What Types Of Exercises Should I Do, And How Often?

If you have been leading a sedentary lifestyle, start an exercise program after you have discussed it with your clinician. Then, start by changing your attitude first. Do small things that will change your activity level.

Park your car further away from your destination than you usually do. Take stairs instead of elevators (do this gradually—stairs can be very tough if you’re out of shape). Walk more briskly than usual while shopping. Take a short walk after lunch instead of eating an extra cookie.

There are two types of exercise that can help to improve your bone health: weight-bearing and resistive. Weight-bearing exercises are those that literally require supporting or carrying weight and include walking, running, aerobics, hiking, stair climbing, dancing, tennis, jumping rope, and kick-boxing, among others. Basketball, soccer, jumping rope, and hiking, while good exercise, can cause more falls due to the likelihood of contact with other players or slipping.

Kick-boxing can pose risks for fractures with contact as well. Due to these risks, kick-boxing, basketball, soccer, jumping rope, and hiking may not be the best choices for people with osteoporosis.

If you have access to snow, cross-country skiing and snow-shoeing are also excellent weight-bearing activities. Resistive exercises mean that you are pushing or pulling against weight or force; thus the activity causes resistance to your muscles and bones.

Resistive exercises include activities like swimming, biking, cycling, stationary biking, Pilates, tai chi, yoga, rowing, canoeing, and weight-training. Regular swimming and street biking by themselves are not effective for strengthening bone. However, continually increasing resistance while swimming or biking and coupling these activities with other exercises that increase stress or load will strengthen bone.

In order for exercise to be effective, you must provide more “load” than your bones are accustomed to carrying. So, for weight-bearing exercise, you must continually increase the duration or the amount of impact of the exercises. For resistive exercises, you should continually, but gradually, add resistance: increase the weights that you lift; increase the resistance on your stationary bike; or swim longer, use water barbells, or do more vigorous water exercises.

Once you stop exercising, the benefits to your bones stop as well. You will begin to lose bone mass with a measurable decrease in bone density in as little as 1 month. Remember, all physical activity is still good, though, whether its effects build bone, strengthen muscles, improve flexibility and balance, enhance mood and self-esteem, or help you to sleep better.

There is ongoing debate in the scientific community about how much and how often exercise must be done in order to be effective. There is general agreement that 30 minutes of exercise three times per week is the mini-mum required to maintain bone integrity. However, the latest dietary guidelines from the United States Department of Agriculture (USDA) and the United States Department of Health and Human Services (DHHS) advise 60 minutes of moderately vigorous exercise daily or most days in order to maintain good overall health. But don’t overdo it! Running for more than 5 hours per week has been related to lower bone mass, and any exercising that leads to amenorrhea (absence of menstrual periods) should also be avoided.

If you are unable to tolerate weight-lifting or do not have access to weights at a gym, there are chair exercises that you can do. Appendix A shows some of the exercises that you can do without having to go to a gym. If you have access to a stationary bike, you can use this as resistive exercise, at least for your legs. Some stationary bikes have handles that allow you to push your arms back and forth while cycling, providing resistance to your arms and upper body. It is important to increase the resistance setting over time to increase the load on your muscles and bones.

Before you engage in a new exercise program, it’s important that you consult your clinician, particularly if you have recently been diagnosed with any new illness or condition, or have been placed on new medication. Even though you may be enthusiastic about changing your activity level, it’s important to change your level gradually.

If you have never been on a treadmill, don’t start your new routine by trying to run miles at a time. You should not jump into a weight-training program by lifting excessive weight or doing too many repetitions. You will end up sore and discouraged. Start out slowly but maintain a consistent schedule. Commit to exercising at least 3 days per week. You should not weight-lift 2 days in a row. Your muscles need time to rest between sessions.

Remember that exercise without getting enough calcium and vitamin D will not help your bones (see Questions 47–51). Similarly, exercise must incorporate both weight-bearing and resistance to help strengthen bone. Exercise works best to increase bone density for women when you are premenopausal or if you are taking estrogen. But that is not to say that you shouldn’t exercise if you are postmenopausal and not taking hormones. In fact, the results of the Nurses’ Health Study showed that walking 8 hours per week was comparable to taking hormones to protect against fractures in postmenopausal women.

If you have kyphosis (see Question 85), there are some exercises that you can do to reduce the amount of curve you have as well as strengthen the muscles around your spine. The goal is to do exercises that extend your spine and strengthen your abdominal, erector, spinal, and scapular muscles. Question 85 discusses which exercises can help you, and Appendix A contains appropriate exercises for strengthening your muscles.

Marjory’s comment:

Water aerobics is a wonderful form of exercise. Even before my knee replacements, water took away almost all of the pain. Although I needed to take anti-inflammatory medications for pain, I was really quite comfortable in the water. Now I go to my water aerobics class 4 times per week. We do cross-country ski movements, jumping jacks, rolls, and knees-to-nose exercises, all in deep water wearing a flotation belt. There is no jarring on my joints, and a warm water pool feels great. I am not able to do any kneeling when it comes to exercise, so exercise in the water fits with what I’m able to do. We do exercises to help our back muscles get strong so that we can have straighter backs, too.

Water aerobics is also a social activity because the instructor makes sure we all know each other by first names before she gets started with the class, where we only see one another from the neck up. Then when we see each other in the grocery store we raise a few eyebrows from onlookers by saying, “Oh, I didn’t recognize you with your clothes on!”