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Posted on Sat, Mar 3, 2012 : 5 a.m.

Targeted exercises can help counter osteoporosis

By Ask Dr. K

Harvard Medical School Adviser by the Faculty of Harvard Medical School


I was recently diagnosed with osteoporosis. I've always exercised regularly, but now I'm worried that the vigorous exercise I prefer might not be safe for my bones. Is it possible to exercise and protect my bones at the same time?


The short answer to your question is yes -- you can exercise while also protecting your bones. In fact, the right exercise program will actually make your bones stronger and can also help you avoid falls and fractures.

There are many ways to benefit from exercise while also keeping your bones safe. Start by having a health care provider who is knowledgeable about osteoporosis look over your exercise program or help you create a new one. She or he will review your bone density measurements and evaluate your current fitness and activities. Bring a list of the medications you take; you may need to adjust or change any that might cause dizziness or affect your balance.

Your clinician (or a physical therapist or other exercise specialist) will assess your posture and gait, range of motion, muscle strength and balance. Based on what he or she sees, you may be advised to add more vigorous exercises to your routine or substitute safer moves. Physical therapists are particularly skilled at designing a program for people who have been inactive or have physical limitations.

Your exercise program is likely to include a number of activities that are specifically designed to help with osteoporosis. These exercises will help you stay mobile by strengthening your muscles and increasing your flexibility and balance.

Weight-bearing exercises are activities you do while on your feet. These exercises work large muscle groups while you support your weight against the pull of gravity. They help strengthen the bones in your legs, spine and hips. Weight-bearing exercises include brisk walking, jogging, dancing, tennis and step aerobics.

But because these are high-impact activities, they can be risky for people with advanced osteoporosis or other medical limitations. For lower-impact alternatives, try machines such as elliptical trainers or stair-steppers. Bicycling and swimming are not weight-bearing, but they can build muscle strength and help your heart and circulation. Swimming and aquatic exercise are especially helpful for people who have joint pain or concerns about falling.

Resistance exercises are also important for bone health. In these, you use the weight of your body, free weights, elastic bands or exercise machines to make your muscles work against force as they contract during exercise. Because your muscles pull on your bones, they help build bone strength as they work against resistance.

Core-strengthening exercises work the muscles that attach to your spine, pelvis and shoulders, helping you stand upright and maintain good posture. When both your core and leg muscles are strong, falls are less likely.

In addition to resistance exercises for strength, activities that move your joints through their full range of motion are important for flexibility, balance and avoiding falls. Gentler activities like swimming and tai chi can help maintain or improve joint flexibility. Yoga can also help, but you should work with an instructor familiar with osteoporosis in order to avoid or modify yoga positions that involve twists and forward bends.

Improving your balance is also an important way to prevent falls and fractures. Balance exercises strengthen muscles and enhance the body's perception of its position. So does tai chi, a series of movements that require you to shift your weight continually. It can lower your risk of falling and bolster your confidence in your balance, reducing falls due to fear. Tai chi classes may be offered at your local Y, senior center, health club or medical facility.

Regular exercise can do more than strengthen your bones. It lessens your chances of getting heart disease, lowers blood pressure, helps prevent diabetes, lowers the risk for colon and breast cancer, improves mood and adds years to your life. A balanced exercise program will help your bones and the rest of your body, too.

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