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21/Jun/2023

We all know regular exercise is essential for good health. It can improve the fitness of your heart and lungs, sleep quality, energy levels and mental wellbeing. And it can reduce your risk of developing conditions such as diabetes.

Exercise is also vital for the health of your bones.

Like muscle, bone is living tissue that responds to exercise by becoming stronger. People who exercise regularly have stronger bones and higher bone density than those who don’t. This reduces the risk of developing osteoporosis.

Exercise also increases your balance, coordination and flexibility, which improves your ability to prevent trips and falls. DYK, falls are Australia’s largest contributor to injuries that require a stay in hospital and are a leading cause of injury deaths? More than half of the hospitalisations were due to broken bones (fractures).(1)

Bones need exercise.

To understand why exercise is important for bone health, it helps to know how bones work.

Throughout your life, your bones are constantly changing. This is called ‘remodelling’. Bone cells called osteoblasts build new bone, while other bone cells (osteoclasts) break down and remove old bone. This process is controlled by hormones such as calcitonin, parathyroid hormone, oestrogen (in women), testosterone (in men), and vitamin D.

From birth to about 25, you build more bone than you lose. Your bones are not only getting bigger as you grow, but they’re also developing their density. This determines how strong they are.

From about 25 to 50, your bones break down and rebuild at about the same rate. They’re in a state of balance. This is when you’ve achieved your ‘peak bone mass’. Your bones are at their strongest.

After about 50, you break down more bone than you rebuild. While this means everyone will experience some bone loss as they age, it doesn’t mean everyone will develop osteoporosis.

Women commonly experience a period of rapid bone loss after menopause. This is due to a drop in oestrogen levels. It’s estimated that the average woman loses up to 10% of her bone mass in the first five years after menopause.(2)

For good bone health, exercise is vital for everyone – from the very young to the very old.

A combination of different exercises is best for bone health.

Different exercises challenge and strengthen your bones and muscles in different ways, so you should include the following in your exercise plan:

Weight-bearing exercises or activities where your body carries its own weight. These exercises put stress on your bones, making them stronger and denser. It also strengthens the muscles around your bones, providing support and reducing the risk of fractures. Weight-bearing exercises include brisk walking, climbing stairs, tennis, and netball.

High-impact exercises such as jogging, running, jumping, and skipping rope. They’re also weight-bearing exercises, but they place greater stress on the bones of the spine and legs as your feet hit the ground. This can provide more bone-strengthening benefits; however, these exercises aren’t suitable for everyone.

Resistance training, also known as strength training, uses resistance or weights to strengthen your muscles by working them harder than you do in everyday life. The strong muscle contractions required to move a heavy weight place stress on the bone where the muscle attaches. When bone feels this strain repeatedly, it responds by becoming stronger. Resistance training uses equipment like free weights (e.g. dumbbells), gym machines, elastic resistance bands or your body weight (e.g. push-ups, squats).

Balance and flexibility exercises such as tai chi and yoga improve balance and mobility and can reduce your risk of falling. This is important for preventing fractures.

Before beginning an exercise program, speak with your health professional. Not all types of exercise are suitable for everyone. This is especially important if you have other health conditions, including osteoporosis. A physiotherapist or exercise physiologist can assist you with a safe exercise program that targets your specific needs and reduces your risk of injury.

Exercise must be regular and ongoing.

You need to exercise regularly to have a significant benefit, so you should choose activities you enjoy. This will make it easier to exercise consistently.

Australian physical activity and exercise guidelines recommend that all adults be active most days, preferably every day, for 30 minutes or more. This includes at least two sessions of strength training every week. However, when you’re just beginning, this can seem daunting.

That’s why it’s good to know you don’t have to do all your exercise in one session. For example, a 30-minute brisk walk can be broken up across your day into shorter, more achievable sessions, such as three 10-minute or six 5-minute walks.

You can do other things to make exercise a regular, ongoing activity.

Exercise with a group or a partner. This can improve your motivation to exercise and provides an opportunity for socialising with others.

Exercise SMART and set goals. A clear goal can motivate you to stay on track with your exercise program. But they must be realistic and specific to your abilities, needs, and health issuehttps://msk.org.au/goals/s. So, ensure your goal is SMARTSpecific, Measurable, Achievable, Realistic and has a Timeframe.

For example, a good SMART goal for resistance training for stronger bones and muscles could be: “I will perform resistance exercises, such as lifting weights or using resistance bands, for 30 minutes, twice a week, for the next three months.”

This goal is Specific (focuses on resistance training), Measurable (30 minutes, twice a week), Achievable (realistic for most people), Relevant (aimed at improving bone and muscle strength), and has a Timeframe (three months).

Constantly evaluate your goals, adjust them as needed and reward yourself for your successes.

Add variety. Vary where you exercise and the type of exercise you do. Include recreational activities such as bushwalking or dancing. This will help keep your mind fresh and your motivation high. Find activities that are enjoyable to you so that you’ll be motivated to continue doing them.

Exercise within your capabilities. Often, people drop out of exercise programs because they exercise at a level beyond their current capabilities. Ensuring your exercise program suits your current abilities will decrease your risk of injury and increase your enjoyment and motivation to continue your exercise program.

Challenge yourself. Increase the intensity of your exercise as your fitness improves. It’ll make your exercise more interesting and also has greater health benefits.

Stop if you have pain. Don’t continue exercising if you experience pain or severe discomfort. Talk with your fitness professional for advice to ensure you’re not doing an exercise incorrectly.

Bone health doesn’t happen in a vacuum.

As well as exercise, you need to also to eat a nutritious diet with calcium-rich foods, get sufficient sun exposure for vitamin D, take medicines or supplements as prescribed by your doctor, quit smoking, and moderate your use of alcohol, caffeine, and salt intake, as they can impact bone density.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

References

(1) Falls. Australian Institute of Health and Welfare.
(2) Osteoporosis, Australasian Menopause Society


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18/Nov/2021

Written by Rachel Lea

During the 32 years of living the life of a Lupus Warrior, I’ve come to liken the feeling of battling lupus to the principles of the board game Snakes and Ladders. When the dice rolls, you take the number of steps forward that the dice dictates. Literally one step at a time. When you’re feeling well, and your lupus is under control, you may even land on a ladder and climb up the board a little bit further. When that’s happening, you feel truly happy, as you’re able to maintain a sense of balance and stability. It just feels good.

But then the game can change without warning, and the dice can roll towards a snake. When you hit a snake, it boldly raises its head and hisses at you. Taunting you. Because you know what’s coming. You’ve suffered another setback, another lupus flare. And so you begin to slide. You slide all the way down the back of that slippery snake, sometimes to the bottom of the board. That soaring happiness dissipates as you realise you have to begin the game all over again, and fight your way back up to the top of the board. This is how the game of lupus is played each day. Over and over and over again. At some point, you’ll always fall back down. Why? Because lupus always wins.

So the never-ending tweaking of medication takes place, whether it be increased steroids or methotrexate. This’ll require months and months of tapering back to the dose at which I was originally controlling my lupus. Before that flare took me down. My symptoms of extreme fatigue, joint and muscle pain, fevers, migraine-like headaches, mouth ulcers and hair loss are being treated by these medicines. It’s draining. And bloody frustrating! Particularly when I felt I was managing my lupus and overall health really well, and then, boom!

After thirty-two years of experiencing such flares, I’ve grown to realise that the only way to fight back is to simply let go. Let go of everything. Place myself in a protective bubble and focus on me. Hope that the drugs kick in quickly and move with the pain and discomfort the best way I can. I’ve grown to learn that it takes strength to surrender and put trust and faith in the universe. That even when I’m struggling like this, I’m exactly where I’m meant to be. I know this because when I’ve been too stoic, trying to rise above the pain and fatigue, the resulting flare has been longer and more challenging to overcome.

I grew to learn very early into my diagnosis the benefits of being very gentle and kind to myself. If that means having a teary and a good sook, so be it. If that means I’m in bed for days or even weeks, I’ve no choice but to give in. If it means I’m back on the higher doses of medications, with all of the nasty side effects that come with them, then that’s just the way it is. I just have to roll with it as best I can. I need to let go so I can get back on the game board again and keep rolling the dice.

I’m a kinder, more considerate and less judgmental person because of lupus. I’m more patient and adaptable when faced with new challenges. I’ve recognised that being able to persevere and be resilient in the face of uncertainty is a gift. Self-acceptance cultivates much inner peace, but when my acceptance of life with lupus is tested, I’ve learned to respect what this disease is and what it can do. If I wage a war against myself and push through without enough rest and respite, I’ll be causing more inflammation, more damage, and undo all the good I’m trying to nurture within my body. And that’s no good for me in the short or long-term. I’m managing a disease without a cure, one that’s unlikely to leave me anytime soon.

Not being well enough to continue my beloved vocation of working as a VCE secondary school teacher, I’m currently on another journey of personal growth and acceptance. In addition to having lupus, I’ve also been battling fibromyalgia for 8 years. As I became sicker, teaching became more challenging than usual, even when working part-time hours. I was also working within a combative, negative work environment. I was constantly asking myself, ‘how can I keep moving forward, finding hope and purpose as a chronically ill person in a toxic work environment like this?’ One where people strongly resisted the opportunity to invest more time and effort into creating greater goodwill and positive change that everyone could benefit from. How long could I endure the frustration of working like this and be in the best health possible? And ultimately, the question which intrigued me the most, ‘how do other people, like me, who have invisible chronic illnesses, cope in stressful, challenging workplaces? How do they find their way in the world when their pain is invisible to those around them? ’

With too many lupus flares to bounce back from and a working environment that wasn’t likely to improve, I resigned from my teaching job. It’s been a very isolating, extremely lonely and sad time for me. However, over time I’ve been able to reflect on the challenges of having lupus and working in a difficult work environment. This has resulted in my book ‘Lupus = Lift Up, Persevere, Use Strength’.

I’ve written my book in 3 parts. The first part, ‘Lift Up’, examines the 3 long years it took to diagnose my lupus. I was symptomatic at age 14 and diagnosed at 16. I describe the social, emotional and physical impacts of being ill as a teenager, its effects on my parents and family, and the stress of misdiagnosis and experimental treatment along the way. In part 2, ‘Persevere’, I discuss the struggles of having lupus while finishing school, university and the fear of entering the workplace as a secondary school teacher with a chronic illness. In the final part, ‘Use Strength’, I share the challenges of life in the workplace with an invisible illness and how I’ve tried to maintain hope and perspective.

It’s my greatest hope that my book can offer companionship and unity to fellow Lupus Warriors, chronic illness fighters, their carers and loved ones. I also hope to generate greater understanding and awareness of lupus, and cultivate more compassion and empathy for the challenges of living with a chronic illness. In all of the teachings that having lupus continues to bring, I know I must keep putting into practice what I’ve learned in being able to surrender and embrace the unknown with more courage, grace and acceptance.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.




Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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