Physical activity and exercise for osteoporosis

Osteoporosis is the most common chronic metabolic bone disease, which is characterised by increased bone fragility. It is estimated that over 200 million people across the globe are suffering with osteoporosis, and according to the International Osteoporosis Foundation, 1 in 3 women over 50 years old and 1 in 5 men will experience osteoporotic fracture at some point in their lifetime.

Unfortunately, there are no symptoms of osteoporosis until you suffer a fracture, and this causes morbidity, and in men, mortality. Various factors increase your risk of developing osteoporosis, such as smoking, lack of exercise, poor diet, gastrointestinal problems, metabolic disease, early menopause and aging.

A recent UK consensus statement "strong, steady and straight" looked into the effects of physical activity and exercise for osteoporosis. For a long time now we know that exercise and physical activity can improve bone strength and reduce the risk of falls. However, there remains uncertainty about the types of exercise that are safe and effective, which is why the consensus was conducted.

Key recommendations were made for those suffering with osteoporosis, and they include:-

1) resistance and impact exercise to maximise bone strength.

2) activities to improve strength and balance to reduce falls.

3) spinal extension exercise to improve posture and potentially reduce risk of falls and vertebral fractures.

There is very little evidence to suggest that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks. Inactivity should be avoided, physical activity encouraged, and reassurance provided to prevent fear avoidance of moving.

Brooke-Wavell, K, Skelton.D.A, Barker.K.L, et al. (2022). Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine. 10: 1136.