Osteoporosis is a medical term most of the adult population will have heard of. Many will associate the word with problems to do with bones, and a smaller percentage will understand its manifestation within the body.

As a fitness professional, I'm aware of how the risk of its hallmark characteristic of ‘brittle bones’ can increase with lack of exercise.

I am no medical expert however, so take it upon myself to learn about osteoporosis in greater detail so I am armed with the knowledge when discussing its complications with fitness clients.

This week I saw me catch up with my friend and colleague Mr Sikandar Iqbal, Orthopedic Surgeon based in London.

Mr Iqbal, who specialises in bones and joints, kindly simplifies the terminology in order to give me a clear overview of osteoporosis and how exercise can be used to inhibit the onset later in life.

“Osteoporosis is not a disease, it’s a condition that makes bones so weak, they’re at risk of developing fractures,”

The surgeon then details how osteoporosis is a silent condition that will not usually present obvious symptoms. Having osteoporotic bones may not have any direct bearing on day to day life, therefore sufferers will not necessarily know they have it until something occurs that raises concerns that their bones are prone to fracture.

As a condition that is not routinely screened for in the UK, I ask Mr Iqbal to explain a typical patient scenario that may raise concerns in their GP.

“A simple fall may break something like a wrist or hip bone, which subsequently causes pain and may alert the doctor to a possible underlying case of osteoporosis. Osteoporosis would present itself as a complication rather than with any specific symptoms. The nature of the bone break would suggest the bone to be osteoporotic and weak.”

Another scenario might be the onset of back pain, where an X-ray would reveal a collapsed vertebra that has crumbled under a minor pressure. An acute back pain would the symptom and osteoporosis would be the cause of the vertebral collapse.

We discuss the main contributing factors for the onset of osteoporosis, which include diet missing vital calcium and vitamin D3, gender, the natural ageing process, environmental factors including lack of exposure to the sun, and insufficient physical activity.

“Bones need calcium to grow and develop, calcium is metabolised in the bones, therefore a lack of calcium in the diet is the major contributory factor in the onset of osteoporosis.”

Natural food sources such as milk and other dairy products, meats, fruits and vegetables along with certain fortified breads and breakfast cereals; all offer calcium in varying degrees along with other essential nutrients.

Vitamin D3 we can get from the sunshine so a stroll in the park on a sunny day helps promotes good bone health along with other health benefits.

Supplementation of calcium and vitamin D3 is recommended for those with restricted diets or poor metabolic function.

Gender plays a huge part. Up to the age of 70, women are 10-15 times more likely than men to develop osteoporosis than men, after which age the risk is fairly equal. This is owing to the hormonal changes in women during and after the menopause.

Women of menopausal age, typically 45 to 55, have the greatest possibility of suffering from osteoporosis owing to the dramatic hormonal shifts at this stage of life.

Reaching old age is another major factor as ageing typically brings about a slowing down of physical activity. This is owing to the body naturally being more tired and other health problems often developing, which cause individuals to be less active than they were their youth.

“If you’re sedentary, you’re at risk of losing calcium from the bones, which leads to osteoporosis. Exercise therefore plays an important role. It does not abolish the risk however it would be fair to say that the more mobile you are, the risk of developing osteoporosis would reduce to some extent.”

We talk about how exercise specifically plays its part in musculoskeletal health.

The physical activity keeps the bones mobilised at their joints, strengthens the bones themselves and increases the rate of the metabolism of calcium within the bones.

“Any physical activity would help reduce the risk of osteoporosis, therefore doing any exercise for 30-60 minutes per day is sufficient.”

The type of activity recommended should be appropriate to the age of the person, taking into consideration any pre-existing medical conditions and current fitness level.

Activities such as resistance training, swimming, cycling, dancing, walking, tennis and golf are popular choices.

There is hope for existing sufferers, as an established osteoporosis can be safely treated with medication.

“There are injectable medications that can be given to reverse osteoporosis,” explains the surgeon. “It does not make the bones go back to exactly how they were, but it helps make them less brittle and weak.”

As with everything to do with maintaining our good health, prevention is better than cure. It is therefore recommended that we all take an informed approach to daily life, with a good diet containing calcium and vitamin D3, exercise and awareness in order to try and prevent this silent but significant condition having a detrimental effect to our wellbeing.

With thanks to Mr Sikandar Iqbal, Consultant Orthopedic Surgeon FRCS

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