Osteoporosis, or porous bones, is a condition that occurs in about 20 percent of post menopausal women, and a smaller, but significant percentage of older men. Dwindling bone mass usually creeps up on us quietly, with few to no symptoms until a fracture occurs. The mechanisms behind why our bodies begin to reabsorb bone tissue and fail to grow more are a complicated dance of hormonal shifts (absence of estrogen in menopausal women, absence of testosterone in men over 60 years), genetics, and variable risk factors. We reach our peak bone mass in our 20s, with an accelerated loss right before the onset of menopause. Women between the ages of 40 and 70 who are not receiving hormone replacement therapy, not getting enough calcium in their diet, and who are sedentary, may lose up to 30 percent of their bone mineral density (BMD), and have a 40 percent increased risk of fractures, frailty, and overall reduced quality of life.
With these sobering statistics in mind, I would like everyone to think of their exercise programs as strengthening the skeleton as well as the skeletal muscles. In addition to diet, supplementation, and prescribed hormone therapy, exercise has been proven to have what is called an osteogenic, or bone building effect. There have been studies of many different modalities of training with regards to their osteogenic potential. Weight bearing cardiovascular training such as walking or using an elliptical trainer is often the best way for a novice exerciser to begin. However, one of the most effective ways to mitigate bone loss is resisitance training. Specifically, a resistance training program designed with higher loads, and fewer repetitions (6-8 rep maximum) will generate a greater increase in BMD over a year than only walking. The exercises need to focus on strengthening all major muscle groups with special attention to the lumbar spine and hip area. And since the weight must be heavier to be effective, perfect form is a must to avoid injury, especially if you are already diagnosed with osteoporosis or it’s predecessor, osteopenia.
The good news is that an intelligently planned and executed resistance training program can improve bone mineral density. Working out, combined with diet and medication or hormone treatment is even more effective. It’s never too soon to start building your stronger skeleton. Get your diet in gear, get your supplements ready, and don’t wait until your first prescribed bone scan to get up and get active. You’ll feel better about what you see in the mirror, as well as what you don’t.