3 Balance Exercises to Help People with Osteoporosis

Your chances of suffering a fracture from osteoporosis increase with age and if you are female.  Many fractures lead to immediate pain.  Other fractures go unnoticed at first and slowly lead to increasing pain and disability over time. Falls are a leading cause of fracture in people with osteoporosis.  Even a minor fall can fracture a weakened and susceptible bone.  This article teaches you how to get started with balance exercises so you don’t have to worry about falling.

A Proven Way to Decrease Your Fear of Falling and Improve Balance

A recent study supported by the International Osteoporosis Foundation and the National Osteoporosis Foundation investigated the effectiveness of exercise in 149 women with osteoporosis.  These women were all 65 years and older.  All had sustained a previous spine fracture.

Half of the women performed a 12-week exercise program of strength training and balance exercises.   These women met twice per week for a one-hour group exercise class.  The other half of the research participants performed no exercise for the 12-week study period.

The women who performed the 12 weeks of exercise showed significant improvements in several areas.  Balance scores, sit-to-stand time, arm strength, and fear of falling all improved in the exercise group.  The group performing no exercise showed no improvement in any of these areas.  These results suggest women with osteoporosis benefit from an ongoing exercise program that includes both strength and balance exercises.

3 Simple Balance Exercises for Osteoporosis to Help You Start

Balance exercise is performed along with strength training.  Squats, step-ups, and lunges are great exercises to build strength, bone density, and improve your balance.  However, you also want to work in exercises that are specific to balance.  These should be done at least 2 to 3 days per week.

We recommend you start with static balance exercises.  These are exercises where you are standing in one place.  It is easy to do these near a chair or wall just in case you become unbalanced.  Common exercises are single-leg standing or standing in tandem with 1 foot in front of the other.  Perform these exercises with at least 10 second holds.  Work up to 30-second holds for at least 3 repetitions on each side.

After you master the static balance exercise, start moving a little more.  Dynamic balance exercises are more challenging and typical of what you will encounter during everyday activities.  An example is walking heel to toe in tandem.  Also, stepping over objects is a simple but challenging balance exercise you can do in your home.  Perform 10 steps in each direction for at least 2 to 3 sets.

Do Balance Exercises Anytime and Anywhere

You do not have to do balance exercises at a gym or at any dedicated time of day.  We recommend you incorporate balance exercise into your daily activities.  For example, balance for 10 to 30 seconds while waiting for the kettle to boil, or cooking.  During television commercials, stand up and practice tandem walking.  Try different things and stick with what works for you.

See Your Physical Therapist for a Personalized Exercise Program

Combining weight-bearing strength training with balance exercises will get you the best results.  You may have difficulty getting started.  This is normal especially if you have some fears about falling.

Many people we work with prefer to get started with the help of their physical therapist.  This is a safer approach for a lot of people who have fallen in the past.  Your therapist will guide you along until you are ready to exercise on your own.  Contact us for help developing the program that is best for your abilities and goals.


How to Build Stronger Bones with Impact Exercise

Just about everyone knows exercise is important for preventing and treating osteoporosis.  But do you know which types of exercises are safe?  Which exercises actually build bone density? Have you heard of impact exercise?  Impact exercises generate a mechanical load on your bone through ground reaction forces. The force from the ground stimulates bone growth. Examples are step-ups, dancing, and various hopping exercises.  If you are not already doing impact exercises, you should start.  This article teaches you how.

Bone best responds to mechanical stimuli applied either through impact with a surface, like the ground or through muscle contractions.  Walking is not an adequate stimulus to develop bone because the impact forces with the ground are low.  Also, walking requires only low-force muscle contractions that are inadequate to trigger bone changes.

Impact Exercises Proven to Increase Bone Density and Function

A 2021 study through the International Osteoporosis Foundation looked at changes in bone density and physical function following home-based impact exercise.  Fifty postmenopausal women with low bone density performed daily single-leg hopping exercises for 4 months.

After the study, no participants reported injuries related to the exercise program.  Significant improvements in hip and lower leg bone density were observed after only 4 months, ranging from 1% to 3%.  Also, chair stand and stair climb times improved significantly after the exercise program.  Sustaining such an exercise program for longer would likely lead to even greater improvements.

Before You Get Started with Impact Exercises    

We do not recommend everyone begin with high-intensity jumping exercises.  Before starting impact exercises it is important you have a strong base of strength.  This base is developed through foundational weight-bearing exercises like the squat, lunge, and deadlift.  Also walking with a weighted vest and performing spine strengthening exercises are great ways to prepare your body for impact exercises.  We recommend you perform these types of exercises for 6 to 8 weeks before starting impact exercises.  If you are unsure, always speak with your doctor first.

4 Simple Impact Exercises to Build Bone

Step-ups are a great way to start training with impact exercises.  Be sure to add weight in the form of hand weights or a backpack.  Shoot for at least 10% of your body weight as a starting load.  This is needed to create the ground reaction and muscles forces necessary to stimulate bone changes. Perform 3 to 5 short sets (4-8 repetitions) with increasing loads (10% to 30% of your body weight).  For an additional stimulus make the step higher.

Jumping jacks are done in your home or just about anywhere.  Start with your body weight but over time add weight using a backpack or vest.  Also, this is not meant to be an aerobic exercise.  Keep the repetitions intense and the sets short (only 5 to 10 repetitions).  Repeated (3 to 5 sets) bursts of loading are best to stimulate the bone.

Ankle hops in place introduce your body to a little more impact.  This creates greater ground reaction forces than the step-up.  You really want to push hard into the ground or floor.  Do this exercise in front of a chair or counter just in case you become unbalanced.  The first few sessions may lead to muscles soreness in your calf.  This will resolve after a few days.  Do 3 to 5 sets of 5 to 10 repetitions daily.  To increase the stimulus, add a backpack, weighted vest, or hold hand weights.

Overhead medicine ball slams incorporate many muscles throughout your body.  When you attempt to slam the ball really hard it actually causes you to jump a bit from the ground.  The strong muscle contractions and force through the ground are ideal for bone building.  Do 3 to 5 sets of 4 to 5 repetitions daily.  Start with a light-weight ball (around 2 pounds) but progress up to 8 or 10 pounds with practice.  For safety, stand near a wall or chair just in case you become unbalanced.

Your Physical Therapist Will Help You Develop the Best Exercise Program

Spend a good 6 to 8 weeks getting stronger with the strength training exercises we recommend.  Then start to add in these 4 impact exercises.  Combining weight-bearing strength training with impact exercises is your best medicine for osteoporosis.

Many people we work with prefer to get started with the help of their physical therapist.  Your therapist will guide and hold you accountable along the way.  Contact us for help developing the program that is best for your abilities and goals.

3 of the Best Strength Training Exercises for Osteoporosis

Approximately 30% of all postmenopausal women in the United States have osteoporosis.  At least 40% of these women will sustain 1 or more osteoporotic fractures.  To make matters worse, 1 in 3 people will die within 12 months of a hip fracture.  This sounds bleak but there is hope.  Exercise is the only strategy that improves all modifiable risk factors (bone strength, fall risk, and fall impact).  Strength training is the best preventative medicine for osteoporosis-related fractures.  This article describes how to start strength training exercises for osteoporosis.

High-Intensity Strength Training Proven to Increase Bone Strength

A recent study out of Australia looked at over 100 post-menopausal women with low bone mass.  Researchers placed each participant in 1 of 2 groups.  One group performed a low-intensity stretching and balance exercise program.  The other group performed high-intensity strength and impact training.  Both groups trained 2 times per week for 8 months.

At the end of the study, the strength training group showed significantly greater improvements.  Strength training lead to large improvements in spine bone density, hip bone density, height, leg strength, balance, walking speed, and power.  No adverse events occurred in any participant.  The remainder of this article highlights the key principles and exercises used in this study.

5 Important Strength Training Principles for Optimal Bone Health

  1. Principle of Specificity. Bone responds to loads applied at specific sites not generally to all bones.  Exercises are always aimed towards specific bones prone to fracture.  These sites are the bones of your spine, hips, and wrists.
  2. Principle of Progressive Overload. Loads (or weights) during exercise must exceed what is encountered during your normal daily activities.  For example, walking does very little to improve your bone health.  However, walking with a weighted backpack that is incrementally made heavier over time improves your spine bone density.
  3. Principle of Reversibility. Any improvement in bone strength from exercise is lost once the program is stopped.  You can never stop exercising or else all your improvements will be lost.
  4. Principle of Initial Values. People with the lowest bone density will see the greatest improvements from strength training.  This is not to say that people with mild bone density loss can’t benefit from exercise.  You just need a greater stimulus to see gains
  5. Principle of Diminished Returns. Your improvements in bone density from exercise will slow over time.  However, if you follow the other 4 principles, especially progressive overload, all improvements will be meaningful.

3 Foundational Strengthening Exercises for Osteoporosis

Large multi-joint compound exercises done in weight-bearing positions are ideal to stimulate changes in bone.  Examples are squats, lunges, deadlifts, and weighted carries.  These exercises apply large loads at important bone sites such as your spine and hips.  At first, proper exercise technique is most important.  Then it is crucial you increase weights and loads progressively over time.

For bone health, it is best to perform weight-bearing exercises with heavy loads using a few repetitions spaced out over multiple sets.  Based on the study done in Australia, we recommend 5 sets of 5 repetitions for each exercise.  Take long rest breaks between sets (2 to 5 minutes).  Heavier loads applied for brief periods spaced out are best for stimulating bone.  This is why long-duration aerobic exercise is much less beneficial for improving bone density.

Always follow proper exercise form.  With this in mind, increase the weight used in each exercise once you feel like you can safely do 6 or 7 reps in a set.  Perform each exercise a minimum of 2 times each week.  How long should you do them for?  Do them for the rest of your life.

Exercises for Osteoporosis: Get More Help from Your Physical Therapist

If you have been diagnosed with osteoporosis or if it runs in your family, you need to take exercising seriously.  Make it a habit to exercise with weights.  Stretching, pool exercises and walking is not enough.  Bone remodeling requires heavy loads applied progressively over time.

If you are having trouble with these foundational exercises, you need to work with a physical therapist.  Your physical therapist will help you develop the right exercise program based on your abilities and goals.  The physical therapists at BSR have been helping people of Southern Ocean County move without pain since 2007.  Call us today and schedule your initial evaluation.

Exercises for Upper Back Pain

According to the latest research, nearly 1 in 4 people experience upper back pain each year.  At some point, most of us have felt pain between our shoulder blades or across the back of our shoulders.  Upper back pain can be coming from your spinal joints, discs, or muscles.  A rounded shoulder posture is a common contributor to upper back pain.  This article shows you 6 postural exercises to help with upper back pain.

Rounded shoulder posture
Forces through your neck and back increase when looking down.

A rounded shoulder posture is common in people who sit for prolonged periods.  This is especially the case for people who work on a laptop or tablet.  Holding your head down when you work exacerbates a rounded shoulder posture.  Also, many people with this posture have trouble holding their heads up when they walk.  Exercise is most effective when combined with frequent postural changes throughout the day.  Move it or lose it!

Exercise is Proven to Help Poor Posture

A large research paper out of Canada investigated the benefits of exercise for improving upper back posture.  Researchers looked at 13 different studies.  They were interested in how exercise influences age-related hyper-kyphosis.  Kyphosis refers to the normal natural curvature in your upper back.  With age-related changes and a sedentary lifestyle, this curvature worsens.  Increased kyphosis is linked to upper back pain.

Most studies showed a benefit to exercise for reducing the angle of kyphosis.  In other words, exercise improves rounded shoulder posture.  Spinal extension exercises and various forms of yoga are most beneficial for improving posture.  This article shows 3 simple stretches you can perform in your own home.  More importantly, the 3 strengthening exercises performed regularly will result in the greatest improvements in pain.

Stretching Exercises for Upper Back Pain

Have you ever noticed how often you look down during your day?  You look down when you work on your computer.  You look down when washing your dishes.  And you probably look down most of the time when you walk.  Your upper back is going to follow the lead of your head.  When your head drops, your shoulders round, and your upper back flexes.  Stretching exercises will help.

It is important to improve the flexibility of your thoracic spine and the muscles of your chest and shoulders.  In particular, you will benefit from performing thoracic spine extension exercises.  A foam roll is helpful for these stretches.  An exercise ball or chair is helpful for stretching your lat muscles.  All you need to stretch your pec muscles is a wall or door frame.  Tightness in your lats and pecs pull your shoulders forward.  Stretch these muscles daily.  Perform 2 to 3 stretches each time.  Hold each stretch for 20 to 30 seconds.

Strengthening Exercises for Upper Back Pain

Stretch the muscles that pull your shoulders forward.  And strengthen the muscles that pull your shoulders and spine back.  These muscles are found along your spine and between your shoulder blades.  It is best to perform exercises in a face-down position.  This works your muscles against gravity.  It also keeps your spine in an extended position.  Remember, we want to improve your spine extension strength and pull your shoulders back.

Perform these exercises daily.  We recommend a minimum of 3 days per week. They are intended to be performed without any weights.  But if they are feeling easy you can hold light dumbbells in your hands.  Proper form and building endurance is more important than adding weights.  Start with 2 sets of 10 to 15 reps.  Work towards 20 to 30 reps per set.

Include Abdominal Strengthening Exercises

Believe it or not, the function of your abdominal muscles plays a role in your upper back posture.  Weak abdominals result in postural changes in your pelvis and lumbar spine.  To compensate for these changes down below, your upper back must round.  Strengthening only your upper back muscles will result in only partial pain relief.  Try working on a couple of the abdominal exercises included here.

How to Start Exercising with Upper Back Pain

These 6 exercises are proven to ease your upper back pain.  They are a sample of many effective options.  You will also benefit from receiving manual therapy performed by your physical therapist.  As always, your unique presentation and goals dictate the approach that is best for you.  Improvements will be small at first but stick with it.  Commit to these exercises for at least 6 weeks.  If you would like help getting started, call our office to schedule an initial evaluation with your physical therapist.

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Osteoporosis Exercises: 5 Ways to Strengthen Your Spine and Hips

Osteoporosis occurs when there is a reduction in bone mass resulting in an increased susceptibility to fracture.  It is the most common bone disease in women over 50.  Osteoporosis affects more than 40 million women in the United States.  This is approximately half of the population 50 and older.  Thankfully, specific osteoporosis exercises are helping many Americans live pain-free.  This article will teach you 5 of these exercises.

Osteoporosis and Bone Fractures

More than 1 million fractures related to osteoporosis occur each year.   The majority of these fractures occur in the hips, pelvis, or spine.  Hip and pelvic fractures commonly occur as a result of falls.  However, spine fractures related to osteoporosis often occur without any form of trauma.

Osteoporosis fractures commonly occur in the spine and hips.

Spine fractures often result from poorly managed osteoporosis.  These fractures lead to ongoing pain, breathing difficulties, poor posture, muscle loss, and deterioration in your quality of life.  Medical management with medications is controversial.  Drugs may address specific bone deficits.  However, drugs do not directly affect the pain, muscle weakness, and loss of function that accompany spine fractures.

Osteoporosis Exercises Proven to Help

Back strengthening exercises decrease your risk of fractures from osteoporosis.  Exercise also improves your pain and physical function after a fracture.  A 2010 study from Canada found decreased pain, improved function, and improved standing ability in women who performed 10 weeks of back strengthening exercises after a spine fracture.

These back exercises can be learned through a few visits to physical therapy.  They can also be performed regularly as part of a home program several times per week.  The following 5 exercises are examples but any program should be tailored to meet your individual needs.

Supine Bridge

The bridge is a great exercise to strengthen your hips, hamstrings, and lower back. Begin by lying on your back with your hips flexed and your feet lined up with your shoulders.  Perform the bridge by lifting both your hips from the floor.  A common mistake is to excessively arch your low back.  Hold the bridge position for 2 seconds then return to the starting position.  Lower the body back down in a slow and controlled manner.

Be sure to bridge by extending through your hips.  If you lack mobility in your hip joints or hip flexor muscles this will lead to compensation through your low back.  This can be corrected with manual therapy and mobility exercises.  You can also try bringing your feet slightly closer together and your knees slightly wider apart.  This will allow you to extend your hip easier.

Bird Dog

This exercise targets your hip and low back muscles.  Begin on your hands and knees with your back flat.   Your shoulders are directly over your hands and hips directly over your knees.

Slowly raise your left arm and right leg until horizontal with your trunk.  Maintain a straight line with your trunk, arms, and legs.  It is important to avoid trunk rotation and not allow your back to sag or arch.

Hold this position for 2 to 3 seconds.  Then repeat with the right arm & left leg, alternating sides with each repetition.  To increase the challenges of the exercise increase the hold time to 10 seconds. Perform 10 to 12 repetitions on each side for multiple sets.

Prone Back Extension

This exercise targets your erector spinae muscle of your middle and upper back.   Begin lying face down with 1 or 2 pillows placed under your stomach.  Place your arms, with palms down, along the sides of your body not touching the floor.  Lift your shoulders and chest away from the floor while keeping your chin tucked.   Maintain normal breathing while you hold this position for 5 to 10 seconds.  Perform 5 repetitions.

Prone Arm Lift

Begin lying face down with both arms elevated to shoulder level and your elbows bent.   Lift your arms away from the floor and pull your shoulder blades down and back.  It is important to keep your chin tucked to avoid over-stressing your neck.

Maintain normal breathing while you hold this position for 5 to 10 seconds.  Perform 5 repetitions.   This exercise targets the erector spinae muscle of your upper back along with your trapezius and rotator cuff muscles.

Wall Slide Exercise

This exercise targets the muscles of your upper back and shoulder blade.  Stand facing a wall with one foot slightly ahead of the other.  Place both forearms against the wall starting just below shoulder level.

Initiate the movement by sliding your forearms up the wall.  Fully extend your arms overhead.  Next, slightly lift your hands and arms away from the wall.  Be sure to avoid arching your low back as you lift away.  Instead, think about tilting your shoulder blades backward as you lift.   Pause at the top of the movement before returning to the start position in a controlled manner.

Help Getting Started with Osteoporosis Exercises

These are only 5 of many possible back strengthening exercises that help people with osteoporosis.  They target the upper and lower back, hips, and shoulder blade muscles.  These are the muscles that are important for maintaining an erect upright standing posture.

We recommend women over the age of 50 perform these or other similar exercises as part of an individualized preventative program.  Your physical therapist can help you determine the exercises that are best for you.  Call us if you would like help getting started.