Osteoporosis: The Mission to Stop Breaking Bones

I have a real soft spot for osteoporosis and osteopenia as a health professional.

Why?

Because it combines my love of strength training to benefit a chronic health condition and completely change peoples lives.

Let’s dive into understanding Osteoporosis and how you can best manage this condition.

What is osteoporosis?

Osteoporosis (‘OP’ for short) is a disease that affects our bones.

This condition occurs as bone mineral density reduces over time where the structure and integrity of bone is lost.

As we age, we begin to lose minerals in our bone such as calcium much faster than the body can replace it.

This is extremely problematic!

Osteoporotic fractures can result when bone density becomes too low.

These fractures can happen a number of ways:

Spontaneously where the bone fractures as it can not handle the bodies mass
from simple tasks such as walking, bending or standing,
A small trip and mis-step,
Falls that result on landing on the wrist, hip or pelvis.

The most effected bones in our body are the thoracic spine, femur, wrist, humerus and pelvis.

Take a look at the picture below, the word osteoporosis means “bone becoming porous”

Osteoporosis is a serious condition!

According to the Australian institute of health and welfare and Australian Bureau of Statistics an estimated 924,000 people reported they suffered osteoporosis in 2017-18. This data is self-reported, with many cases undiagnosed and not reported.

However, the incidence and prevalence of osteoporosis is much larger than that.

An Osteoporosis Australia report from 2012 indicate 2 out of 3 people over 50 have osteoporosis or osteopenia (the early stages of this condition), this was 4.74 million people. It was estimated to climb to 6.3 million people by 2022.

I wonder where we’re at in 2023?

Rewind back to 2013 and OP resulted in 1 fracture every 3.6 minutes and is projected to be about 1 fracture every 2.8 minutes now.

So by this stage of the blog someone in Australia has suffered an osteoporotic fracture, and by the end of reading this at least 5 fractures have been created by this condition.

That is scary!

What is scarier is that it is estimated that 1.6 million fractures per year will be due to osteoporosis and osteopenia, costing $3.84 billion in direct and indirect costs to the patient and health care system.

1 in 4 men and 2 in 5 women over the age of 50 will experience a fracture as a result of osteoporosis.

In the first 5 years following a minimal traumatic osteoporotic fracture, a review of the participants of the study by the Dubbo Osteoporosis Epidemiology Study found that 26% of women and 37% of men died.

If a repeat fracture occurred the risk of death increased to 75% in men and 50% for women.

The fatality rate for an acute osteoporotic hip fracture above 75 years was 20.7% in men, 7.5% in women.

Get this, up to 90% of men are not even aware they have osteoporosis.

No wonder us blokes die more.

These are some crazy statistics don’t you think?

What are the Risk factors for Osteoporosis?

Increasing age: over 50 years, male or female!
Family history of osteoporosis
Low vitamin D levels
Low calcium levels
Low body weight / body mass
Excessive smoking and alcohol consumption
Physical inactivity
Reduced oestrogen levels

How do I know if I have osteoporosis?

The unfortune thing about osteoporosis is it presents without any symptoms in many individuals.

Because of this, most diagnosis usually comes from a fracture, most commonly after a fall.

However with screening, Osteoporosis can be diagnosed before a fall or fracture with the use of the DXA scan.

Osteoporosis is typically diagnosed by using dual-energy x-ray absorptiometry (DXA). This scan is a simple and non-invasive process that does not take long to perform.

The scan will give data in the form of a T-score to diagnose and categorise your bone mineral density.

There are 3 categories of bone mineral density from your scan:

T-score of 1 to -1 (Normal)
T-score of -1 to -2.5 (Osteopenia)
T-score of -2.5 or more (osteoporosis)

How can I check if I have osteoporosis?

If you read the above risk factors and thought “do I have osteoporosis?”.

The best method is to go and have a discussion with your GP about osteopenia and osteoporosis and whether you are at risk.

They can arrange the appropriate scans to diagnose the condition.

How is osteoporosis treated?

Treatment will depend on your T-score and certain lifestyle factors.

Treatment has begun to change significantly over the past few years and the best approach for any level of osteopenia or osteoporosis is a multi-disciplinary approach.

The main treatments are:

Medication

Pharmaceutical intervention has been shown to effectively help improve bone mineral density by helping to return the balance of your osteoclasts (bone break down) and osteoblasts (bone builders).

There are various medications that can be used from orals to injectables and will be given based on your individual needs.

Diet

Another primary prevention strategy for osteopenia and osteoporosis is diet and supplementation.

You may be referred to a dietician for advice on changes to your diet that can help with eating foods that increase your over-all health, but also increase calcium and vitamin D levels.

Supplementation of vitamin D and calcium will also help increase bone mineral density for those diagnosis with osteoporosis.

Exercise

Certain exercise has come out in the ever-evolving research in the treatment of osteoporosis as a very effective method of treating osteoporosis.

Certain modalities of exercise have been shown to maintain and, in most cases, reverse the breakdown of bone over time.

It was previously thought that low impact exercises like walking, swimming, or even bodyweight exercises may help to improve bone mineral density.

However, current research has now shown that these types of exercises do not have enough impact to actually stimulate bone growth.

What type of exercise actually has the ability to promote bone growth?

Evidence now shows that exercise needs to have high impact (loads and forces) to actually stimulate the bone to improve its density again.

There are specific types of exercise that help to get the very best results when compared to other types of exercise.

So, what are they?

Resistance Training for Osteoporosis

Not just any type of resistance training though.

Strength training!

Lifting heavy weights has been shown to greatly improve bone mineral density.

For the best and most effective results, weights need to be lifted at around 80 to 85% of an individuals estimated 1 repetition max.

Not sure what that means?

It essentially means that exercise needs to be heavy and add compression to bone.

Exercises such as barbell squats, deadlifts, and lunges.

Most research shows that when done with a trained health professional such as a headache physio in Gold Coast or Exercise Physiologist, it is safe and very effective to grow bone by lifting heavy weights!

Plyometric Training for Osteoporosis

Plyometrics are another form of exercise that involves jumping, hopping, bounding etc.

This type of exercise requires rapid force production of our muscles which can give many benefits to the body.

Check out this blog post: “The benefits of Plyometric Training for the everyday person!” for more info.

Plyometric training has been shown to be very effective along with resistance training to improve on bone density.

Balance Training & Retraining

Balance training helps to improve on the body’s ability regulate our posture and movement.

Balance exercises come in many forms and will challenge our sensory inputs within our body to improve on our bodies movement control.

Although balance won’t directly help with building bone mineral density, it is essential for out older population as it will help to reduce the chances of a fall which is one of the largest risks of a bone fracture.

Falls in older populations that involve a fracture of the bone can be fatal so it is essential to make sure that balance is a top priority when dealing with osteoporosis.

Fighting Fit Physiotherapy promotes the use of all the above treatments for the best management of people suffering osteopenia and osteoporosis.

We have you well and truly covered on the exercise component of your treatment.

Our clinicians, including myself, are experts in designing and implementing safe and effective exercise plans to improve your condition and quality of life.

Not sure how to get started?

It’s easy, fill in your details here and we will be in touch. Looking for other services? We offer also offer exercise physiotherapy in Gold Coast.

Dean Phelps

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

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Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

What is osteoporosis?

Osteoporosis is a serious condition!

What are the Risk factors for Osteoporosis?

How do I know if I have osteoporosis?

How can I check if I have osteoporosis?

How is osteoporosis treated?

Medication

Diet

Exercise

Resistance Training for Osteoporosis

Plyometric Training for Osteoporosis

Balance Training & Retraining

The Desk Worker’s Guide to a Pain-Free Neck

Hip Osteoarthritis: Why It Hurts and How Physio Can Help

The #1 Mistake Athletes Make After an Ankle Injury

The Secret to Beating Back Pain? Walk This Way!

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