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Improving Exercise Guidelines for Bone Health

Stronger Evidence for Stronger Bones

KohrtWhen a woman is prescribed exercise for the prevention or treatment of osteoporosis, there are two questions she will probably want to ask her orthopedic doctor: “What exercise activities are best for my bones?” and “How much exercise do I need?”

Surprisingly, there is not enough clinical research data to provide definite answers to these important questions.  Instead, doctors currently base their advice on general health guidelines and known skeletal adaption factors. 

While several studies have proven that exercise training can generate increases in bone mineral density and decreases in fracture risk, few studies have evaluated physical activity in a quantitative manner.  In other words, we know that physical activity is an effective treatment for osteoporosis, but we don’t know which activities and what doses are most effective. Until there is conclusive clinical data about factors such as mode, frequency, duration and intensity, doctors have no way to be certain they are prescribing the best exercise regimen for the prevention or treatment of osteoporosis.

This does not mean that the current osteoporosis exercise guidelines provide “bad advice,” or that osteoporosis patients shouldn’t exercise.  It does mean that the current guidelines can be improved!

In the meantime, osteoporosis patients should exercise according to the current guidelines.  As your doctor will tell you, the guidelines promote “weight-bearing” activities, such as walking, soccer, weight lifting and dance. These activities are considered the best exercises for increasing bone mineral density and decreasing fracture risk.

Dr. Wendy M. Kohrt
University of Colorado


References:
1. Feskanich, Dianne, et.al. Walking and Leisure-Time Activity and Risk of Hip Fracture in Postmenopausal Women, JAMA: 2300-06. Nov. 13, 2002.
2. Kohrt, Wendy, et.al. Muscle Forces or Gravity: What Predominates Mechanical Loading on Bone? Medicine & Science in Sports & Exercise Vol 41 No 11: 2050-55. Nov 2009.
3. Martyn-St James, Marrissa, and Carroll, Sean. Meta-Analysis for Preservation of Bone Mineral Density in Postmenopausal Women. The Bone Journal Vol 43, No 3: 521-531. 2008.