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Exercise and Bone Health

How can exercise improve my bone health and help be age better?

One of the hallmarks of aging is decreasing bone density. You reach your peak bone density around the age of 30, and it decreases a certain amount every year after that. Our bones are always going through a renewal process involving removing old bone cells and regenerating new ones. Both of these processes are going on at the same time, but as you age, the process of regenerating bone decreases resulting in an overall decrease in bone density instead of maintaining or increasing bone density. The cells that regenerate bone make collagen and other non-collagen proteins. The collagen is what provides bone its strength and resistance to deformation. There are also changes in the structure of the collagen in the bone as we age that lead to increased stiffness and brittleness. Lots of other factors such as genetics, hormones, peak bone mass earlier in life, drugs or medication use, other medical conditions, nutrition, and yes, even physical activity can impact bone mass.

We all know that our bones get more brittle and are more likely to fracture as we get older which is why so many people shy away from physical activity as they get older because they don’t want to hurt themselves.

The question is, how do you prevent further excessive loss in bone mass as you age?

You can’t control all of these factors leading to where you are now, but you can do something moving forward!

Exercise is a great way to help increase bone density as you age. Certain kinds of exercise can help to stimulate the generation of new bone cells. Bone responds to something called “mechanical loading” (which is muscle contraction or bearing weight) by increasing bone formation. The increase in bone formation is proportionate to the amount of mechanical loading or strain put on the bone. Furthermore, including rest periods in-between the periods of time where strain is present (more of a dynamic workout situation) increases the bone formation even more. Exercises that induce strain that is unlike normal strain put on the bone (think multidirectional jumping or versus walking or running) induces the formation of bone. Another reminder, like all processes in the body, certain nutrients are necessary for optimal function. Therefore, adequate protein, calcium, and vitamin D is necessary to experience the full benefits of exercise for bone health. Furthermore, hormonal status and function is important to maintain good bone health. 

Here are some tips for maintaining bone health as you age:
– Maintain a healthy body weight: a body weight that is too high or too low can negatively impact bone health. Many don’t think about low body weight but that can negatively impact bone health as much as a higher body weight.
– Eat a healthy diet with adequate protein, calcium, and vitamin D. An adequate vitamin D status is required for optimum absorption of calcium in the gut, so it doesn’t hurt to eat both at the same time.
– Incorporate light weight-bearing aerobic activity: jumping, tennis, volleyball, hiking, etc. Remember to always start light and slowly increase.
– Incorporate light weight-bearing resistance training: Grab some small weights or use your body weight and do various exercises to increase your muscle strength and stability. Remember to always start light and slowly increase.
          – Here is a website with some great exercises for increasing strength while maintaining stability:

            https://americanbonehealth.org/exercises/
– Mix up your movement: Like we discussed above, dynamic exercise is best for increasing bone density. Create a workout plan with your doctors that changes up the types of exercises you are performing.

Remember to always talk to your doctor if you have or are at risk for a bone-related disease, are at risk for falling or fractures. It is always a good idea to run ideas past your doctor before trying to implement your own workout or diet plan.

Sources:
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383520/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402109/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467150/#:~:text=At%20the%20apical%20surface%2C%20osteoblasts,proteins%2C%20including%20osteocalcin%20and%20osteopontin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991386/
https://pubmed.ncbi.nlm.nih.gov/15984409/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179512/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323511/
https://pubmed.ncbi.nlm.nih.gov/16680498/
https://www.osmifw.com/sports-medicine/bone-density-and-weight-bearing-exercise/

Exercise and Chronic Pain

Does exercise help or hurt my chronic pain?

Chronic pain is defined as pain that lasts for longer than 3 months. This is the time period chosen because it is beyond when normal tissue healing should occur. In the United States in 2021, an estimated 20.9% of people experienced chronic pain. This is a general term as other forms of chronic pain cause actual continued tissue damage such as cancer or osteoarthritis. Since there are such a wide variety of chronic pain syndromes with different causes, we won’t be diving into any of the specifics of those diseases.

When you experience constant pain that doesn’t go away, it is only normal to question whether or not exercise would be helpful for you. This pain can even begin to affect your daily life. Pain is never fun; therefore, it is our natural response to want to decrease the pain. Our natural instinct is to move less in order to try and reduce pain. It is counter-intuitive that exercise can help improve chronic pain. However, inactivity can also lead to other issues such as muscle atrophy (your muscles get smaller because they’re not being used), poor posture and stability, and other health problems. Fear is a common emotion experienced with chronic pain. Avoidance of certain behaviors or movements that caused pain in the past can invoke more fear and it becomes a vicious cycle. Fear of pain can become debilitating and perpetuate inactivity.

On another note, one of the proposed mechanisms for chronic pain is some kind of local or systemic inflammation. Scientific literature is showing that exercise can decrease systemic inflammation and in contrast, a sedentary lifestyle can even increase or contribute to inflammation. Consistent exercise is the most important thing, even if the sessions are short and of a lower intensity. Additionally, exercise can influence certain neurotransmitters and endogenous opioids (made by our own bodies) which promote the decrease and control of pain through pathways in the brain. Studies are also showing improved neuron regeneration after exercise which could help our nervous system respond better to pain signals. There is also a sensation where exercising a body part that does not hurt can help to decrease the pain in the area that does hurt. In additional to all of these benefits, exercise also helps to reduce fatigue, reduce excess weight, improve sleep, reduce anxiety and improve mood.

This being said, please make sure to talk to your doctor before trying to complete exercises if you are experiencing chronic pain. Figure out a plan that works for you and your specific condition.

If you’re wanting to increase your movement, here are a few non-intimidating forms of movement that you can slowly (and progressively, as possible) try to incorporate into your life:
– Leisurely walks of increasing length: Start slow and increase. For example, walk for 5 minutes, and rest and repeat. Walk for 10 minutes, rest and repeat. Etcetera. 
– Stretching and yoga: Incorporating small amounts of stretching into your day can help to increase flexibility and mobility, especially at the beginning and end of the day and when you’ve been sitting for a while. 
– Light core strengthening: Try getting an exercise ball and use that for various exercises. There’s no need to jump right into an intense amount of crunches.
– Incorporate more activity into your daily tasks. When you get up off a chair, sit down and get up a few more times. When you’re going up the stairs, redo a few stairs at the end. Sweep the floor more often than you need to. 

Schedule an appointment online today with one of our doctors if you’re experiencing chronic pain!

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/
https://link.springer.com/chapter/10.1007/978-981-15-1792-1_16
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716/
https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm#:~:text=During%202021%2C%20an%20estimated%2020.9%25%20of%20U.S.%20adults%20experienced%20chronic,(8.0%25)%20(5).
https://extension.usu.edu/heart/research/exercise-and-chronic-pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993768/
https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Moving-the-Body-in-Chronic-Pain.pdf

Exercise and the Brain

We all know that exercise can help us manage our weight, build muscle, and is generally good for us, right?

Did you know that exercise also helps improve your sleep, mood, thinking and judgment skills, and reduce your risk of some cancers, heart disease, neurodegenerative diseases, and other metabolic diseases such as diabetes and metabolic syndrome?

When we think of the benefits of exercise, improving brain health doesn’t usually come to mind. However, research is showing that regular aerobic exercise (otherwise known as “cardio”, the kind of exercise that gets your heart rate up) helps to improve memory and other learning process. In fact, it can preserve or even increase the volume of the areas of the brain involved with cognitive functions (particularly the hippocampus). Furthermore, exercise induces the creation of new neurons in the brain and more integrated neural networks. Muscle synthesis, as a result of exercise, can cause the release of certain molecules that modify neurotransmission in specific areas of the brain.

In addition to structural changes, exercise can also promote recovery after an injury and has anti-depressive effects. One reason for this could be is that exercise has been known to increase tryptophan (a type of amino acid) levels in the blood which is a precursor to serotonin. A lot of antidepressive medications attempt to increase serotonin as it has a relaxing, feel good effect. Exercise also increases blood flow to the brain and releases endorphins that help to improve mood by influencing pain and the body’s response to stress. Also contributing to this “feel good” effect is an increase in opioids made by the body as a result of acute exercise (a burst of exercise).

Acute, or short-term exercise, has also been shown to increase cognitive function and performance- more specifically motor skills and academic achievement. Studies show that exercise intensity greatly affects the responses that contribute to improved function.

You might be asking yourself this question, what is the best kind of exercise for my brain health?

The kind that you can get yourself to do regularly and enjoy. Sure, a mixture of aerobic (cardio) and resistance training (weight lifting) are beneficial in different ways, but if you absolutely hate both, maybe tennis is the way to go. Or biking. Or swimming.

Here are some tips for incorporating exercise into your life or finding ways of exercising that are enjoyable for you:
– Find an exercise buddy: Nothing is as fun if you’re doing it by yourself. Find someone else who is as committed to exercising as you are and will encourage you to exercise when you don’t want to. 
– Be willing to try something new at least two times: Maybe you decide to try a new fitness class at the gym or a friend invites you to try something out with them like rock climbing or hiking. Maybe something goes wrong and you absolutely hated it. Try it at least one more time. There are always things that can randomly go wrong so give something two chances before giving up on it.
– Try mixing up your exercise routine: Doing the same thing over and over again can increase the risk of injury. Try doing a different activity or exercise routine each time you plan to workout this week.
– Choose activities that you enjoy so that your workout routine is sustainable. If you’re having trouble finding something you enjoy, keep trying new things until something sticks. Just don’t give up.

Sources:
https://medlineplus.gov/benefitsofexercise.html
https://www.nia.nih.gov/health/real-life-benefits-exercise-and-physical-activity
https://neurosciencenews.com/fitness-neuroscience-23228/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770965/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680508/
https://pubmed.ncbi.nlm.nih.gov/2678895/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077351/#:~:text=Several%20lines%20of%20research%20suggest,function%20in%20the%20human%20brain.
https://pubmed.ncbi.nlm.nih.gov/22480735/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928534/

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