Rx for Osteoarthritis and Osteoporosis: High-Impact Exercise

Laird Harrison

Disclosures

December 24, 2015

In This Article

Exercise and the Problems of Aging

Despite having mild osteoarthritis at the age of 44 years, Riku Nikander, PT, PhD, plays tennis as often as possible. His determination to stay on the courts runs contrary to mainstream advice about arthritis, which is to avoid activities that jar the joints.

But from research done at the University of Jyväskylä in Finland, where he is a professor of sport and health sciences, Dr Nikander believes that tennis can improve the health of his bones while not hurting his cartilage. "The first studies show that when the osteoarthritis is not very bad, you could still do impact sports," he says.

Though more research is needed, these initial studies are helping resolve a dilemma for clinicians who advise aging patients about controlling two of the most common health problems of aging: osteoarthritis and osteoporosis.

Much of the research up until now has posed a dilemma. Although studies have consistently shown that exercise benefits both conditions, when it comes to the type of exercise, the findings point in different directions.

The National Osteoporosis Foundation's 2014 Clinician's Guide to Prevention and Treatment of Osteoporosis recommends "weight-bearing and muscle-strengthening exercise." And it specifically mentions walking, jogging, tai-chi, stair climbing, dancing, and tennis as examples of weight-bearing exercise.[1]

These exercises are typically considered "low to moderate impact," and studies have shown that they can preserve bone mineral density at the lumbar spine and femoral neck when combined with resistance training. (Muscle-strengthening examples include "weight training and other resistive exercises, such as yoga, Pilates, and boot camp programs.")[2]

Benefits of High-Impact Exercise

Reviews of the research found that high-impact exercises—typically defined as activities that involve jumping, such as basketball, gymnastics, and ballet—were also effective when combined with other types of exercise, such as resistance training.[3,4]

In another study—this one looking at premenopausal women—resistance training and high-impact exercises produced 1%-2% gains at the lumbar spine and femoral neck.[4] (Much less research has been done on men, who are at lower risk for osteoporosis, but the few studies that have been done suggest that their bones would benefit from the same kinds of exercise.)

"People who do high-impact might have 20%-30% stronger bones in their lower-extremities," says Dr Nikander. "And animal experiments have shown that it should include movement—and, if possible, quite rapid movement. It's been said that this is due to a fluid flow inside the bone that starts a cascade of events that leads to stronger bones."

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