Exercise and Bone Health

Date: August 17, 2009

Expert: National Osteoporosis Foundation (NOF)

Q: What is the best form of exercise for FM patients to do to improve osteopenia? Impact work, like weightlifting and/or jump rope, is out of the question. (I only work out in a pool—great for muscles, not so great for the bones.)
A: People with low bone density, which is also called osteopenia, have an increased chance of getting osteoporosis. Physical activity and exercise can help keep bones strong and healthy. People who are confined to bed or who are very sedentary are at increased risk for osteoporosis. To keep your bones healthy, you should exercise about 30 minutes a day. If that’s too much, aim for at least 21/2 hours a week. It’s best to set a goal and gradually work towards it.

People with fibromyalgia may tolerate shorter exercise sessions more easily. For example, instead of exercising for 30 minutes at a time, try 3 sessions for 10 minutes each. This provides the same bone benefit as one 30-minute session. If you haven’t been exercising, start out slowly and gently. Also, start with shorter sessions, even if each is just a few minutes at a time. Then increase the length of the sessions as you are able to handle more exercise. Try to make exercise part of your routine every day to benefit your bones and overall health.

Two types of exercises benefit your bones. They are:

• Weight-bearing exercises. These include high- and low-impact exercises. Low-impact exercises may be more suitable for people with fibromyalgia. Examples are walking, low-impact aerobics and exercising on cross-country ski machines, elliptical training machines, stair-step machines and treadmill walking. Examples of high-impact exercises are dancing, high-impact aerobics, hiking, jogging, jumping rope and playing soccer and tennis. Weight-bearing exercises can be done every day.
  
  
• Muscle-strengthening exercises. These are also called resistance exercises.
  Examples are lifting weights, using elastic exercise bands, lifting your own body weight or using weight machines. Pilates and yoga are also muscle-strengthening exercises but may need to be modified for safety. These types of exercises are usually done two to three days a week. You can create resistance in the pool by using discs or cuffs on the wrists and ankles, or barbells or webbed gloves for the hands. This increases benefits to the muscles and bones as you move through the water during your pool exercises.

Although swimming and biking are good for overall health, they do not provide much of a bone benefit. One way to add physical activity to your day is by taking the stairs. Even if you can only walk down the stairs, it benefits your bones. Try parking farther from the store or your office, or add a walk after a meal.

People who have osteoporosis should check with their doctor or other healthcare provider before beginning a new exercise program to make sure it’s right for them. A healthcare provider may also recommend seeing a physical therapist to learn exercises that are safe and appropriate.