It’s no secret.
I’ve never loved going to the gym.
All that sweat and Lycra and too loud music. It gives me a headache just thinking about it.
Give me a quiet trail filled with sunlight and birdsong any day, and I’ll keep walking from dawn to dusk.
But sometimes needs change despite our personal preferences.
I’ve been going to the gym twice a week for the last couple of years.
At first, it was to overcome injury.
Then it became more about building strength and balance.
Now, there’s an even more important reason.
Osteoporosis. Yikes!
My Dad had terrible osteoporosis that left him unable to stand upright, unable to lift his head to see more than people’s feet.
Being of slender build, I’ve been aware of the need to monitor my bone density, particularly after traversing menopause when women quickly lose bone mass to the tune of 10% over five years. Twenty percent in some cases.
I’ve stayed in the osteopenic range for years – thinning bone, but not yet osteoporotic.
Or so I thought.
Fast forward and an X-ray ordered for an unrelated condition revealed a compression fracture in my thoracic spine.
The DEXA was insufficient to pick this up as it only looks at hip and lumbar spine.
Did you know that 50% of post-menopausal women over the age of 60 will experience at least one fracture due to osteoporosis.
I never imagined that would include me.
Hurrumpf.
It’s time to get serious about rebuilding bone.
Osteoporosis is a significant health challenge which unchecked can contribute to fragility fractures, loss of independence and lower quality of life. This is not something I want for my future.
Fortunately, we now have (apart from medications) some good evidence-based research that shows how non-pharmacological interventions can play a valuable role in improving balance, strength and bone density.
#Lifestylemedicine in action!
Studies from Griffith University have shown that post-menopausal women and older men with low bone mass can safely undertake high-intensity resistance training with proven benefit.
Lifting heavy weights stimulates bone to adapt, initiating remodelling and bone growth.
You can find out more about the specific exercise training program here.
In my gym session earlier this week, I noticed a lady of similar age and build to myself undertaking a serious session of lifting weights.
I asked her how long she’d been doing weightlifting. Eighteen months, she told me, and then, with a huge smile on her face, volunteered the information on how this has reversed her osteoporosis back into the osteopenic range.
Wow!
This is where the rubber (or should that be weights?) need to hit the road.
Let’s look at what the options are for treating osteoporosis in women.
1. Lifestyle factors
- Weight bearing exercise.
Put a load on your bones by walking, jogging, running, jumping, skipping, dancing, playing tennis and weight training.Stomping is a particular exercise I learnt from Anna-Louise Bouvier. Anna-Louise is the founder of Physiocise and a regular guest on Richard Glover’s ABC Radio Show in Sydney. She advocates stomping forward with both feet, then taking one step back and repeat.Let’s get stomping!
Weighted vests have become popular with many people choosing to wear them for all their activities and not just during exercise. 5 kgs is plenty. You’re not training for the Olympics.
Pick an exercise you’ll like doing. I love hiking but the choice is yours. The main thing is to commit to making it a regular activity and something you look forward to. Keep Fit, anyone? Sadly, swimming, kayaking and cycling don’t count here – even though they are good forms of exercise, because you’re not getting the weight-bearing aspect.
The aim is a minimum of 150 minutes of moderate intensity exercise a week. I find it easier to aim to do something every day for 20-30 minutes, so it becomes part of your daily routine.
- Strength training.
Strong muscles build stronger bones. Start low and build up. There are no brownie points for injuring yourself. Press ups, lift ups are all helpful Talk to your friendly physiotherapist or exercise physiologist to determine what’s right (and safe) for you.
- Balance exercise.
Good for posture and balance, so walk tall and reduce your risk of falls. Can you “do the flamingo?” Raise one knee so your thigh is horizontal to the floor and stand still on the other for a count of 10. Got it? Now repeat while raising one arm straight above your head. Do this 10 times on each leg twice a day to start with and your balance will improve astronomically.
- Diet.
Eating a diet with plenty of calcium rich foods, think dairy (milk, cheese including Parmesan, yoghurt), leafy green vegetables, broccoli, fish (salmon, sardines), beans and lentils, almonds, seeds, (chia, sesame, poppy) figs, edamame and tofu. We need around 700 mg of calcium a dayOne easy way to get more calcium is to make your own muesli and toss in a selection of seeds and nuts, add a dollop of yoghurt and/or kefir (I have both) and top with some delicious berries for their antioxidants.Ensure you get enough vitamin D through safe sun exposure (10 minutes is often enough in Australia) but remember vitamin D levels tend to decline with age. If you’re found to have a low level, take a supplement. Vitamin D is also found in oily fish, red meat, live, egg yolks and fortified foods
Watch your alcohol intake because it can interfere with calcium absorption.
And while tobacco isn’t a food, smoking is associated with an increased risk of osteoporosis.
2. Medication
a) Bisphosphonate.
This medication slows bone loss, improves bone density and reduces the risk of fractures. As tablets these drugs are taken either weekly or monthly or there is an annual intravenous infusion option.
b) Denosumab.
This medication also works to slow bone loss, improve bone density and reduce fracture risk. It’s given as a 6 monthly injection. The main issue being that a missed dose can lead to rapid bone loss.
c) MHT (Menopausal Hormone Therapy).
Typically, this is used in women under the age of 60 who have osteoporosis and need treatment for symptoms associated with menopause or have experienced early menopause (before the age of 45) or who are under 60 and unable to take other forms of osteoporosis medication.
d) SERMS (Selective Oestrogen Receptor Modulators)
This acts in a similar way to oestrogen to slow bone loss and reduce the risk of spinal fractures in post-menopausal women.
Even if medication has been prescribed, it’s still important to seek ways to keep your bones and muscles strong with lifestyle interventions.
Right now, I’m on a mission. To revert my osteoporosis to osteopenia by focusing on my gym and weight sessions and ensuring I get a calcium-rich diet. I’m also on medication (for the time being). It’s not going to happen overnight, but consistency will get me there.
No, I don’t love the gym, but I do love knowing that doing the work and lifting those weights are fundamental to my future bone health and that’s something I’m willing to commit to.
What about you?
Have you been able to use exercise to improve your bone density after menopause?
I’d love to hear your experience.
