Exercise – Role in bone health and arthritis
September 18, 2021
The benefits of exercise to improve muscle strength and endurance, reducing the risk for heart disease and stroke, and preventing obesity are well known. Regular physical activity also helps in building and maintaining healthy bones. Prolonged inactivity due to any reason results in loss of bone mass and density
Aging, along with certain diseases and medications, can cause bones to become very weak over time — a condition called osteoporosis. It often occurs in women after menopause, and also in older men. The reduction in bone strength puts people at a greater risk for fractures and can seriously limit mobility and independence. People who develop osteoporosis also have less muscle strength and are considered frail. They are more likely to fall and more likely to sustain an insufficiency fracture
Human bone continues to adapt in form and function over time in response to the stresses applied to it. Regular exercise makes the bone stronger by building more bone tissue and increasing density. Regular stimulus to the bone in the form of exercises is important to maintain bone strength as we grow older. This also requires good nutrition to provide calcium and vitamin D which are necessary to build bone tissue. Exercise improves co-ordination, balance and flexibility. These are important as we grow older to avoid ground level falls and insufficiency fractures.
What exercises can I do to improve my bone strength?
There are many different types of exercise and they all offer health benefits. Exercise can range from simple stretching and postural training to weight bearing and strength training. Simple stretching and postural training may help elderly patients to maintain their spinal tone and avoid slumping which can put them at higher risk for spine fractures with simple activities like tying a shoe lace. Stretches can maintain muscle tone, avoid stiffness and also maintain joint mobility in older patients with arthritis.
Weight-bearing exercises are done on your feet that works your bones and muscles against gravity. With the lower limb carrying your body weight, more stress is placed on your bones, making your bones work harder. These exercises in young adults can help prevent further bone loss and strengthen bone as they grow older. They also help in improving cardiac and respiratory reserve thereby improve endurance.
Examples of weight-bearing exercises include:
- Brisk walking and hiking
- Simple dance forms
- Sports like Tennis, badminton, ping pong,
- Team sports, such as basketball, soccer, and volleyball
- Stair climbing
During strength-training, resistance is added to specific movements in order to make muscles work harder and, over time, build mass and become stronger. Since muscles attach and work on the bones, these exercises are beneficial to improve both bone and muscle strength.
Common types of strength training include using own body weight, different weight equipments and also resistance bands. A general guideline for strength training is to exercise each major muscle group at least twice a week with adequate rest in between.
Non-impact exercises such as yoga are not as effective at strengthening bone, but provide significant flexibility and balance. Exercises, such as swimming and cycling may not increase bone density but are excellent choices to strengthen muscles as well as the heart and lungs. If you have a musculoskeletal health condition, such as arthritis, that prevents you from doing weight-bearing activities, these are good alternatives.
How do I start?
An effective exercise program for bone health includes 30 minutes of weight-bearing exercises, four days a week. To help you stay motivated, choose an activity that you enjoy. Your 30 minutes of exercise can be done all in one stretch or broken up into shorter intervals. A 10-minute brisk walk three times a day is a great way to get started.
If it is not safe to walk outside, walking throughout your house, climbing stairs indoors and even walking in place are all great weight-bearing exercises. If your knees hurt due to arthritis, then stair climbing can be avoided.
All exercise sessions should end with stretching. Increasing your flexibility improves your ability to move easily, can reduce your risk for injury, and provides mental relaxation benefits. Before choosing an activity, it is important to consider your risk of falling inadvertently. Make sure you consult your doctor and physical therapist to help you plan your exercise program.
Is loosing weight beneficial to improve my bone strength?
Remember, when people lose weight, they also lose bone mass and density. Low body weight at any age is associated with a greater risk for bone problems and fractures. Very low body weight inappropriate for age has greater consequences for women. If a female athlete focuses excessively on being thin by eating too little, it can result in long-term health problems and loss of bone strength.
If young women exercise excessively or eat too little, they can lose enough weight to cause hormonal changes that can stop regular menstrual periods. This loss of estrogen, the hormone that is necessary for maintaining bone mass can cause progressive bone loss at a time when young women should actually be adding to their peak bone mass. For both males and females it is important to avoid being obese, maintain a body weight that is appropriate for their age and height without too much focus on aiming for a very low body weight.
I have arthritic knees, Can I do exercises?
Considering that cartilage has no nerve endings, most of the pain from arthritis come from different sources especially in the early phase. Pain comes from muscles and capsulo-ligamentous structures that stabilise and move the joint. Thus exercises can have an extremely positive effect in the setting of early arthritis. Exercises help to keep the body weight under control thereby reducing the overall impact on the knee joint. It strengthens muscles and improves bone quality which improves pain relief and overall performance of arthritic joints. Exercises also help in loading the joint which is essential for cartilage survival and regeneration since joint cartilage gets its nutrition from diffusion. Stretches and focussed strengthening of vital stabilising muscle groups can help in keeping arthritic pain at bay and yet maintain mobility.
Exercises are a great option for patients with arthritic joints. Stretches and muscle strengthening help to maintain muscular tone, joint mobility and stability considered important for keeping arthritic pain at bay. Since the joint surfaces get their nutrition by diffusion of joint fluid, it is important to keep the arthritic joints mobile by regular exercises to maintain cartilage nutrition.
Although exercise has been shown to have clear bone-building effects in young adults and bone-preserving effects in the elderly, it is just one element of a total program to prevent bone loss and minimise fracture risk. It is important to understand your individual risk for osteoporosis, such as genetic factors and family history. A balanced, calcium-rich diet, adequate Vitamin D, and a healthy lifestyle (avoiding excessive alcohol and nicotine) are also important factors for maintaining long term bone health.