Osteoporosis Exercise Guidelines⭐
/I you are a woman over 50 with osteoporosis, or osteopenia or are at risk, you probably have questions about the best exercises you should do to stay strong for years to come.
I am sending out a big thank you 🙏 to the Canadian Medical Association Journal for publishing these guidelines on osteoporosis management a few weeks ago.
Clinical Practice Guidelines are something astute healthcare providers look forward to in order to stay on top of the most current research. Guidelines like these are compiled by a group of healthcare professionals who go through all of the research and provide best-practice treatment recommendations. This is a time-consuming process, and the results often change what healthcare providers recommend to their patients.
While the guidelines are meant for healthcare providers, I think it is helpful for anyone with bone loss to know what the evidence for intervention supports and what it debunks. The complete document is sort of long, but there are 25 recommendations and 10 good practice statements you can check out.
I am going to highlight a few things I think are worth knowing, but of course, you can read the whole guide here.
👉Recommendations (Check out tables #2-4 in the guide):
#1: Exercise.
💪 Balance and functional training more than 2 times per week. This includes reaching beyond the comfort zone, increasing repetitions and sets over time, changing the pace, and moving while doing something - all to improve balance and reduce the risk of falls.
#2 Nutrition.
Calcium from food, NOT FROM SUPPLEMENTS. Get 1200mg per day from calcium-rich foods.
Vitamin D - It is hard to get the recommended dose from food, a supplement of 400 IU/day may be appropriate.
Other - if you have a healthy diet, they suggest no supplementation of protein, vitamin K, or magnesium to prevent fractures. If you are on medications, consult your physician for your own plan.
#3 Fracture Risk.
Use the FRAX tool to assess risk.
✅Bone Mineral Density testing in postmenopausal females and males who
a. are aged 50–64 years with a previous osteoporosis-related fracture or ≥ 2 clinical risk factors OR
b. are aged ≥ 65 years with 1 clinical risk factor for fracture OR
c. are aged ≥ 70 year
#4 Pharmacological Recommendations
Before initiating pharmacotherapy, good practice includes assessing for secondary causes of osteoporosis, and for potential limitations when considering specific osteoporosis pharmacotherapy.
Check out the complete table #4 for all recommendations, including specific medications and durations.
I hope you found this helpful.
I think one of the biggest challenges I see when women are first diagnosed with osteoporosis or osteopenia is the immediate desire to load up on supplements. While I understand the desire to take action and make up for something that might be missing in your diet, supplements are more often than not, not absorbed and therefore useless, expensive, and at times, harmful. I recommend supplements ONLY if you have been SPECIFICALLY told to take them by YOUR physician. DO NOT fall for the marketing of unregulated, untested supplements sold online, in health stores, or by personal trainers.
👉There is some specific research for very few supplements that can help with muscle 💪 and bone strength: vitamin D, Collagen, and creatine. Other than that, most vitamins, minerals, and protein should be taken in as food. Spend your money on organic food, exercise programs for women over 50 or exercise equipment - you will get more bang for your buck!
If you do see something that you want to try, please check with your doctor to make sure it isn't going to interact with the medication you are taking.
And remember, bone strength 🦴 is built by using it, not by ingesting the building blocks. Get out there and build bone by lifting weights.
Stay strong and retire active,
Andrea Trombley PT, DPT
Reference:
CMAJ 2023 October 10;195:E1333-48. doi: 10.1503/cmaj.221647