To help you to remain vibrant, independent and healthy – manage osteoporosis and reduce fracture risk!

Exercise – for building strength

My field of expertise is in teaching exercise for people with osteoporosis, but I also firmly believe that eating a nutritious diet, having sufficient quality sleep, managing stress and maintaining happy social connections are equally important goals in the formation of a holistic bone health programme.

Regular exercise to maintain stability, balance and strength to reduce the risk of falling and therefore reduce fracture risk is so important. If we have a strong core and strong legs, we are more stable and less likely to fall. We will also be able to support our spine and remain upright in good posture. There are many exercises we can do to strengthen our core without having to bring our head and shoulders into forward flexion (sit ups). The latter is not advised for people with bone density issues.  There are however many people with osteoporosis who are and remain fit and active. I enjoy finding and teaching challenging exercises we can do safely like planks and side bridges with modifications and progressions if required.

The type of exercise we should be doing to maintain strong muscles and bones is strength and resistance. Muscles ‘pull’ on bone and encourage bone formation.  We need to stimulate and stress the bone to promote bone renewal and remodelling which we can do using weights (dumbbells or kettlebells), resistance bands, toning rings and of course weight bearing exercises like supported side plank, knee hovers and bridge variations. Impact exercise (appropriate to the individual) like heel drops, jumps, hops and dancing, racquet sports all play a vital part as ground force reaction. Our feet striking the ground helps to stimulate bone cells and the process of bone cell renewal.

Building awareness in how we use our bodies in everyday life is key. For example, everyday tasks that are part of daily life activities like putting on our trousers, shoes and socks, personal care tasks and carrying out household chores like loading the washing machine, are movements which involve bringing our spine forwards but we can learn how to do these functional activities safely and with ease.

Moving forward into spring, summer and autumn, activities like gardening which give people joy require lifting, carrying and bending, pushing and pulling movements. If this is not done correctly it can put additional stress on our spines because of top heavy posture so it’s important to learn how to move in a way that supports the ‘spine in line’ like a hinge movement, to distribute weight more smoothly and minimise risk.

Balance is an integral part of the Pilates programme. Everyday activities like walking up and downstairs, walking on uneven surfaces like pavements, getting on and off buses, require balance. We can practice a) standing on one leg with eyes open or closed b) reverse and forward lunges or split squats c) heel – toe walking and d) moving in different directions as part of functional exercise.

Nutrition – for Bone Health

Good nutrition is essential for maintaining strong, healthy bones throughout life. Calcium-rich foods, such as milk, yoghurt, cheese, fortified plant milks, leafy green vegetables, and canned fish with edible bones, provide the minerals needed for bone strength. Protein is also important because it supports the structure and maintenance of bones and muscles; good sources include eggs, chicken, fish, beans, lentils, tofu, nuts, and seeds. Vitamin D helps the body absorb calcium and can be obtained from oily fish such as salmon and sardines, fortified foods, and sunlight. Eating a varied, balanced diet containing these foods, along with plenty of fruit and vegetables, can help support bone growth, repair, and long-term bone health.

I try to source and eat a small amount of protein with each meal as its vital for growth and repair and makes up about 50% of bone volume. Recommended amounts seems to suggest we should consume 0.8 -1.1 g per kg of our body weight. The recommended amount of calcium in the UK is 1,200 mg of calcium for those with osteoporosis. However, our body can only absorb 500mg calcium at any one meal. Ideally, we should obtain most of the calcium from our food. If that is not possible then a good calcium supplement containing vitamin D3, K2, magnesium, and other trace minerals such as boron is a good idea.

Bones require minerals and protein to remain healthy and strong. Muscle is built when we combine adequate protein with strength training. Protein provides the building blocks. Exercise provides the signal to the body to use the protein blocks. Therefore, protein and strength training work best as partners. Strong muscles support strong bones!

Stress – Cortisol the Stress Hormone

A little bit of stress is perhaps good for us, it gets us up and going, but chronic stress is not good for our bones in the long run as it elevates cortisol, our main stress hormone. This is because high cortisol levels circulating in our bodies creates inflammation and we may get faster bone loss as inflammatory cytokines stimulate bone breakdown known as ‘resorption’. Cortisol inhibits osteoblast activity, the cells responsible for bone formation. Chronic stress causes bone deterioration.

Stress also inhibits calcium absorption in the intestines and excretes more calcium through the kidneys. Our adrenal glands which produce cortisol are situated above our kidneys and work overtime when we are anxious and stressed, stimulating our need to go to the toilet. We can lose and excrete calcium in our urine.

Incorporating stress reduction practices can help to mitigate the negative effects of stress. Breathing techniques, mindfulness practice, relaxation therapy , walking in nature and doing what brings you joy can be helpful and supportive to your body, mind and soul. Boundary setting and learning to say ‘No’ on occasions is something you might find helpful. Or can you learn to manage stress by letting go of things that no longer serve you?  One of the best things we can do is to take TIME TO BREATHE, to think clearly and take a step back.  Find your favourite restorative modalities to support your bone health!

At the end of my classes, I have on occasion included a guided visualisation or a muscle relaxation technique, but I have found that sound baths have recently become popular.

Sleep Health – Restorative Sleep

There are many reasons that so many of us do face sleep issues like disruptive sleep patterns, insomnia in our lives and struggle to get enough sleep. Like so many other people, hormonal changes and transitioning through menopause can affect us too.  Stressful episodes at work, within the family, relationships, worry and hardship, physical pain and an inability to control our stress responses all impact our sleep too.

Social media, podcasts, books with hints and tips, TV programmes and Apps on how to get and advise on achieving restful sleep are readily available.

We understand why sleep should be prioritised particularly for bone health as its during sleep that our bones renew and repair. If we don’t get enough sleep according to one clinical trial done in the UK, we lose bone faster. This same trial concluded that sleep problems account for 17% of fractures. Insufficient sleep affects our coordination, our ability to focus and think quickly and therefore our risk of falling or stumbling is increased. There are many remedies we can try to support our sleep at night.  Herbal teas containing herbs such as valerian, lavender, chamomile and hops may work for some. Many sources I have come across reference a supplement called magnesium glycinate half an hour prior to going to bed as this form of magnesium is proven to have a calming effect, conducive to relaxation.  Nonprescriptive over the counter herbal supplements are also available.

Other recommendations to ensure a good night’s sleep advise ‘electronic and device screen free areas’ in the bedroom, absence of harsh lights etc, maintaining a cool, dimly lit bedroom at night.   Some people may find muscle relaxation techniques or gentle stretches prior to bedtime helpful.

One recommended piece of advice I like is to walk outdoors in the early morning sunlight to build up healthy serotonin levels which help to create melatonin the sleep hormone at night. It is a good idea to boost our circadian rhythm when outdoors in the early morning light as this helps to manage and regulate our sleep pattern. Aiming for around 7-8 hours of sleep time  is optimum but perhaps not less than 6 hours a night on a regular basis. Establishing a regular sleep pattern of going to bed and getting up at the same time every day is recommended.

Social Connections – for Bone Health

Social connection is an important, yet sometimes overlooked, part of a holistic approach to bone health. Maintaining regular contact with others can support emotional wellbeing, motivation and healthy lifestyle habits, while reducing the loneliness and isolation that can sometimes accompany ageing. Being active and socially engaged may also encourage us to keep moving, whether through walking, exercise classes, hobbies or simply meeting friends for a coffee.

Meetup groups, available in many cities and towns across the UK, provide a great way to discover local activities and meet people with similar interests—from walking and fitness groups to book clubs, dancing, crafts and social gatherings. Building and maintaining meaningful connections can therefore complement good nutrition, weight-bearing exercise, strength training and other aspects of bone health, helping us to stay active, confident and connected throughout life.

In Summary

 In summary, a comprehensive bone health programme integrates targeted exercise, good nutrition, stress management, restorative sleep, and safe functional movement. This holistic framework helps you to remain active, independent, and healthier over the long term.

References:

Fracture Proof your Bones by Dr John Neustadt

Practical Regeneration – Paul Lee