Muscles attach to bones and apply stress to them to produce movement. This stress helps build your bones. If you don’t use your muscles, stress isn’t applied to your bones and they become weaker.
Goals of exercise
Exercise has many benefits. It can help you:
- prevent falls by improving your balance, mobility, muscle strength and posture
- move safely and protect your spine
- strengthen your back extensor muscles
- improve posture by stretching muscles
- prevent further bone loss through muscle strengthening and weight-bearing dynamic exercise
Exercise tips
- Be active daily to surprise your bones with a variety of light, safe activity.
- Hinge forward at your hips when lifting and bending (buttocks out and knees bent).
- Keep your core strong with planks, bridges and exercises on your hands and knees.
- Engage your pelvic floor during exercise.
- Breathe rhythmically, inhaling before you move and then exhaling during the movement. Never hold your breath.
- If sitting, stand up every 30 minutes.
- Move your feet when you turn so you don’t twist your spine.
Spine sparing
It is important to keep your spine properly aligned during activities. You can modify exercises that flex or twist your spine.
You should limit movements that are rapid, repetitive, weighted while bending forward or twisting to the side.
Types of exercise
The following types of exercises should be included in a comprehensive exercise program. (as suggested by Osteoporosis Canada).
Strength training
These exercises use resistance (your body weight, bands and weights) to strengthen your legs, arms, chest, shoulders and back.
Strength training should progress gradually, starting with light weight, to avoid injury while still challenging the muscles.
Frequency
Two or three times per week
Allow 48 hours between exercises to allow the muscle to recover.
Repetitions
Aim for 10 – 20 repetitions.
Doing low repetitions with a weight that challenges your muscles is better than high repetitions with a weight that is too light.
Balance training
Balance training involves static and dynamic exercises.
Static exercises challenge you to stand with a narrower base or on an unstable surface. Dynamic exercises include walking activities, tai chi, dancing, etc.
Frequency
Daily for 15 – 20 minutes
Posture awareness
Posture exercises help you improve your stability and prevents you from stooping.
Frequency
Daily
Endurance training for back extensor muscles
When training your back extensors:
- use a pillow during supine (lying on your back) exercises if your spine is curved
- unload the spine during the day by lying on your back
- alignment during exercises is as important as the intensity
Frequency
Daily for five to 10 minutes per day
Repetitions
Perform holds for three to five seconds
Aerobic exercise
These are often weight-bearing exercises (such as walking, stairs, cross-country skiing and dancing) done at moderate to vigorous intensity (effort).
If you have a spine fracture, these exercises should be moderate intensity, taking extra care to have good alignment.
Frequency
30 minutes per day, five days per week (total of 150 minutes of moderate activity per week or 75 minutes of vigorous activity per week)
You can break sessions up into 10 minute sessions three times in one day if 30 minutes of continuous exercise is too much.
Precautions
Do not add high-impact exercises to your routine if you haven’t already been doing them. Consider seeing a BoneFit physiotherapist before going to the gym or doing exercises with weights.
Always be careful when lowering heavy objects from overhead or picking them up from the floor.
Exercising with a spine fracture
If you have a spine fracture, consult with your physician before resuming exercises or heavier activities. Choose positions that place as little stress on your spine as possible. These include:
- lying on your back or standing (rather than exercises where you are sitting)
- focusing on alignment during exercise more than intensity
Movements to limit and reduce
Limit
You should limit repeated, sustained, weighted and end range movements such as:
- flexion
- rotation
- side bending
Reduce
You should reduce flexed, slouched and rotation postures during your everyday activities and work.
Bone mineral density
Consider your bone mineral density test results and your risk of fracture when choosing activities.
Low risk 10% risk of fracture in the next 10 years | Moderate risk 10 - 20% risk of fracture in the next 10 years | High risk More than 20% risk of fracture in the next 10 years |
|---|---|---|
| Consider higher-impact, higher-intensity exercises. | Reduce impact activities | Do not perform high-risk activities (avoid activities with a risk of falling). Make sure you always have at least one foot on the ground during activities. |
| Perform weight-bearing activities | Perform weight-bearing activities | Perform less intense weight-bearing activities (intensity should be equal to brisk walking) |
| Use spine sparing strategies | Use spine sparing strategies | Use spine sparing strategies |
Positioning for exercises
How to safely get down to the floor
Getting down to the floor to exercise allows you to strengthen and stretch the muscles that will improve your posture.
Use a carpeted surface or yoga mat when exercising on the floor. If you cannot safely get down to the floor, you can also lie on a firm bed.
- Face a stable chair, putting your hands on the arm rests.
- Come down onto your knees, one knee at a time.
- Back your knees up, placing your hands on the floor
- Guide yourself down onto your stomach, then onto your side.
- Bend your knees and roll like a log onto your back.
Positioning on the floor
Once you are on the floor, you need to have proper support for your head and neck.
- Find a neutral position for your chin. If your head tilts back, use a pillow or layers of towels so your chin is parallel to the floor. Avoid using a thicker pillow or towels than you need.
- Place your arms comfortably by your sides, palms up.
- Keep your knees bent, with the soles of your feet on floor.
Getting in and out of bed (log roll)
Getting into the bed
- Sit on the edge of the bed.
- Using your arms, lower yourself down so you are lying on your side.
- Once you are on your side, roll onto your back. Make sure your knees stay bent so you roll your whole body as one unit. Your shoulders, pelvis and knees should all roll together.
Getting out of bed
- Bend your knees and roll onto your side.
- Reach your arm across your body to start rolling. Your shoulders, pelvis and knees should all roll together.
- Once on your side, use your arms to move into a sitting position.
