Let’s clear something up first
Osteoporosis and osteoarthritis. Two very different conditions, but two conditions that get mixed easily.
So before we go any further, let’s sort out the difference.
Osteoarthritis is the normal, age-related wear and tear that happens where bones meet to form a joint. It can cause pain, stiffness, reduced mobility and a poor range of movement if it isn’t managed well.
Osteoporosis, on the other hand, is the thinning of the bone structure itself, which means bones become more brittle. On its own, it doesn’t cause pain and it doesn’t cause falls. What it does mean is that if someone with osteoporosis were to fall, they’d be far more susceptible to fractures, simply because their bones aren’t as strong.
Make sense? Good. Now let’s talk about how to manage it.
Why “prehab” is the key to confidence
The first thing we’d say about managing osteoporosis is just how important “prehab” is, and what that does for your confidence.
If you’ve put the work in with your strengthening, you can be confident you’ve done everything within your power to “fall-proof” yourself. That doesn’t guarantee you’ll avoid a fracture if you do fall, but it does mean you’re far less likely to fall in the first place.
Here’s what we mean:
Picture someone who spends most of the day sitting in their chair, worried about falling. The longer they sit, the more muscle mass they lose, and the more frail they gradually become. So when they do get up to walk to the kitchen, they’re unsteady on their feet and much more likely to fall.
Now compare that with someone who’s active, goes for a few walks a day, and follows a strengthening programme 3-4 times a week (whether that’s in the gym or at home). This person is stronger, their bones are less brittle, and they’re far less frail and far less likely to fall. And with that comes a renewed confidence, not just in their body, but in themselves.
So what should I actually be doing?
So much of the research these days points towards strength training for pretty much every condition, and osteoporosis is no different.
Whether you’re a seasoned gym-goer or you’ve never lifted a weight in your life, there’s no better time to start than right now.
We know strength training can sound a bit daunting, so let’s simplify it.
Strength training = training against any kind of resistance. That could be bodyweight work like squats, lunges or push-ups, all the way up to deadlifting 100kg. Gravity, your bodyweight, dumbbells, resistance bands… resistance is resistance.
So strength training doesn’t have to mean hours in a gym if that’s not your thing. A home-based programme can be just as effective, as long as you’re working against some form of resistance.
Progressive overload (and why pacing matters too)
A key part of any strengthening programme is progressive overload. You’ll hear this term a lot in resistance training, and it’s especially important for bone health in osteoporosis.
In simple terms: for your strength to grow, the resistance you’re working against needs to gradually increase alongside your capabilities.
But as important as progression is, so is pacing.
Yes, we want to gradually increase the resistance, but “gradually” is the key word. Too much, too soon, is a recipe for other soft tissue injuries.
It’s important to chat with your physio and/or personal trainer before starting a strengthening programme, so they can make sure it’s right for your body and what it’s currently capable of.
How can we help you?
There’s a lot more we could say about osteoporosis, but we wanted to keep this as a general overview with a few key takeaways you can come back to.
If you’ve got questions about managing your condition, or want to give yourself the best chance of staying injury-free and continuing to do what you love, why not book an appointment with us to chat it through? You can then join a Pilates class or a strength and conditioning or continue on your own at home following our guidance.
Darren Knox, specialist musculoskeletal Physiotherapist, Border Physio
