better. Once you build confidence here then maybe you could try out a different place if you want to go it alone.
- Make a goal. If you are exercising to relieve your arthritic pain then you start to run away from the pain. It’s better to have a separate goal to achieve to keep you motivated.
If you have any questions about the treatment of arthritis feel free to contact us for more information. You can contact us here
