In this blog we have gathered info and insights from our physio Jane-Anne, our exercise physiologist Kylie and our dietitian Briony, regarding pain management, strength training and nutrition for osteoporosis.
Fast facts
There are over 1.2 million Australians affected by osteoporosis
Many people don't know that they have osteoporosis until they break a bone.
Osteoporosis can be managed through exercise, lifestyle changes and prescription medicines that strengthen your bones.
What is Osteoporosis?
Osteoporosis (meaning ‘porous bones’) is a condition that causes bones to become thin, weak, and fragile. This occurs when bones lose minerals, such as calcium, faster than the body can replace them. This is also referred to as a constant process our bones go through called ‘Bone Remodelling’.
In osteoporosis, the rate of bone resorption is increased, but the rate of bone formation is not. This means that we get rid of old bone cells at a quicker rate than we create our new ones, causing an overall change in the integrity of our bones.
Osteoporosis is classified based on your Bone Mineral Density (BMD). You will receive a T-Score when you go for a bone mineral density scan. This score represents the density of your bone and classifies it into three categories:
Osteoporosis can be diagnosed with:
T score <-2.5
Osteopenia, (the stage BEFORE osteoporosis) can be diagnosed with:
T score -1 to -2.5
Normal bone:
T score > -1
How can I improve my Bone density and treat, manage, or prevent Osteoporosis?
PHYSIO
Balance and Fall Prevention
Osteoporosis-related fractures are often the result of falls. Physiotherapists are skilled in assessing balance and gait, identifying potential fall risks, and creating personalised exercise programs to improve balance and coordination. By incorporating exercises that challenge stability and agility, individuals with osteoporosis can enhance their confidence in everyday movements and reduce the likelihood of falls.
Education and Empowerment
Physiotherapists also play a pivotal role in educating individuals about osteoporosis, its impact on the body, and strategies for managing the condition. Through education, individuals can make informed choices about their physical activities, posture, and overall lifestyle. Physio's can provide advice and guidance around the specific exercises that are required to make a difference to bone density in people with osteoporosis.
EXERCISE PHYSIOLOGIST
Strength training is one of the best types of exercises for Osteoporosis and numerous studies have shown that proper strength training can improve BMD/T-score and therefore prevent osteopenia developing to osteoporosis and prevent the risk of falls and fractures.
Studies highlight that it is a specific form of strength training that can help improve chronic health conditions such as osteoporosis and osteopenia. This is called High intensity, progressive resistance and impact loading and it is this type of exercise that the bone remodelling process responds to, so that the bone building cells increase at a faster rate than bone cells that breakdown the bone matrix.
The key characteristics of EFFECTIVE strength training for osteoporosis relies on the correct MAGNITUDE, RATE and FREQUENCY. This is best determined and prescribed by an qualified health professional such as a physio or exercise physiologist to minimise the risk of fracture.
DIETITIAN
Like all chronic conditions there is a WEALTH of information out there about what foods should be eaten and what should be avoided and not all of that information is evidenced based
Let's summarise the current guidelines for managing osteoporosis through diet...
Calcium: The Building Block of Bones
Calcium is a mineral that provides structural integrity to bones. Insufficient calcium intake can lead to weakened bones, making them more susceptible to fractures. Good dietary sources of calcium include dairy products (such as milk, yogurt, and cheese), leafy greens (like spinach and kale), fortified plant-based milks, and certain fish (such as canned salmon with bones). Everyone should be aiming for 1000mg of calcium per day (mostly from food)
Try this calcium calculator to see how much you get in a day!
Vitamin D: Improves Calcium Absorption
Vitamin D is a crucial partner to calcium, as it enhances the absorption of calcium in the intestines. It also helps regulate calcium levels in the blood and supports bone mineralization. Exposure to sunlight is a natural way to produce vitamin D, but dietary sources also play a role. Fatty fish (like salmon ), egg yolks, fortified foods (such as orange juice and cereals), and supplements can contribute to maintaining adequate vitamin D levels.
Protein: Muscle mass
In order to support any rehab or exercise program, it is important to eat enough protein to support your muscles. Strong muscles are more able to exert LOAD on your bones, making them stronger and reducing fracture risk
Sports Dietitians Australia recommend 35-40g of protein at each meal for older adults.
Caffeine:
High coffee intake may increase the risk of osteoporotic fracture, especially in females. Some national guidelines recommend limiting coffee intake to <4 cups daily to limit this risk.
Want to find out more?
Whether you’re seeking advice to prevent, treat or manage osteoporosis, an Accredited Exercise Physiologist can assist you by guiding you through an individualised, safe, and evidence-based exercise program to “armour” your bones!
At GP+S we have just launched an Osteoporosis specific exercise class based on the latest evidence that focuses on building strength and increasing bone density. The class has been developed using best evidence guidelines, to slowly increase load and strengthen bones! It runs every Tuesday and Friday (these exercises need to be undertaken twice per week to have an effect). Give us a call if you'd like to find out more!