Written by Exercise Physiologists, Nicole Shue of Kieser Malvern and Ben Milner of Kieser Brighton
Over 1 million Australians have osteoporosis and two-thirds of those aged over 50 have either osteoporosis or osteopenia. Osteoporosis is a disease classified by excessive loss of bone density – which makes bones brittle and increases the risk of fracture. Normally, bone mass begins to decline gradually after the age of 25–30 in both men and women, with more rapid bone loss seen in women post menopause. An excessive loss of this bone mass is called osteoporosis and when combined with reduced stability and muscle strength greatly increases our risk of fracture with age.
Despite its prevalence, there is much confusion around osteoporosis and the best way to manage the condition. Read below as we break down some common myths and misconceptions around osteoporosis.
Myth 1: Osteoporosis isn't that common
According to the Australian Institute of Health and Welfare, there are nearly 1 million Australians diagnosed with osteoporosis and over 6 million with osteopenia. Osteopenia is the pre-cursor to osteoporosis and a major risk factor for the development of osteoporosis.
Osteoporosis is often called the "silent disease," because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture. In fact, a recent study (1) found that as many as 75% of people with osteoporosis don't know they have it. This means that the 1 million Australians currently diagnosed with osteoporosis is likely much higher.
Myth 2: Osteoporosis doesn't affect men or young women
While women are four times more likely to get osteoporosis than men, that doesn't mean that men are exempt from the condition. According to the Australian Institute of Health and Welfare, nearly 1 in 4 Australian men aged 50 and over will experience a minimal trauma fracture in the future. Minimal trauma fractures of the hip are one of the most serious outcomes of osteoporosis.
The rate of bone loss starts later in men than it does in women and progresses more slowly, however by age 70 men catch up to women in the rate that they lose bone. Due to this, men are usually older when they are diagnosed which makes the complications from broken bones potentially more serious. It is just as important for men to maintain their bone density as they age and watch for the signs of osteoporosis such as a loss of height, change in posture, a fracture or sudden back pain.
You are never too young to develop osteoporosis. While osteoporosis is primarily diagnosed in post-menopausal women, it can affect men and women at any age. Pre-menopausal women who develop osteoporosis often develop secondary osteoporosis, which is osteoprosis that is caused by a medical condition or a medicine. These conditions include breast cancer, eating disorders, thyroid disorders or conditions that require you to take steriods.
Myth 3: If you have Osteoporosis, it's too late to prevent your bones from fractures
While an osteoporosis diagnosis can be startling, there are lifestyle changes you can make to improve your condition overtime. Bone is dynamic tissue that adapts to mechanical loads throughout life. Bones are continually changing through a process called remodeling, where new bone cells replace older or damaged bone cells. Due to this, can improve your bone health and decrease your risk of fractures with physical activity, diet and medication.
At Kieser, we regularly see new clients in their 60's, 70's and 80's who are strength training for the first time. Under the right supervision, with an Exercise Physiologist or Physiotherapist, strength training can be done safely at any age - see myth #5 for more information.
Myth 4: Participating in walking and swimming is enough to prevent fractures
For clients with osteoporosis, the thought that 'all exercise is good exercise' is not necessarily true. Prolonged aerobic activities, such as swimming and walking, while good for overall health, have little to no effect on bone health as they don't provide enough stimulating load to build bone density.
In order to build strength in your bones it is important to participate in activities that put dynamic stress on the bones. An optimal bone loading program consists of four components: progressive resistance training, weight bearing, balance and impact exercises.
Myth 5: Resistance training is unsafe for those with osteoporosis
One of the most common myths about osteoporosis is that resistance training is unsafe and can lead to fractures. However, resistance training is currently recommended as one of the main ways to prevent and manage osteoporosis due to the dynamic loading of bones.
Evidence has shown that in order for exercise to improve bone health, the loading must be dynamic, induce relatively high bone strains and be applied rapidly. As long as the exercise is performed at an optimal intensity, fewer repetitions can actually be more effective as bone cells can become desensitised to repetitive loading (2).
Strength training programs at Kieser involve progressive overload at a high intensity for 90-120 seconds at a time, which makes them ideal for clients looking to improve bone health. Our team of Exercise Physiologists hold weekly falls & balance classes as well as osteoporosis-specific screenings and group classes. These group classes are customised to the individual and are designed for clients of all levels of ability.
Falls and balance
We can't talk about osteoporosis without mentioning falls & balance. Falls and balance training is a key component of exercise therapy for those with poor bone health. Due to the high risk of fracture for individuals with osteoporosis, fall prevention is key. Exercise that includes activities to increase lower limb strength and improve balance and stability are extremely beneficial.
While falls and balance training may not directly improve bone mass, it is still crucial in the management of osteoporosis, especially among the elderly or those at a higher risk of falls.
For many, an osteoporosis diagnosis can come as a shock and require significant lifestyle changes. However, with early intervention and safe and supervised strength training, we can help to avoid a large number of vertebral and other skeletal fractures caused by osteoporosis. Kieser's team of Exercise Physiologists are able to design specific programs for clients to ensure they are partaking in the 'right' kind of exercise.
If you, or someone you know, has osteoporosis and you'd like to join one of our group classes or see an Exercise Physiologist, send us an email at info@kieser.com.au
References:
1. Nguyen TV, Center JR, Eisman JA (2004) Osteoporosis: underrated, underdiagnosed and undertreated, Med J Aus 180:S18.
2. Robling AG, Burr DB, Turner CH. Recovery periods restore mechanosensitivity to dynamically loaded bone. J Exp Biol 2001; 204(Pt 19):3389–3399.
