Osteopenia and Osteoporosis

By Barbara Gordon

Osteoporosis is a progressive disorder in which the skeletal bones gradually lose bone mineral density (BMD). It begins with a thinning of the bones, called osteopenia. Loss of BMD continues until bones become weak, porous and fragile, called osteoporosis.

Your bones are in a constant renewal process. Weak, old bone is broken down and reabsorbed. At the same time, new bone is laid down to replace the loss. Osteopenia and osteoporosis occur when bone formation does not keep up with bone removal.

Osteoporosis can lead to fractures that happen spontaneously or from stresses as simple as a sneeze. Fractures often occur in the hip, wrist or spine. People who experience compression fractures in the spinal column often develop a stooped posture, which increases pressure along the front of the spine and can lead to more compression fractures in a domino affect.

Osteoporosis is called a "silent" disease because bone loss occurs without symptoms. A fracture is usually the first sign. According to Osteoporosis Canada, "Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined." The organization also states that 1 in 4 women and 1 in 8 men over age 50 has this disease. The International Osteoporosis Foundation states 1 in 3 women and 1 in 5 men will experience osteoporotic fractures. Of people over 50 who sustain a hip fracture, 20 - 25% will die within the first year. Just as shocking, younger and younger people are developing this disease, and its incidence is expected to increase rapidly given the sedentary and dietary lifestyle of children.

Causes of and Risk Factors for Osteoporosis:

Prevention and Management

Prevention is the best strategy. Peak bone mass density occurs between ages 16 and 30. It is critical for children and young adults to have proper nutrition and keep physically active, because, as the Mayo Clinic puts it, "the higher the peak bone mass the more bone you have in the bank to use later on." It is equally important for people older than 30 to remain active in order to maintain bone density and minimize its loss. This is especially important for women over 50, as 3 to 7 years after menopause they can lose 20 - 35% of BMD due to loss of estrogen. Achieving peak bone mass early on and maintaining it throughout life is crucial.

If you have osteoporosis, the objective is to maintain and increase BMD and prevent fractures. You can help do this through diet, medication and or surgery, and physical activity. Bones and muscle never lose their ability to become stronger. Research has shown that exercise is a fundamental factor in the management of osteoporosis and osteopenia, as well as osteoarthritis. Exercise, alone or in combination with nutritional supplements and medications, can slow or even reverse the loss of BMD.

How Does Exercise Make Bones and Joints Strong?

Bones respond to stresses such as gravity, muscle contractions, impact with the ground, and vibrations by creating more bone mass, which makes them stronger. Bones do this because the skeleton experiences these stresses as challenges to its structure and begins forming new bone to withstand them. Consistently applied stresses to bones in good alignment will create a strong, sturdy skeletal architecture.

Exercise creates strong muscles. Muscles are attached to bone. When they contract they pull on the bone. Strengthening muscles around the ankles, knees and hip joints strengthens bones in the legs and hips. Contractions of the upper-body muscles transmit force to the spine, strengthening bones in the spine and arms. Besides improving BMD, strong muscular fitness helps keep joints in alignment and better able to absorb shock, makes all daily activities easier and reduces the risk of falling.

To treat osteopenia and osteoporosis Women's College Hospital, Osteoporosis Canada, and the Mayo Clinic all recommend:

Pilates Standing and Mat Work:

Consult your doctor before starting any exercise program for osteoporosis. Ask for a bone-density scan to test your BMD, which helps define the onset of disease. Doctors are now looking at fractures as a symptom of osteoporosis, so be sure to tell your doctor if you have ever had a broken bone.

For more information, visit:

Centre for Osteoporosis & Bone Health ~ Women's College Hospital
You Can Live Well with Ostoporosis ~ Osteoporosis Canada
Osteoporsis ~ Mayo Clinic
International Osteoporosis Foundation