Robin’s synopsis of OSTEOPOROSIS & EXERCISE with Dr. Lora Giangregorio

Lora Giangregorio is a researcher and professor of Kinesiology and Health Sciences at the University of Waterloo.

Dr. Giangregorio and Osteoporosis Canada developed BoneFit, a two-day training for practitioners, to learn how to assess and treat people with osteoporosis.

Then for the public, to reduce the burden of fractures for those with osteoporosis, Too Fit For Fracture was developed with recommendations for exercise.

BALANCE AND WALKING

Statistics tell us that the majority of fractures are due to falls, therefore, having good balance is key to prevention. Balance activity must be functional or dynamic, which means not just static standing on one leg, but moving or doing an activity while challenging your balance.  Static standing on one leg can be a good place to start if balance is difficult, but it must progress to a more challenging activity.  Margie pointed out that Tai Chi can be an effective, dynamic balancing activity.

More research needs to be done, but the current thought is that walking alone is not going to improve balance and actually can increase someone’s risk of falling.

Flexibility also needs to be addressed as stiff hips, knees or ankles affect how you walk and can increase the risk of falling.

Balance is not just an issue for the older population. Even young people should be checked for balance issues and have balance training as part of their exercise routine.

HIGH IMPACT EXERCISE

We do know that running, jumping, or strength training when you are pre-puberty and into young adulthood can build bone strength.  As we age, research shows that we become less responsive to mechanical loading, however, it is unclear the mechanism for this change.  We lose muscle and often become less active so the studies, some poorly done and with a small sample size, are inconclusive.

We have some evidence but need more, to definitively state that you can do a specific exercise for bone strength.  There are results of an Australian study that shows that high-impact exercise was effective but it needs to be supervised and is not adaptable to a home program.

Both Margie and Dr. Giangregorio emphasized the safety issue for anyone attempting to execute an exercise program.  A qualified professional is needed to oversee activities for osteoporosis.

EXERCISE PROGRESSION

Any program should progress in order to build bone density.  If you need to start out with low weight, say 2 lbs., you cannot do that for 10 years and expect to build strength.

Make exercise fun and goal-oriented, both short and long-term, so you feel you are working towards something.

ROUNDING the SPINE

It is normal to have a slight curve, rounding, of the mid-back.  This kyphosis can increase due to poor, slumped, posture, changes in the structure of ligaments or in the vertebrae due to arthritis, or vertebral fracture.  Once the curve is greater than 40 degrees, it is considered excessive and called hyper-kyphosis.

Studies show that with intense exercise, there can be a slight improvement in this curve if due to posture or arthritis, but no significant change if due to fracture.

In addition to working your back muscles by lifting your chest off the ground while lying on your stomach, Dr. Giangregorio uses visual clues to reduce kyphosis during daily activities.  Imagine you are gently lifting your chest by thinking of your collar bones and spreading them as if they were wings.  You can also visualize your shoulders moving away from each other.

YOGA

There is not enough data on the effects of yoga and osteoporosis to make conclusions about how this modality affects bone.  There are few research studies, most are poorly done and since there are many types of yoga, it makes generalizing difficult.

We do know that deep spinal flexion (forward bending), balancing on the neck, or twisting should be avoided.

Practice yoga if you like it, you feel it improves the overall function quality of your life, and modify the poses to be safe.  There is currently a study being done in Australia with a large population looking at the efficacy of yoga on osteoporosis.

PILATES

There is also little data to support Pilates as a modality for osteoporosis but it has been shown it does improve balance. The same principles that were discussed for Yoga should apply here.

New Guidelines

Since there is little research data, Dr. Giangregorio and her team polled professionals in the field to come up with Guidelines. The To Fit For Fracture guide is currently being updated.

Conclusion

Define your goals, start where you are and challenge yourself with safe progression.

You can find more information, or volunteer to be in a research study, at the website, Bone Health & Exercise Sciences Lab, or follow Bones Lab on Facebook and YouTube.

My solution for creating new habits:

Start small, do it in community, have an accountability partner!

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