A holistic approach to exercise and lifestyle can decrease the fracture risk for those living with osteoporosis.

I recently had the opportunity to attend a training program for health and fitness professionals who work with clients at risk of developing osteoporosis or who have been diagnosed with osteoporosis or osteopenia. The program was called Bone Fit; a comprehensive and practical workshop covering safe exercise prescription and adaptation. The material in the program comes from evidence-based research and I was thrilled to be able to add the principles and exercise prescription guidelines to my practice.

The Bone Fit workshop was developed by Osteoporosis Canada, the only national organization serving people who have or are at risk of osteoporosis, in conjunction with an advisory committee of clinicians and academics in the area of osteoporosis and exercise. At the core of the training is an emphasis of a multi-component exercise program appropriate for those with osteoporosis or spinal fracture, called Too Fit to Fracture (TFTF). The TFTF guidelines were developed in consultation with an expert panel of researchers and clinicians from Australia, Canada, Finland, USA and partners from Osteoporosis Canada.

In the week’s column I’ll be answering questions that my clients and I have been asking about osteoporosis and exercise based on what I learned at the workshop.

Is this program just for “old people?” While osteoporosis is most often associated with older individuals, it can be seen in younger people as well, as a result of poor nutrition, lifestyle, and genetic factors or as an association with other chronic diseases. Peak bone mass is achieved at an early age and built during childhood and adolescence while both women and men start to lose bone in their mid-thirties.

Why is exercise so important? Physical activity is important for a number of reasons in the treatment of osteoporosis and in reducing fracture risk. It helps to maintain bone strength, proper posture and core stability while building endurance and enhancing balance and coordination. For someone living with osteoporosis, working out can also improve the ability to manage the activities of daily living in a safer, more comfortable way. One of the main goals of the TFTF program is to administer and monitor clients fracture risk in an effort to minimize the risk over time.

What type of exercise is most important? In the TFTF program, there are a number of exercise components that are emphasized; strength training, balance exercise, postural awareness, spinal strengthening and spine sparing exercise and aerobic training. The program emphasizes a holistic approach toward maintaining bone health while adapting the activities of daily living to make them safer and more manageable.

Some of the exercise options available to participants in the program include weight training, Tai Chi, Yoga, walking and bodyweight and resistance band training among others.

Is walking enough? While walking is an activity that contributes tremendously to overall health, there are conflicting views on how valuable it is in helping people to manage osteoporosis. Some studies show that it can improve bone density in the hips and lumbar spine, while others state that walking on its own is not sufficient to preserve bone density. It should be part of an overall wellness plan and can help to improve dynamic balance and agility, but, it should not be used to the exclusion of formal strength training workouts.

What about aqua fitness? Working out in the water is a great, safe, fun way to exercise. Water workouts can be a tremendous way to work on endurance and mobility, but, they are not an effective way to build significant muscle or for maintaining bone strength. The reason for this is that there is so little gravity involved when exercising in a pool due to the flotation effect that the load on the body is almost non-existent. Therefore, aqua fitness should not be one’s choice for strength training when attempting to guard against bone loss.

Will working out help to re-grow lost bone? According to recent research, there is no evidence to suggest that, past a certain age, bone lost to osteoporosis can be “re-grown.” There is some evidence, however, that pre-menopausal women “might” be able to re-grow lost bone; making the case for women starting strength training early in life. While men can also suffer from osteoporosis, they have been somewhat ignored historically as a cohort group when it comes to gathering data about the disease.

The therapeutic goal of the Bone Fit program, therefore, is to slow down the loss of bone once it has begun and to enhance strength, balance and agility in an effort to decrease the risk of falls and fractures.

In next week’s column, I will be presenting a conversation that I recently had with Bone Fit’s content lead and lead trainer; Dr. Judi Laprade from the University of Toronto. In the meantime, if you are interested in finding a Bone Fit trainer in your community who can help you to better manage your osteoporosis, go to www.BoneFit.caand search the locator map found on the home page under “Find a Professional.”


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