People with fragile bones urged not to be ‘fear of exercise’


Experts say people with weak bones shouldn’t be afraid to exercise regularly.

There are no UK guidelines on exercise and osteoporosis, with some expressing a ‘fear’ of exercise.

But experts say strengthening muscles and other physical activities can preserve bone strength and reduce the risk of falls.

A new paper sets out a consensus statement on the topic from academic experts led by experts from Loughborough University.

Inactivity should be avoided, physical activity encouraged, and comfort provided to eliminate fear of movement

Key recommendations in the paper published in the British Journal of Sports Medicine include:

– People with osteoporosis should engage in resistance and impact exercise to maximize bone strength—ideally two to three days a week.

This should include “progressive muscle resistance training” and should target all muscle groups.

Daily physical activity is recommended throughout the day while avoiding prolonged sitting.

– People with osteoporosis should also engage in activities that improve strength and balance to reduce falls – this may include tai chi, dance, yoga and Pilates.

This type of exercise should be done twice a week to reduce the risk of falls.

For those who have already fallen, exercise interventions to prevent falls should be tailored by local fall services so that individuals do not increase their risk.

– To reduce the risk of vertebral fractures, improve posture, and manage the symptoms of vertebral fractures, people with osteoporosis should participate in exercises to improve back muscle strength to aid posture and support the spine.

But any exercise that causes excessive back flexion, especially with added loads, should be modified or avoided.

– Osteoporotic patients with vertebral fractures should be referred to a physiotherapist and given “just in time” advice on mobility and weightlifting to “reduce fear and preserve mobility and function”. This may include daily exercises to strengthen muscles.

People with osteoporosis should be encouraged to do more, not less

At the same time, the authors write, spinal extension exercises can improve posture and may reduce the level of pain caused by vertebral fractures.

They write: “Physical activity and exercise play an important role in promoting bone strength, reducing the risk of falls, and managing vertebral fracture symptoms, so they should be part of a broad approach that includes other lifestyle changes and, where appropriate, combined with drug therapy.”

“People with osteoporosis should be encouraged to do more, not less.

“This requires professionals to take a proactive and encouraging approach, focusing on ‘how to’ messages rather than ‘don’ts’.

“While specific types of exercise may be most effective, even minimal activity should provide some benefit.

“The evidence shows that physical activity and exercise are not associated with major injuries, including vertebral fractures; in general, the benefits of physical activity outweigh the risks.

“Professionals should avoid restricting physical activity or unnecessary exercise … as this may hinder exercise or activities that promote bone and other health benefits.”

“Most importantly, inactivity should be avoided, physical activity encouraged, and comfort provided to eliminate fear of movement, which may adversely affect bone strength and health/quality of life more broadly,” they added.

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