It is important to bear in mind that the correct drug treatment, a calcium-rich diet and weight bearing exercises can all increase bone mass ( the amount of bone) therefore minimising the risk of fracture. Physical activities and ‘weight bearing exercises’ such as walking, climbing stairs and push-ups, which improve bone strength, are beneficial for people with osteoporosis.
Most of the people we talked to made a concerted effort to exercise every day. Exercise, like diet provides a sense of control over the condition and people trust that by playing an active role in managing osteoporosis they are helping to prevent or halt deterioration of their bones.
Walking is one weight bearing exercise that almost everyone we talked to did on a daily basis. Some said that they have been given advice by their doctors to walk on a regular basis. Since being diagnosed, many people’s attitude to physical activity has changed. Some said that they were no longer using their cars for short or medium distance journeys. Some people tried to include 30 minutes to an hour of brisk walking into their daily-routine.
Valerie said that on average she walks about seven hours per week. Since her diagnosis Carol walks rather than drives to and from the city centre several times per week. Each journey is around two miles. Gloria walks now for short journeys and she goes for longer walks with her husband at weekends. Several people put their aches and pain after a walking session down to ‘old age’ rather than the walking itself. A few noticed that they have put on weight since having a fracture.
Since diagnosis some people had attended exercise classes or joined a gym. Pilates classes and swimming sessions were popular. Pilates exercises, such as back extension, postural exercises and stretching, are good for someone with osteoporosis. Clare says she feels better after doing Pilates and Susannah felt it had made her more aware of her posture and had improved it. But not everyone felt fit enough to do Pilates. Joan gave up the idea because she has physical limitations. Her arms don’t straighten very well after her surgery and so she can’t cope with any kind of strain or weight.
Valerie found the place where her local class is run too cold and has stopped going. Jenny was concerned about what Pilates exercises she should avoid.
A few people were attending exercises rooted in Eastern traditions such as Tai Chi and Chi Kung. They said that they have an effect on the physical as well as the emotional well-being of the person because they involved deep breathing and relaxation techniques.
Many people found swimming beneficial because it helped to tone the muscles and increased their energy levels. Although many people said that swimming benefited their joints, Jenny stopped swimming because she was getting neck pain after swimming breaststroke.
People with restricted mobility preferred to swim during quieter periods because they found it more relaxing. Gloria learnt to swim at the age of 50 after her consultant advised that swimming was good exercise for people with osteoporosis.
Several people we talked to suggested that there are few or no public or private swimming facilities in their local area. Susan said that the public swimming pool in the village is closed and she cannot afford the private one. Valerie checked the facilities in her area and found that there are only two pools within a five-mile radius and they tend to be very busy. Travelling distance has put Betty off swimming. She finds it hard to take public transport. Also several people explained that it is difficult for them to do regular exercise due to family and other commitments.
Challenges for the elderly
Some elderly people faced particular challenges regarding their ability to do exercise. The one physical activity that most elderly people still do is walking. The distance and time involved varied and while some pointed out that ‘going up and down the garden’ was their exercise, others were still able to walk into the city centre and back, or go for regular walks in the park. But some elderly people are limited on how much walking or exercise they can do before feeling pain. In the last two years Elizabeth, has stopped going swimming because she is afraid of slipping and breaking another bone, she found getting into the pool difficult to do. Joan, however, has joined a swimming club in a private pool and feels safe.
Older people we talked to said that they feel safer walking on certain surfaces and not on others. Also many avoid walking into busy areas for fear of falling or said they wouldn’t venture into the city centre on a Friday evening or on a Saturday. They feel fragile and are afraid of bring caught in big crowds of shoppers or worse drunken people (see also Osteoporosis, mobility, driving and transport
Bad weather can also put people off from venturing out but Ann said that she goes up and down the stairs in her homes several times a day. Her doctor advised her that it is a good way of doing a weight bearing exercise in safety. Some people do exercises at home to strengthen their muscles, including lifting light weights, Tai Chi exercises, using an exercise bike and doing the exercises they were given by their physiotherapist.
Some elderly people felt fit enough to live an active life and considered exercise an important component of osteoporosis management. Victoria Iris went dancing once a week at her local tea dance.
A more balanced approach to exercise
Most people talked about having a balanced approach to exercise, meaning the need to do weight bearing exercises like walking that are gentler on the skeleton and to avoid putting themselves at risk of spinal or other fractures. They thought that people with osteoporosis need to exercise frequently for short periods, and gradually build it up to a level they are comfortable with. Some people believed that pounding the ground in the form of high impact exercises such as jumping, running, heavy lifting and pole vaulting was not such a good idea. Michelle thinks that there is a need to be aware of one’s own genetic limitations.
Two women with maternal history of osteoporosis in their families used to do high impact types of exercises before diagnosis. Marylin used to train and run marathons and Susan was an athlete until her late teens. Marylin goes to a gym every weekday but now she mostly concentrates on doing low impact type of classes.
Skiing and running were two of the physical activities that several of the people we talked to used to do but they have now given up as a precautionary measure to avoid falls and fractures and generally prevent a decline in bone mass. In fact, many stressed the need to avoid taking unnecessary risks.
Going to the gym
Several of the people we talked to have joined a gym and are doing exercises using weights. Since 1992 Emma has attended keep fit classes at least once a week and recently joined a gym but finds that the trainers are not equipped to help her regarding weight bearing exercises. She feels frustrated about it. Chris is aware of the need to build bone mass through exercise.
People wanted information and advice regarding osteoporosis and exercise. Some people felt unsure as to the type of exercises that are best for them. Weight lifting is considered to be good to keep and build bone mass. But people have questions as to how much weight they should use and the type of weight lifting exercises that are suitable for someone with osteoporosis. Another question is regarding stretching and strengthening exercises.
Several people wanted to know if bending and stretching forward or downward are good exercises for someone with an osteoporotic and fractured spine. Also people would like to find out whether a low impact exercise like walking is as effective in protecting bone mass as a high impact exercise like running.The National Osteoporosis Society (NOS) website can provide information on the best exercise for people with osteoporosis to do. Michelle said that after her diagnosis she was advised by a consultant to include a weight bearing element to her exercise routine. Michelle ran for years for an average of ninety minutes per session (see also Information needs for people with osteoporosis and Sources of information for people with osteoporosis).
Many felt that general guidelines were not enough and what they would prefer is tailor made advice to fit their needs; level of fitness and physical limitations. Several, like Valerie also would like to see induction-type courses run by qualified physiotherapists in hospitals. Many found that the trainer at the local gym was not qualified enough to provide specialised type of information and advice or, they felt unsure about it. However Iris said that her exercise teacher had contacted the NOS to make sure that the exercises they were doing were appropriate for people with osteoporosis.
Several people said the NOS leaflet on exercise had provided helpful guidance.
Several people indicated that they were very active before being diagnosed with osteoporosis and that it wasn’t a lack of exercise that was a contributory factor or caused it. But a few people stopped exercising because they were frightened of falling and fracturing again.