Understanding osteoporosis

Osteoporosis, derived from the Greek words for “porous bones,” is a chronic
condition characterised by a reduction in bone mineral density. It occurs when bones
lose minerals, such as calcium, at a faster rate than they can be replenished, leading
to compromised bone structure and increased fragility, making them more prone to
fractures. When bone density decreases but doesn’t reach the level of osteoporosis,
the condition is termed osteopenia.

Risk factors

While osteoporosis and osteopenia can manifest at any age, they are more prevalent
in older populations. In females, the prevalence of osteoporosis rises from around
age 45 to 54, while in males, it typically increases from about 55 to 64. Several
risk factors contribute to osteoporosis, including low levels of vitamin D and calcium
intake, lack of physical activity, excessive alcohol consumption, and smoking.
Additionally, certain medical conditions and medications, such as long-term
corticosteroid use and reduced oestrogen levels, can impact bone health.

Prevalence and impact

Osteoporosis significantly increases the risk of minimal trauma fractures, which are
relatively common among individuals aged 50 and older. Statistics from the most
recent national health survey conducted by the Australian Bureau of Statistics (ABS)
reveal that 924,000 individuals self-reported having osteoporosis or osteopenia.
However, due to the silent nature of the disease, it is estimated that the real number is more than 1.2
million Australians. Annually, osteoporosis incurs a cost of over $3.82 billion to
Australia, with a substantial portion of this attributed to the more than 183,000 bone
fractures it causes each year. With an aging and increasingly sedentary population,
these numbers are expected to rise.

Prevention strategies

Despite its prevalence, osteoporosis is largely preventable through various measures.

Primary prevention involves dietary supplementation to ensure adequate calcium
and vitamin D intake, along with lifestyle modifications such as regular weight-
bearing and resistance exercises, limiting alcohol consumption, and refraining from
smoking. Physical activity, in particular, is highly effective in counteracting many age-
related health conditions, including osteoporosis.

How much exercise is enough?

The Australian Government Department of Health recommends that adults engage in
physical activity most days, ideally daily. This includes either 2.5 to 5 hours of
moderate-intensity physical activity, 1.25 to 2.5 hours of vigorous-intensity physical
activity per week, or a combination of both. Muscle-strengthening activities should
be incorporated at least twice a week. For individuals aged 65 and over, at least 30
minutes of moderate-intensity physical activity on most, preferably all, days is
advised. Starting with any level of physical activity and gradually increasing towards
the recommended amount is encouraged.

What type of exercise should I be doing?

Regular exercise, particularly resistance training, is widely advocated as an effective
non-pharmacological approach to improving and maintaining bone mineral density
while reducing the risk of falls. The mechanical loading induced through resistance
training stimulates various mechanisms supporting bone health and may help
improve bone mineral density and prevent the development of Osteoporosis.

Unsure where to start?

At CSSM we can help by formulating a plan, including corrective exercises, to
enhance bone health and address any injury concerns or physical limitations to keep
you moving. Additionally, CSSM provides exercise classes such as Pilates and
PIER, allowing you to complete structured exercise programs under the
guidance of one of our healthcare professionals.

About the author 

Osteopath Eliot Hird enjoys treating neck and shoulder issues as well as sporting injuries and the rehabilitation of those injuries, helping people get back to their sport or hobbies.

Eliot believes everyone should be able to participate in the sport or activity that they enjoy and finds being able to help a patient get back to the activities that they enjoy through injury management or education is one of the more rewarding aspects of being a health professional.

Away from the clinic, Eliot enjoys training in the gym doing a mix of strength training, CrossFit and Brazilian Jiu Jitsu. On the weekends, you’ll find this Essendon fan watching AFL and the UFC.

References

About osteoporosis. Healthy Bones Australia. (2023, September 12).
https://healthybonesaustralia.org.au/your-bone-health/about-osteoporosis/

Bae, S., Lee, S., Park, H., Ju, Y., Min, S.-K., Cho, J., Kim, H., Ha, Y.-C., Rhee, Y., Kim, Y.-
P., & Kim, C. (2023, May). Position statement: Exercise guidelines for osteoporosis
management and fall prevention in osteoporosis patients. Journal of bone metabolism.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10345999/

Chang, C.-F., Lee, J.-I., Huang, S.-P., Geng, J.-H., & Chen, S.-C. (2022). Regular exercise
decreases the risk of osteoporosis in postmenopausal women. Frontiers in Public
Health, 10. https://doi.org/10.3389/fpubh.2022.897363

Chronic musculoskeletal conditions : Osteoporosis and minimal trauma fractures. Australian
Institute of Health and Welfare. (n.d.). https://www.aihw.gov.au/reports/chronic-
musculoskeletal-conditions/osteoporosis

Healthy Bones Australia – 2022-23 pre-budget submissions. (n.d.).
https://treasury.gov.au/sites/default/files/2022-03/258735_healthy_bones_australia.pdf