Osteoporosis is diagnosed based on a comparison of your bone mineral density to that of an average 30 year old person. Thirty is the age when bone density has reached its peak. Osteoporosis, “porous bone,” is defined as being 25% less dense than a 30 year old’s bone. The bone is weaker and looks like a honey comb rather than a solid structure.
Osteopenia is defined as bone density that is 10-20% less dense than the 30 year old comparison. It does not automatically worsen and become osteoporosis.
Brittle bones are obviously a concern. There are natural hormone cycles that cause bone resorption to occur at a faster rate than new bone gets formed; this is a natural part of aging. The process is accelerated after menopause when there is a significantly less estrogen. This is why we tend to hear more about it with older women.
But osteoporosis does occur in both men and women. Research shows that weight bearing exercise and muscle strengthening can help slow the loss of bone mineral density. Both types of exercise send a “message” to the bones to stay strong to handle the load being placed on the body.
Strengthening exercises that use body weight (like squats or TRX), resistance bands, free weights, or kettle bells cause the muscles to exert a force at their attachments to the bone. As long as the load is not too light or too heavy, the bone responds from that input by trying to stay strong.
Balance training is essential to help prevent a fall that may result in a hip or wrist fracture because of poor bone density. There is plenty of research that shows balance declines if a person doesn’t practice because it involves so many things: strength, vision, inner ear, coordination and physical objects we encounter like walking on uneven ground or stepping up onto a curb.
As physical therapists and fitness trainers, we have the opportunity to impact both young and older folks’ bones by providing guidance on appropriate weight bearing and muscle strengthening exercises and balance training.
If you think of your bones as a bank, you have up until about age 30 to maximize your “deposit” and build bone density. After that, you want your “withdrawals” of the minerals that make up that bone to be as slow and controlled as they can be. Exercise is one of the factors that you can control that will impact this inevitable part of aging.