This is a topic that seems simple on the surface but has some areas for real care and concern. From an earlier post http://www.west4thphysio.com/wp-admin/post.php?action=edit&post=530 , you’ll remember that bones are always in transition. Building and breaking down and rebuilding again in response to the loading that is placed on them. This process of turning physical load into tissue (bone) change goes by the wonderful name of mechanotransduction. Good bone building load is gained from exercise that involves:
- weight bearing, that is exercise done while upright so that the force of gravity acts vertically through the upright skeleton
- resistance training, as in against gravity,weight, elastics or springs
- if your joints can tolerate it, some impact. High or low impact stimulates bone development
At one end of the spectrum are physically able people with relatively good balance who have either normal bone mass or who are just into the zone of osteopenia. Their options for exercise are fairly open. In addition to weight training in a gym they can safely try activities such as speed walking, hiking, dancing, jogging, yoga, Pilates or Tai chi. Lower impact options might include elliptical trainer or walking on the treadmill.
At the other end are those whose balance is faltering and who are at real risk of falling. They must take great care in their choices of exercise lest their attempts at improvement result in a fall and fracture. The message here is to be assessed before you embark on an exercise program that is too ambitious. Your physician and physiotherapist can assess your balance ability and help you find the suitable strength exercises that are safe. Your exercise program can follow the same principles of being upright and using gravity and resistance. You just have to be more careful with where and how you exercise. Especially pay attention to exercise that will help improve your balance reactions. A physiotherapist should help you with these and if necessary can instruct a family member or friend to help you at home. Exercise might include holding onto the back of a chair for support and then doing toe stands, knee bends and side steps. As you improve you can move on to more challenging resistance exercise involving weights, elastics and lifting your own weght against gravity. When you are ready, Tai chi is a great way to slowly improve balance and flexibility, both of which will help protect you from falls and fractures. Here in Vancouver, many community centres offer courses in Senior’s exercise and Tai chi. If you are concerned about your ability, have a physiotherapist assess your balance and make recommendations for safe and progressive exercise.