Exercise: Can a few minutes a day keep a hip fracture away?

Nandini Mani, MD

Contributing Editor

Let’s face it: we are all getting older. As I write this, I am aging, and as you read this, you are, too! Today I want to talk about an aspect of aging that we don’t often think about, but which research shows we can do something about: osteoporosis, or brittle bone disease.

As we age, our bones naturally tend to become weaker. This is one reason that people often become slightly shorter as they age. Particularly for women, this process accelerates more quickly after menopause. Because bones become weaker, it is easier for them to break, sometimes with very little provocation. Hip fractures are an especially dreaded complication of osteoporosis, because they require hospitalizations and painful surgeries to repair, because recoveries can be particularly complicated, and lastly, because it sounds absolutely terrifying to break a hip! For all these reasons, the medical community worries about osteoporosis and we are constantly thinking of ways to prevent or ameliorate it.

There is a growing body of evidence that physical activity later in life (as well as earlier in life!) can help combat the effects of aging on our bones. Now, I know what you are thinking — I don’t have time to exercise! Well, I have good news for you. Just a little bit of the right type of exercise for just a few minutes a day may help.

You don’t need to train for a marathon to strengthen your bones

A recent study looked at the quantity and quality of exercise required to make a real change in bone strength, as well as how to measure that exercise. Researchers accessed pre-existing data from a large, public database in the UK in order to learn more about how exercise affects bone health in a group of healthy women at risk for brittle bones. In this study, both pre- and post-menopausal women wore accelerometers to record the intensity of their movements. The researchers wanted to see if they could learn about the patients’ movements with very brief measurements, and they found that they could.

More interestingly, what they found was that the women who had the most intense activity, recorded for what amounted to just one to two minutes each day, had a reduction in risk for brittle bones. Furthermore, they had a higher reduction than those women who did less intense activity, although those women saw some reduction in risk too. And the intensity required to achieve this? One to two minutes of running for a pre-menopausal woman and slow jogging for a post-menopausal woman.

More support for exercise and bone health

The study had some limitations. First, it measured bone health by looking at bone density in the heel by ultrasound. The best way to measure bone density is really with a special x-ray called a DEXA scan. We also care less about bone health in the heel and more about bone health in the spine and hip — places where a fracture is more dangerous. However, the general finding of better bone health in those who exercise has been seen throughout the medical literature, so I think we can still safely depend on the results of this study. Another potential limitation is that the patients they studied were all Caucasian females. However, there is no reason to presume that the research wouldn’t apply to healthy women of other ethnicities as well.

This study is so important because it really gives all of us such a reasonable goal. Can we give it our strongest effort for one to two minutes a day? I think we can. It also shows that if we make a small, measurable, but regular change, we can all dance, run, jog, jump, or hop our way to better health!

Comments:

  1. Deborah K. Lynn

    What about a woman who already has been diagnosed with advanced Osteoporosis (-4.0 spine, hip, 65 years old), what is the best exercise?
    I am very active, but also very insecure about the best way to workout for fear of hurting myself.

    • Nandini Mani, MD

      Deborah, You are right to observe that this particular study does not apply to your specific situation. In your case the best exercise is one that is a) weight bearing (e.g. not swimming or stationary biking – you need your body weight) and b) where you feel secure in your balance that you won’t fall. This could be jumping gently on a trampoline with a hand-rail to hold onto, walking, jogging on flat/even ground, weight lifting, yoga, tai-chi! Hope that helps.

  2. Sharon

    I take it the study did not apply to women who already had osteoporosis. Can exercise strengthen bones in women who already have osteoporsis.

    • Nandini Mani, MD

      Sharon – yes, and yes, although depending on your age and/or other medical conditions, you may have osteoporosis that is more advanced. Weight bearing exercise will help, but it will likely not be protective enough alone. You may need to combine exercise with medication or other treatments. Please see my answer to Deborah for more info. Good luck!

  3. Janet Rowley NZ Dip Phys, MHSc

    Great news, but does it have to be high impact? Presumably this is because you get a greater force than body weight down through the bones, but a significant number of women at this age will have – or be at risk of, stress incontinence and so would be advised to avoid high impact exercise. I would be keen to know low impact ( ie one leg weight bearing on the ground at any given time) options.

    • Nandini Mani, MD

      Hi Janet, you will get the most bang for your buck, so to speak, with high impact, weight bearing exercise, but any weight bearing exercise will help. You are right that stress incontinence is often an issue for many women. In this case, see if you can find the lowest impact exercise you can. However, another major observation of this study was the limited amount of time you really need to be doing high-impact. So, some women may find they can empty their bladder fully, then jog for a few minutes (high impact) and then ratchet down the activity level before the bladder fills up again.

  4. Nandini Mani, MD

    A great alternative is jumping on a small trampoline for a few minutes a day. This is actually quite easy on the joints, but still provides the right kind of forces on the hip to help with bone and joint health. If you try this, be sure it is a small trampoline with a safety bar so you can remain safe!

  5. ABDULLAH ALOMRAN

    You article is encouraging to women/men who can do intense activities, but if a person can’t run or jog, then what is the alternative? I understand that brisk walking for more minutes can benefit and strengthen the bone, I my right? if not, what it is?

    Thank you.

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