A-Z

Osteoporosis

Osteoporosis and exercise

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.
 

Clare, a physiotherapist, has a brisk half hour walk before breakfast and she goes to Pilates...

Clare, a physiotherapist, has a brisk half hour walk before breakfast and she goes to Pilates...

Age at interview: 65
Sex: Female
Age at diagnosis: 64
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And I think my backache is getting better. But I do make a concerted effort now to do exercise every day. So I try, don’t always succeed. But I try to go for half an hour’s fast walk every morning before breakfast. And walk to places rather than take the car. And if I go to Sainsbury’s I park the car a long way from the entrance so I’ve got that extra bit to walk. And in that way, I hoped I’d be getting more exercise.
 
I’ve also bought a pedometer. And you mentioned 12,000, 10,000 steps a day I think. So I do most days, I make an effort to do 10,000. And you just see what happens in the future really.
 
I do the garden, I do the house, I do, I walk, I swim, I ...
 
How, how often do you swim?
 
That's a good point. I try and swim once a week, because I walk five times a week and I give myself one day off but by not going everywhere by car, and being more active I go to Pilates and I’m teaching exercises all day, all morning anyway.
 
Well I do Pilates and I probably do a lot of back extension exercises, and postural exercises and stretching’s. I can't remember what specific ones I do.
 
Do you know any type of exercise somebody with osteoporosis shouldn't do?
 
Shouldn't do?
 
Shouldn't do?
 
Heavy lifting, jumping, that type of thing. High impact sport.
 
So one of the things that you have changed or modified after the diagnosis has been your attitude to using the car?
 
Yes, it has, and the increase in petrol prices. But that's recent, yes. Yes, I, I think I now view the car as somewhere if I'm going any distance I will go in it, but if I can possibly walk there I'll walk there. Regardless of weather [laughs].
 

Alice plays golf twice a week so walking around the golf course gives her plenty of exercise.

Alice plays golf twice a week so walking around the golf course gives her plenty of exercise.

Age at interview: 75
Sex: Female
Age at diagnosis: 75
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I play golf twice a week and then I go out with my friends. We go shopping and wander about here and there. I don’t walk much well, I mean I don’t go for a walk as specifically but I do walk. If you see what I mean. I don’t go off for miles walking.

 

Would you say that you walk every day?
 
I guess so, yes.
 
Okay, and roughly how, how much would you walk a day?
 
Perhaps not as much as I should. I don’t I don’t know. Quarter of an hour, half an hour maybe if that.
 
And when you are playing golf?
 
Oh, it’s about four hours.
 
Okay, then you are up and.
 
Yes.
 
Down the slopes?
 
And you do lots of walking there, yes [laughs] to hit the ball so it’s, you know.
 
For how long have, how long have you been playing golf?
 
Since I was fifty about, no sixty, sorry sixty, when I retired, sixty for about fifteen years.
I used to, hockey, volleyball. Netball at school. I’ve been quite active. 
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.
 

Carol believes exercise is important. She walks regularly, does Tai Chi and Chi Kung weekly but...

Carol believes exercise is important. She walks regularly, does Tai Chi and Chi Kung weekly but...

Age at interview: 71
Sex: Female
Age at diagnosis: 70
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So what I did in the January, I joined a Tai Chi class because my niece, amongst all the leaflets that she’d sent me was this book from the National Osteoporosis Society, which talked about exercise. I had heard that Tai Chi was really good exercise. So I joined this class January 2007 and I go once a week. And I also practice at home very day. And then in the July I joined a Chi Kung Chinese exercise class, which again is very good. It’s all good for the body and the mind. So I’m still attending that one. And I also attend another Tai Chi class, which is a different form. I joined that in January of this year. So I’m doing the three types of Chinese exercise, three times a week, plus I do it every day at home myself.
 
So I thought that at least will hopefully help. And because obviously exercise is important. We live a mile from the town and whereas I used to take the car now I’ll walk down and walk back.
 
Yes, so I just feel that the exercise is important. And whereas I thought my life had come to an end, I mean, obviously it hadn’t come to an end at all, I just had to be really careful. So it’s the sort of thing where I wouldn’t take unnecessary risks like roller skating I wouldn’t go ice skating or rock climbing because, yeah, I think you have got to be sensible. And avoid taking unnecessary risks.
 
And when I was attending, will I still attend tai chi. But where it was, and I’m sorry they’ve moved because that was two miles. So I used to walk the two miles there and the two miles back. As well as doing the tai chi in the middle. But I didn’t feel any ill effects. I felt quite good actually.
 
So do you do brisk walking?
 
Yeah. I don’t walk slow. I think, I think, yeah. I can’t walk slowly. If I go out with my husband, he’s trailing behind me [laughs].
 
And how many times do you that, how many times a week do you walk?
 
Walk? I was… I say I was doing it because obviously at this time, there’s been a lot going on. Usually I’ll do that three or four times a week.
 
But I’m also very active. I never sit down, only in the evening. I’m just on the go all day. And when I do sit down to watch something I’ll go to sleep [laughs].
 
So on average you are walking something like eight miles a week?
 
Probably.
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.
 

Swimming benefits David’s joints and the day after a swim they feel loose.

Swimming benefits David’s joints and the day after a swim they feel loose.

Age at interview: 25
Sex: Male
Age at diagnosis: 23
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I’ve started to go swimming a little bit which is good, you know and I find that really benefits me.
 
Where do you go to?
 
There’s a place up the road, it’s and it’s called [sport centre], so I’ve been going there when, as and when I can, you know I find, you know I find that really loosens me up. You know I can move a lot more freely in the pool. I mean ‘cos I haven’t been to hydrotherapy for years, you know, there isn’t really that facility open any more
 
So how often do you go to, is this a private pool or, or public?
 
No it’s like a public pool, You know it’s not warmed up, it’s just cold and you know but it’s, finding that the water benefits and have been able to get in. I mean because there was a time when like, I mean I don’t really like the water but I find it does benefit my joints and I felt really good after. And the day after I felt really loose.
 
 
Do they, do they have the special sessions at the pool?
 
No. I mean it’s just, like you mean at the public pool where I go? Not as far as I know. No, I just go on a, I mean when I go last time it was like a Sunday evening, so it’s fairly quiet. You know I mean, I mean I wouldn’t go now ‘cos, you know ‘cos all the, it’s the school holidays, I wouldn’t, I wouldn’t risk it, I’d go in the evening probably.
 
You’re a bit nervous about it?
 
Yeah, I mean I’m not a good swimmer so I wouldn’t want loads of people in there anyway. And you know I mean you know that goes for any pool, I wouldn’t want it, even if I was going to the hospital you know?
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.
 

Susan finds brisk walking easier to do than slow walking. She does exercises at home when she has...

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Susan finds brisk walking easier to do than slow walking. She does exercises at home when she has...

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Stretching, stretching I find is quite good, depending on what sort of pain it is. I, I do fast walking because I find that fast walking is far better than slow walking. Like yesterday with these friends we went to the [city] and we were ambling around the colleges, in and out of, you know, this and that and I had such a backache by the end of the afternoon. So I actually came home and I left them there. But if I do fast walking I can walk from here two or three miles. Fast walking and I’m much better and I don’t get the pain like that. So I find fast walking does help me [laugh].
 
It does help you?
 
Yeah, yeah. Swimming is difficult because although it’s very good for you I can’t do crawling, only breaststroke or backstroke so which backstroke is ok. But I would love to swim more but the [village] pool is now closed down. The private ones I can’t afford. So [laugh].
 

 

Well I, if I do my exercises I do my sister’s video, not video, the tape, her tape and you know she tells me exactly what to do. And actually that exercise is. The one which the physio showed me in the hospital that gave me the sheet for I don’t think honestly they make a great deal of difference. I mean they are mostly stretching or moving your legs sideways or you’re holding onto a chair and do gentle little things which helped at the time a little bit with the pain, you know, but I don’t think it’s, maybe it could be used also as a maintenance if I had the time for it but/or. It’s not a question of will power it is just simple I have so little time for myself that sometimes [laugh] I just like to sit and read the paper and I yeah at night I go and play bridge quite a lot. So you know I’m not around at night to do exercises then [laugh]. 

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).
 

Diana is a member of the local walkers club and once a week she goes with a friend for an hour...

Diana is a member of the local walkers club and once a week she goes with a friend for an hour...

Age at interview: 77
Sex: Female
Age at diagnosis: 72
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And also that’s another thing, I walk, I walk a lot. Because that is important as far as I’m concerned, as far as osteoporosis is concerned. I try and walk every day, even if it’s like just ten minutes down the village, or I go the long way round so that it gives me that extra walk. And my friend and me, we joined the [name] Walkers and that’s an hour’s, we, you know, there’s so many different walks around that you can do, but that hour’s walk is quite enough at my age and my friend’s age as well. She’s, she hasn’t got osteoporosis but she’s still, you know, we’re still that much older.
 
How, how often do you have this hour walk?
 
The hour, once a week.
 
Once a week?
 
The hour, on a Tuesday, the hour walk, yes. But, like I say, I walk most days, because to me that is more important. You can read all the time or hear all the time that walking is the best thing. I mean I’d love to garden and that. But I can’t because I can’t get down, you know, to, it, I don’t think it’s so much osteoporosis, I think it’s your age. You know, you can’t put everything on to osteoporosis. When you are getting to my age you, you’ve got to.
 
You are 76?
 
9.
 
79?
 
Oh, sorry, no, 77. I was thinking of my friend and she’s 7-, she’s 79 this next birthday. No, 77, sorry [laugh]. Gosh, not many people would make themselves older than what they actually are, do they?
 
No, that’s for sure.  
 

Joan has a favourite park for walking because the surface is level and there are plenty of people...

Joan has a favourite park for walking because the surface is level and there are plenty of people...

Age at interview: 73
Sex: Female
Age at diagnosis: 69
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I’m going through a stage of getting confidence back of walking. I will not walk in [city] even with my stick. I really am. It’s so uneven and people sort of almost it seems as though they try to bump into me. No I’m very. I’m. I’ve lost a little confidence again as a result of a fall, just about two months ago.
 
So you avoid places like high streets with lots of people?
 
Yes, yes, yes.
 
Ok.
 
Yes I drive, I feel so confident in my car. I changed my car because of the knee problems. I have an automatic now and of course I have power steering. But I feel safe in it. I’m not going to fall. I’m a good driver [laugh]. I drive all over the world.
 
Do you have spots where you go for a walk?
 
Yes. I have one very good one that I like very much and I have to drive there. It’s an [name] city park called [name] Park and the reason I like it because I’m, I feel not safe very much on bumpy ground, on grass for example. If it’s got bumps and hollows I find that very worrying. I need to have two sticks with me for that. But [name] Park has around the whole perimeter and lots of little zig zags which are hard surface with a sort of a gravel on the top and there are lots of people around and lots of other dog walkers. So I have targets on keeping moving particularly if my knees hurt or my arms. I also joined a swim club for exercise. I swim usually twice a week. There is a Jacuzzi with steps into it and rails and it’s wonderful. So those are my forms of exercise that my little dog and I do. He doesn’t go swimming but he, the walking yes and it’s. I feel safe. There are people there if I do fall.
 
I try to avoid. The one thing I can’t do and that’s because of so many fractures. I’ve broken several toes and my big toe before, earlier. I can’t remember. In fact I broke a toe only last year. Is I don’t like slopes. I cannot, I cannot walk up a slope or down a slope. Down a slope is impossible. I’m just a. I tried with two sticks as well and a friend nearby. No. No I will not go down a slope but you know, there are other wonderful places to go without... So I’ve. That’s why I like [name] Park [laugh] It’s level [laugh].
 
And you feel safe?
 
I feel safe and it’s wonderful, the trees are just fabulous there.
 

James’s level of activity has been greatly reduced and he said that getting used to that was one...

James’s level of activity has been greatly reduced and he said that getting used to that was one...

Age at interview: 82
Sex: Male
Age at diagnosis: 81
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Ten minutes is about the average, yes. Just occasionally I can do a little bit more but they told me at the hospital not to try and push through the pain barrier.
 
And before you started having this backache how much were you able to do in terms of walking?
 
Well, I have, I suppose until about four years ago I could do a couple of miles quite easily, before that very much more. I’ve been quite an active walker.
 
How old are you now?
 
Eighty three.
 
Late seventies you were still walking quite ….?
 
Oh yes, quite comfortably. And I must say until then I, I thought I had the strength and the energy to do what I wanted to do. What I needed to do which was fine. It’s been very difficult coming to terms with that.
 
So it’s basically just within the last couple of years that you have to limit what you do?
 
That’s when there’s been the serious decline.
 
And how did you feel about it?
 
I totally unprepared I would say. People tell you about old age but until you begin to experience it you simply don’t have the full knowledge or the full conception of that. And that’s, that’s been the difficult bit.
 
I suppose there’s some element of disappointment that life is ending like this. But otherwise I think I’ve been reasonably philosophical about it. There isn’t much alternative [laughs]. 

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.

 

Ann’s doctor advised her that going up and down her stairs at home several times a day was good...

Ann’s doctor advised her that going up and down her stairs at home several times a day was good...

Age at interview: 69
Sex: Female
Age at diagnosis: 62
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We had four very steep steps to the kitchen door, a turn and four again, steep steps narrow steep steps. So bearing in mind my husband and I are getting older we decided to remove those steps completely. We now have a wider landing outside the kitchen door and we have four shallow, four wider steps but shallower, a bigger turn and eight, sorry we have six, a turn and eight wider this way but shallower steps. That has proved it’s worth. It’s worth every penny we paid for that. I’m now going down the steps and coming back up the steps in confidence, you know. And I can run up and down those steps like nobody’s business now and it’s doing my hips the power of good because I’m several times a day I’m doing fourteen steps umpteen times a day which is good for my hips, my bone density on my hip joints, you know. Because Doctor [name] says that like in inclement weather, and I always advise this when I do talks on osteoporosis, that rather than going out in very slushy rainy weather if you have a normal set of thirteen stairs, an ordinary staircase, if you do that twelve times in a period of twenty four hours you’ve walked two and a half miles. And I keep this in mind when I’m doing the back steps and the normal staircase, you know. I’m doing my hip joints the power of good every single day. And I enjoy doing that. I look upon that as not a chore that I have to do but something that I enjoy doing and it’s working well. It’s doing my hip joints the power of good. You know.

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.

 

Victoria Iris strongly believes in exercise and she goes to weekly classes which she feels do her...

Victoria Iris strongly believes in exercise and she goes to weekly classes which she feels do her...

Age at interview: 83
Sex: Female
Age at diagnosis: 64
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I do believe in exercise. I’ve always exercised. One of the subjects I qualified in was physical education, the other being history and, and I have always been interested in some kind of sport. Now at the moment I go to one exercise a week and it’s run by my local group with my sister-in-law and I taking the lead in it. I go to a tea dance on a Friday afternoon at our local civic hall and there we do line dancing, sequence dancing and ballroom. Until this last six weeks I have found that the floor is so slippy that I am frightened to do line dancing because there is a risk of me falling. And I have complained about it but of course, I won’t get it altered. But I am sorry about that.
 
But nevertheless I talked to my doctor last week and said, ‘Can I contemplate a second exercise class when we start back in September?’ And he said, ‘I must test your heart and blood pressure first’. Which he did and he said my heart was ok and my blood pressure was better than he expected so yes provided if I feel tired at all or feel anything I just sit down, I withdrawn. And on that consideration I aim to be doing two exercise classes in September.
 
What type of exercises do you do?
 
Now it, it’s really more a traditional going back a good many years to do with. It was designed by a ballet dancer originally, Margaret Morris. And our teacher is very experienced, getting on in years and she has adapted. We’ve had other teachers but she’s adapted her teaching and she contacts us, the society and with a view to making sure that people who’ve got osteoporosis can cope and that the exercises are suitable for them. And that means that we’ve got a tremendous amount of support. And I find they do me the world of good. I’ll admit that I feel as if I’ve worked when I come home after that but nevertheless they are, her exercises, the Margaret Morris movement exercises are better than I’ve ever had. And I’m in a position to judge really having taught physical education myself such a long time ago. But I do believe in exercise. I strongly believe in it and I know I’m not walking because I’ve got a disabled sticker but I would advocate it to anybody, exercise.
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.

 

Marylin cycles everywhere and goes to an exercise class at the gym every evening.

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Marylin cycles everywhere and goes to an exercise class at the gym every evening.

Age at interview: 59
Sex: Female
Age at diagnosis: 56
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I was probably running almost every day. Not, when I first started running it was Sunday mornings. I joined a running club, and then, people I met there, that was, I must have started running in perhaps 80, 1982, 81. Around about 81. And then during 82 a group of us decided to do the 1983 London Marathon. So of course, then we were running long distances. And I kept that up. I did five marathons in all. But I did have problems with my knees and then after I'd stopped the marathon training, I just ran short distances. But I still used to do it quite often. But I don’t run any more. I can’t run now.
 
How many years did you keep it up for?
 
I started in about 81 and I must have stopped running … the marathons I finished doing marathons in about eighty, eight five. I did five marathons. And then I just kept doing sort of short jogs and I think I gave up running now about ten years ago.
 
But I still cycle everywhere, I have always cycled. I still go to the gym. But I do the classes at the gym. I used to actually do two or three classes a night. But now I do one most nights.
 
Okay. Are they sort of high impact type of exercises?
 
No, not any more. A lot of, a lot of the classes at gyms now are – the trend has changed. It used to be, you used to get lots of aerobic classes, you know, things like that, but now the girls, the young girls nowadays they don’t want that. They like the legs, bums and tums classes where you are lying on the floor all the time [laughs]. So I suppose it's good for me. It has made me tone my exercise classes down. So now I do legs, bums, and tums, and yoga and Pilates. And a lot of the gyms now have got these body training system classes. They're like a franchise. And those classes have taken over. There's body combats, which I don’t do. My joints wouldn’t like it. There is a lot of kicking and punching. There is body attack which is hard, very hard, but we don’t have it at my gym. And there is body pump, which I do. Because that is, that is weights. And I should do some weight, weight exercise to try and protect my joints. So I do body pump which is weights. I do Pilates. I do yoga. I still do circuit training. That's the only, that's the only high impact class that I do now.
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.
 

Michelle has stopped skiing and she recently stopped jogging because she is afraid to fall and...

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Michelle has stopped skiing and she recently stopped jogging because she is afraid to fall and...

Age at interview: 63
Sex: Female
Age at diagnosis: 45
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I have given up skiing. I mean you were saying how’s it affect your life. I gave up skiing and I’m not going to go back and that’s because I’m afraid to fall.
 
You have that fear now?
 
Yeah. I have that fear now, yeah. And I’m not going to go back to jogging because I think it will provoke, well I don’t know if it will, I maybe provoke spinal fracture, injury or pain. Or now I’ve had one hip I feel lucky to have escaped. Will the other one have a problem? Will my knees have a problem? And I don’t know that that’s really about osteoporosis because that might be about joints.
Seeing this rheumatologist and his view of my mother’s health with the sjorgen’s and he’s not too keen on running so that will I think probably you do need some running to help you with your osteoporosis and I probably won’t get it now.
 
And I’m not going to jog again either. I mean it’s not only that I think I might injure my joints I think I had those two falls. You know, osteoporosis did not cause those falls. Right? I don’t know why I fell when I was jogging. So I just think I’m getting older and I have and I can’t I don’t know why I’m only sixty four sixty three. How old am I? I’m sixty three. And my balance should be good, I’ve been active all my life and but I think that I shouldn’t have had those falls. And now that I’ve got I’m post-op with this hip of course my balance is not as good likely it’s not very good and all that stuff so I am actually at risk.
 
I’ve now I’ve given that up and I was that was my I didn’t I skied for I don’t know fifty years, sixty years. You know, just that was my big thing but...
 

And that is a fear of that is a fear of fractures, not so much a fear of falling. It’s just this notion I have osteoporosis and I shouldn’t be on the ski slopes. I don’t want to be like my mother who had so many fractures, you know. That’s so that’s what that is, it’s whether I actually, I am also afraid of falling but it’s more that notion of a certain fragility. ‘Oh yes you have osteoporosis you shouldn’t be doing that.’ And don’t want be like your mum, you don’t want to be, you know, trying to protect yourself so that’s the biggest thing I’ve given up. And I don’t think I’ve given up anything else really, just a bit of caution.

 

 
What do you mean by when, when you say sort of not being like your mum?
 
Well she had she just ploughed ahead and she had a million fractures, you know [laughs]. And she was always getting hurt from something and I just think, well she didn’t take into account her own her own genetic limitation, perhaps didn’t realise it. I mean because here I am just realising it a third generation and thought like I do, culturally, naturally just think, ‘Well more is better and that’s how you get tough and that’s how you stay tough.’ Well guess what? That’s wrong sometimes. You know, swimming is good and cycling is good but pounding a pavement is not.
 
I think I’ll be like her (mother). I think I’ll be like her, yeah. I’m biologically like her. In a lot of ways so I think, ‘Oh you know, well you have to modify your risk factor. You have to what can you do? You try to do better than your mother did and a lot of the things that she believed were good for her and I believe was good for me, we were wrong about that. We were both wrong. Some of the pound pavement pounding was not good. That was dumb.

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.
 

Although Linda finds her regular visits to the gym boring, since she has been diagnosed with...

Although Linda finds her regular visits to the gym boring, since she has been diagnosed with...

Age at interview: 62
Sex: Female
Age at diagnosis: 60
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I think I am quite active and I walk I walk as much as I can. But I do more since I’ve been diagnosed. I make myself do more.
 
Like what, more walking?
 
More walking, more going to the gym, the more activity. I can remember when I was first diagnosed going for very long boring walks doing absolutely nothing but walking and I thought, “Oh, this is so boring.” Then I went then I thought, “No, gardening is just as good.” So I prefer to do something with a purpose. That’s why I found the gym quite hard. Just going there and walking on those machines and it’s quite boring but anyway. And the other thing of course I believe very strongly in is staying flexible and mobile and I think, you know, as long as we can keep our muscles strong then presumably that keeps the bones protects the bones.
 
Tell me about the types of exercise you do?
 
Okay.
 
When you go to the gym?
 
I go on the well, the running machine but I walk on it but I walk quite hard and I walk up. I sometimes run for a minute here just to get my heart beat up but I don’t run a lot because I gather that’s not particularly good for bones. I then use there’s about half a dozen machines I use where you sit and you push your legs backwards and forwards on one with a with weights on and the same with the arms. I use that Swiss ball and do sit-ups on that. I do weight with weights I do things above my head. I do that thing of leaning against a ball against a wall and going up and down. I just try and vary it as much as possible.
 
Who has provided you with advice about the type of exercise you do?
 
Well, when I first got diagnosed I went to the gym and I said, “Is there anybody here who knows anything about osteoporosis?” And I got this girl who gave me these exercises and then every sort of six months or so I get somebody else just to get some different exercises. I don’t whether many of them know much about it. It’s hard to tell really.
Information gaps
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).
 

Michelle was advised to run for no longer than ninety minutes per session but she would like some...

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Michelle was advised to run for no longer than ninety minutes per session but she would like some...

Age at interview: 63
Sex: Female
Age at diagnosis: 45
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So I’ve been running about ninety minutes because that’s what was recommended to. You shouldn’t go over ninety if you’re trying to prevent bone loss. I mean that that was what I was trying to do was keep my activity up. That was the idea. That’s what you do for osteoporosis. Take your if you can’t drink milk, take your pills and you run so I thought that was beneficial. But my knees won’t tolerate running anymore plus there were some, the sports therapist said, ‘Well don’t go more than ninety minutes because there’s some suggestion that you’re worsening your risk for osteoporosis if you go more than ninety minutes.’ So I don’t I couldn’t find that literature but that’s what they’re advising I thought, ‘Well they must know something.’ So I did I did keep my walks to just an hour and a half I wasn’t no longer trying to do these, sort of, two hour runs. And then when I switched more to walking I went a bit longer but not much longer. I tried to keep it shorter.
 
I don’t I don’t know actually. I don’t know well I do a lot of I will do a lot of running again. It’s coming my as I get my hip back I’m already doing a bit on the weekends. But I don’t know if that if low impact I haven’t I haven’t reviewed the evidence. You probably know if low impact actually protects you adequately or as well as running. Certainly there’s one of this the one of the experts that I saw in this woman I saw in 2000 thought you had to have some vertical impact. And so if that’s correct just walking is inadequate but I haven’t really checked on that.
 
That’s another thing I would like is a lot more direction as to what I should be doing and I think my GP should be doing that. I just this question here. If you can’t run are you how, how much benefit are you getting from walking?  
 
 

Emma gets headaches when she is at the gym and she is unsure what exercises she should be doing.

Emma gets headaches when she is at the gym and she is unsure what exercises she should be doing.

Age at interview: 61
Sex: Female
Age at diagnosis: 47
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So now I have recently joined since last year, I have joined keep fit, [Fitness Club]. It’s a gym. I only go there and do walking. And do some cross training. And that’s two I can do. I can’t do much more than that. I would like to do some weight training. But the trainers, they, they don’t know themselves sometimes what I can do and what I can’t do. So I try to take some sort of advice from them. Or I ask my doctor, mostly I ask my doctor. And I tell him that I have joined the gym now. And I’m doing this and I’m doing that.
 

And because last year when I could not even hold even a glass or mug, coffee mug. My hands were so weak I could not even the glass of coffee mug. Since then my daughter told me that I should do some weight training. So I started with like ten grams, twenty grams, those weight training. And I do that even at home. And I, it helps me a lot.

 

And how often do you those?
 
Practically every day when I’m sitting and watching television. But when I go to gym I started doing weight training with them, I had to come out of it because I started getting headaches. And those headaches are either from due to the work related as well as weight, I’m not sure. That I’m working on it now to find out whether it’s, what is the reason. Because I had a change of my desk at work and I started weight training. There were two things together. So it is very difficult for me to pinpoint. To find out exactly what is the cause.
 
If there are some treatments then good, they should tell us. And even if I go to the gym now I’m doing trial and error, I don’t know what to do at the moment. There should be some medically, who can tell us exactly how, what sort of exercise I should do. So that I don’t get headaches. If I do too heavy things then I get problem with the head, these headaches. I don’t know whether headache is because of that or headache is because of the work-related, I have to identify that myself.So somebody should be there to guide me.
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.
 

Jenny had private physiotherapy sessions that enabled her to devise an exercise programme that is...

Jenny had private physiotherapy sessions that enabled her to devise an exercise programme that is...

Age at interview: 62
Sex: Female
Age at diagnosis: 55
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And your neck exercise for how long?
 
I do probably about ten, ten for each one and I do this one twice, bringing this back with a double chin. I’ve also got a tennis ball in a sock which I stand against the wall and rub that up and down. It’s on a sock so I don’t lose the ball [laughs]. And that I rub up and down the spine. I also stand against the wall and bring my hands right up so that I’m flat against the wall. I wasn’t flat to start with but I’m more flat now. I can bring my arms up, it jolly well hurts, but it aches to start with, and I hold that for ten seconds. And they are all the exercises from the physio for people with osteoporosis and neck…. I’ve also got the book. I have written to the society and I have got the osteoporosis exercise book which is good. And I can let you see that. I think that costs about four pounds. So I actually got that.
 
So there is a book that people can buy?
 
There is a book and I’ll show you that. You can have a look at that. And it’s got all the exercises in it, the ones that aren’t good are the bending forward ones because you can hurt your back if you’ve got it quite badly in the spine. I think that’s not good for it.
 
I dance. I do an awful lot of dancing. Three times a week we dance. So, yes, we dance and that is brilliant, the dancing we do, for osteoporosis.
 
What are you doing?
 

Well, we started out as line dancers, American line dancers. We do the couples now and that they say, the pounding of the floor is excellent for it. And we probably do it three times a week. My husband does it so we do couples dancing. But line dancing if you are on your own is excellent. And I think they do advocate that, they mention it in their book how good dancing is.  

 

 

(Text altered in accordance to Jenny's wishes.)

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.

 

Jane is concerned about exercising because she is frightened of falling and causing fractures.

Jane is concerned about exercising because she is frightened of falling and causing fractures.

Age at interview: 42
Sex: Female
Age at diagnosis: 36
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So I do Pilates and stuff. And, and so when the teacher goes, “Has anyone got any health problems?” I actually don’t say now, because it’s, they, I know that I know it better than what they do, as I know what I can do and what I can’t do. But I knew, if I knew that I did that every week of my life that I’d get more flexible, which I’m not getting any more flexible, then you know that you could do something that was like long term going to help you.

 

I can’t usually do much but Pilates is good because it, it’s supposed to increase your core strength. And because I know mine’s very weak, so I work at probably a third of the level or everyone, and I brace with every movement that I do anyhow, generally, but I can’t, like my knees won’t bend any more so I can’t do any positions with a bent knee. I look a bit kind of ridiculous. And then anything to with sit up, which is the, using the whole stomach muscles that have never worked since I had a baby, I know that’s always, there’s a bit in my head that goes, “I wonder what’s going to happen with my back?” And then if I try to forget about it, then it works better. But I predominantly have like a fear, of trust in my body again.

 

Because I can’t go back to where I was. And I know I will do eventually but I can’t, like I can’t describe the pain and I can’t go back. And so I’m terrified of going back. And so, as, I probably clam up in doctors’ surgeries because if they mention it because I think that, “Have you got any idea… [laughs] what the pain level is?” And so I think the whole being relaxed with your body’s finished really. And so although I want to go running round the park I can’t actually go running round the park. And I can visualise myself running around the park and then I, and then I realise who I am and I’ve put on a lot of weight because I’m more sedentary.
 
And so when, also I’m told by consultants that I have to start to be more active now, I sort of think, “How, how do I do that? How do I know what’s good pain and bad pain when whatever I do, if I do any exercise, if I do Pilates, it, usually the day after I can’t even move.” And so if I’m doing that every week and yet I’m still the same.
 
And I know a lot of it is mental, but I, if you ask a consultant will I not fracture if I fall down, they can’t say, “No, you won’t.” Because they can’t say that. And I know that I can’t fall down. I can’t go back. And so you’re held in this limbo of trying to maintain the quality of life you’ve got right now. Even though it might be quite, not as good as it was six years ago. But if I push it, do I lose it again? And I’m quite sure if there’s a psychologist in the room and they’ll be going, “Oh no, she needs to push it.” But when you’ve got it weighed up with memory of pain you just think, “Oh no, I don’t think so.” [laughs] So I’m a bit trapped by it really. 
 

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Last reviewed June 2017.
Last updated June 2017.

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