What types of exercise do you need?
Your exercise routine should include exercises in each of the following areas:
- Strength training
Strength training refers to exercise where free weights (e.g., dumbbells), weight machines or exercise bands are used to make the bones and muscles work by lifting, pushing or pulling a “load.”
Strength training is a type of exercise with the goal of improving muscular strength. It involves performing movements against resistance; it is sometimes referred to as resistance training. Exercise bands, weights, machines or even your own body weight can be used for resistance. Strength training may increase spine and hip bone mineral density.
- Posture training
Posture training involves paying attention to how the parts of our body are aligned with each other. The alignment of the vertebrae of the spine can become a concern among individuals with osteoporosis. Some kyphosis, or curvature of the upper back, is normal, but fractures or weak back extensor muscles can cause the spine to curve more than usual, resulting in an exaggerated kyphosis or excessively curved upper back.
Poor alignment, especially during activities that involve bending and twisting, can cause increased loads on the spine and result in fractures. Attention to alignment during activity and at rest, along with exercises targeting the back extensor muscles, can improve the alignment of the spine.
- Balance training
Balance training exercises are those that challenge your balance. Examples include:
- Reducing your base of support (e.g., standing on one leg instead of two, walking on your toes or your heels),
- Walking in an unusual pattern (e.g., heel to toe walking in a line, figure eights),
- Shifting weight to the limits of support (e.g., moving your weight more to one foot than another).
Physical activities like dancing, or Tai Chi, that involve balance and coordination may also reduce falls and fractures.
Tai Chi is a very safe and effective low impact form of exercise that improves balance and reduces the risk of falls.
- Weight bearing aerobic physical activity
An activity can be considered aerobic physical activity if:
- It is a rhythmic activity that you do for at least 10 minutes at a time continuously, and
- It increases your heart rate and makes you breathe harder than you usually do during your daily activities.
Canada’s Physical Activity Guide suggest that ALL adults (including those over 65 years of age) participate in at least 30 minutes of moderate to vigorous intensity physical activity on most days of the week (5 days a week or more). Moderate intensity exercise is exercise that makes you work and breathe harder; you could probably still have a conversation, but you couldn’t sing while doing it. With vigorous exercise, you are working and breathing harder, and it would be difficult to talk or sing.
For individuals with osteoporosis, we often recommend weight-bearing aerobic exercise or physical activity. In weight-bearing physical activity, bones and muscles of the legs and trunk work against the force of gravity while they bear the weight of the body. Activities like walking, jogging, step aerobics, dancing and stair climbing are all examples of weight-bearing exercise, as are sports that involve running and jumping such as soccer, basketball, volleyball, racquet sports and others.
Not all aerobic exercise is weight-bearing (e.g., swimming and cycling). It doesn’t mean you shouldn’t still do things like swimming or cycling, just that you should engage in weight-bearing aerobic physical activity on several days per week.
If you have osteoporosis AND have had a spine fracture, all of the above forms of training are still important. Emphasize good alignment, low impact and moderate over vigorous intensity aerobic physical activity.
Start by speaking with a physical therapist to ensure you are choosing safe and appropriate physical activities for you.
Remember: if you have osteoporosis, aerobic exercise is not enough. Strength training and balance training are essential to maintain bone and muscle, and prevent falls.
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