In Part 1 yesterday I introduced you to osteoporosis and how it impacts on people, both the physically active the more sedentary. Here in Part 2 I take you further into this condition and what can be done in terms of prevention and coping with its onset… 

In this section for physically elite/fit senior, I will be discussing prevention from Osteopenia which will become osteoporosis if nothing is done.

This section will be discussing ways to improve bone mineral density as it applies to athletically fit older seniors.

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Fitness/Wellness program:

The American College of Sports and Medicine (ACSM) recommends 1 set of 15 repetitions of 8-10, exercises performed at least 2 days per week at an intensity of 50% or 1-rm²⁵.

After 3-4 months; a progression of 2-3 sets and an increase of intensity to 70% of 1-rm² can be made⁵.

This type of progression is a safe way to ensure that the athlete can increase bone mineral density and cause a reduction of the risk of developing osteoporosis without risking potential fractures²⁵.

Examples of types of resistance training:

– free weights

– circuit training on weight machines such as leg press, knee extension, lat pull down, and chest press

– body weight exercises such as squats and lunges

The use of aquatic training can be utilized to avoid joint compressions to already compromised joints such as the hip, knee and ankle joint⁵.

Bones strengthen when the muscles attached to them become stronger

In the 1 year Bone Estrogen Strength Training Study, strength training was done 3 times a week³.

The most significant positive effect for the hip-bone strength was from weighted squats³.  Weighted marching showed the most significant correlation (11% increase) between total load and total body bone mineralization density.

Senior fitness clients that play racquet sports have a higher bone mineralization density in the racquet arm compared to their non-racquet arm.

Specific sites respond differently to exercise stimulus

Two studies used overall body routines to stimulate the hip and spine and reported 1.3 and 1.6% increases in spine bone mass density at 9 and 12 months after initiating a progressive resistance training program.

Another study reported significant increases in hip bone mass density only after 18 months, with significant increases in spine bone mineralization density at 5 months³. 

Intensity

osteoporosis treatment_4

Relatively high force loading is necessary to increase bone mineralization density.

In a meta-analysis, studies showed that exercise training programs prevented or reversed an average of 1% bone loss per year⁴. The positive effect of exercise was nearly twice as large when women chose to be in the exercise group⁴.

Studies theorized that women who were more enthusiastic about their training worked more intensely and had better results than those who did not⁴.

These studies concluded that strength-training programs that failed to improve bone mineralization density did not apply the unusual strain distributions and high strain rates required for measurable increases³⁴.

In studies where no change in bone mineralization density was found researchers concluded that exercisers did not train to muscle fatigue or with adequate loads for increased bone mineralization³.

Frequency, rest, load, & sets

High-load, low-repetition exercise routines with adequate recovery time build bone mineralization density most effectively.

Animal studies have found that bone mass density increases with exposure to prolonged exercise progressive intensities and mineralization is enhanced by frequent rest periods between brief intense skeletal-loading sessions.

Rats that jumped 100 times a day had no greater bone mineralization density improvement than those that jumped 40 times. Rats given 24 hours of rest between sessions had superior bone formation to those given 0–8 hours of rest³.

Bone mineralization density in postmenopausal women

In postmenopausal women, studies have found that maximal load stimulates bone mineralization density increases, not load frequency.

Women were instructed to exercise 3 days a week for 1 year (with 2 sets of 6–8 repetitions with loads at 70–80% 1 repetition maximum [1RM]).

Exercise attendance averaged twice per week.

Exercises focused on muscle groups with attachments on or near bone mineralization. Exercises chosen included a squat variation, seated leg press, pull-down, weighted march, seated row, back extension, 1-arm dumbbell press and the rotary torso machine.

Loading cycles and exercise intensity

Studies have reported that fewer loading cycles/sets were most effective for increasing bone mineralization density and there were diminishing returns with more³.

Two other studies explored the association of load and exercise intensity to bone mineralization density increases. These studies have shown that strength groups (8 repetitions at 8RM) increased bone mineralization density by 2% in most hip joint sites within 1 year, whereas endurance exercisers (20 repetitions at 20RM) showed no change³.

In the third and final part tomorrow we will look at the benefits of progression in training, strength work and the importance of nutrition.

Connect with Expert Keith Chittenden

References:

1. Petranick, Kimberly and Berg, Kris; The effects of Weight Training on Bone Density of Premenopausal, Postmenopausal, and Elderly Women: A Review, The Journal of Strength and Conditioning Research, 1997, 11(3), 200-208

2. Nguyen, VuH MeD, Loethen Joanne, Lafontaine Tom; Resistance Training and Dietary Supplementation for Persons with Reduced Bone Mineral Density, Strength and Conditioning Journal, Vol. 30, number 5, October 2008

3.  Mansfield M. Elaine; Designing Exercise Programs to Lower Fracture Risk in Mature Women Strength & Conditioning Journal, Vol. 28, Number 1, February 2006, pages 24-29

4.  Wolff, I. J, Van Croonenborg, H, Kemper, P Kostense, and J. Twisk; The effects of exercise training programs on bone mass; Osteoporosis International, 9: 1-12 1999

5. Dickey, Christa; Strength Training Increases Bone Mineral Density in Postmenopausal Women; American College of Sports Medicine; January 14, 2003 accessed on 10/09/2009

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