Stretching is a way to work on improving flexibility. When done correctly and consistently, it can ease muscle tension, restore joint range of motion, and improve muscle length (Page, 2012). However, a complete exercise program consists of multiple types of exercises.
Those diagnosed with or at risk for developing osteoporosis should have a fitness routine that contains three types of exercises to benefit and boost bone health and preserve bone density: weight-bearing exercise, resistance training, and balance training. Stretching exercises can be a great addition to this program. This article will go over specific stretches and suggestions for how to add them to your routine.
Types of Exercise for Osteoporosis
Because stretching alone will not benefit bone health, we must go over the best exercises for osteoporosis. The below-mentioned exercises can help reduce bone loss and improve bone mineral density. In addition, these types of exercises provide the most bone-building benefit when done together.
- Resistance training: Also known as strength training or weight training. These exercises use resistance from your body weight or dumbbells, free weights, weight machines, resistance bands, etc., to increase muscle strength and produce stronger bones.
- Weight-bearing exercises: These are commonly known as aerobic or cardiovascular exercises. They are beneficial for bone integrity as well as your general health. Weight-bearing exercises require your bones and muscles to support their weight against gravity as you move. These types of exercises can vary in intensity and impact. Physical activities such as walking and tai chi are low-impact examples and are often the safest option for those with osteoporosis. On the other hand, high-impact exercises like running or jumping can have bone-building benefits, but may not be appropriate for everyone with bone diseases. Before starting a new exercise program, talk with your healthcare provider about what will be the safest weight-bearing exercise for you to help build bone.
- Balance exercises: These exercises are important for improving the strength of the muscles that keep us upright and also help reduce the risk of falls. A physical therapist often gives these exercises if you have osteoporosis, are at risk of falling, or have a high risk of fracture.
Stretching and Bone Health
Stretching does not have a direct impact on bone health. However, the benefits of stretching can be beneficial for those with osteoporosis.
Regular stretching can improve joint range of motion and tissue flexibility, especially when combined with other types of resistance and strength training exercises (Nuzzo, 2019). This can help improve balance and can lead to more effective strength training. For example, ankle and calf stretching can improve balance and decrease falls (Kim, 2018). In turn, this can decrease one's risk for bone fractures.
It is also helpful to incorporate stretching into your strength training routine. Stretching before, after, or between strength sessions may ease post-exercise soreness (Herbert, 2004).
Stretching alone will not prevent osteoporosis, but it makes a great adjunct to the above-mentioned types of exercise that do build healthy bones.
Posture Training
Postural training is often part of an osteoporosis exercise program. Individuals with low bone density should be educated on proper posture while performing activities of daily living (ADLs) and when exercising. This will ensure efficient and safe movement that will improve bone strength.
Poor posture can cause neck pain, low back pain, upper back pain, and more. Pain signals that your body doesn’t like what is going on. For those with bone diseases, this could mean that further movement with poor posture could lead to vertebral compression fractures.
Postural training typically involves a combination of stretching and strengthening. If you are unsure of where to start fixing your posture, speak with a physical therapist. Yoga and pilates are also great ways to incorporate posture and stretching into your routine. Both programs involve balance, and weight-bearing exercise, which we know are beneficial for osteoporosis!
What You Can and Can't Control
With most diseases, there are things you can and cannot control. There are several modifiable and non-modifiable lifestyle factors that can affect your prognosis when it comes to osteoporosis. Family history, age, gender, and past medical history are examples of things you cannot change. Diet and exercise are the two major modifiable factors that can positively impact your bone mass.
The types of foods you eat (and don’t eat) play a role in bone density. Generally, eating whole, nutrient-dense foods will give your body the best chance of receiving the right nutrients needed to maintain bodily functions. When it comes to bone health specifically, Vitamin D and calcium are the stars of the show. They both help with building and maintaining bone mass.
Maintaining an active lifestyle and doing the right types of exercises are also in your control. Inactivity is a major factor in the loss of bone mass.
With the right regimen, your prognosis is in your hands; you can improve your bone density and prevent osteopenia from progressing to osteoporosis (Bolton, 2012).
Stretches for Osteoporosis
Before going into what types of stretches to do, let’s discuss the types of movements to avoid. If you have osteoporosis, it is best to avoid extreme and rapid bending or rotation of the spine. This includes sit-ups, which typically involve pulling on the neck and quickly bending forward through the spine. Other abdominal and back exercises that involve excessive trunk rotation should also be avoided.
Below are some stretches that are beneficial for those with osteoporosis. Note that stretches are to be held for 30-60 seconds in duration and repeated for two or three repetitions. If you cannot hold a stretch for the entire duration, back off and ease into it to tolerance. You should spend 1-3 minutes stretching each body part mentioned below.
1. Single Leg Hamstring Stretch (Hamstring Stretch with Strap)
Lay on your back. Bend your left leg and keep your foot flat. This will help maintain pelvic alignment. Using a strap or belt, wrap it around your right foot and gently pull your right leg towards your face. Keep your knee as straight as you can. You should feel a stretch at the back of your thigh.
Hold this stretch for 30-60 seconds. Be sure to perform this on the left leg as well. Repeat this twice on each leg.
This exercise helps maintain flexibility in the muscles in the back of your legs. It can help with bending forward activities, such as tying your shoes or picking something up off of the floor. Tight hamstrings can also cause low back pain, so this stretch is often prescribed to those with low back pain.
2. Calf Stretch (Gastrocnemius Stretch)
Stand up facing a wall. Place your hands on the wall for balance. Step your right leg back, keeping your knee straight and ensuring your heel stays flat. You should feel a stretch in the back of your lower leg.
Hold this stretch for 30-60 seconds. Be sure to perform this on the left leg as well. Repeat this twice on each leg.
This stretch helps maintain ankle flexibility. When your ankles stay flexible, balancing and walking can be easier and safer. This exercise is often prescribed to people with foot, ankle, or knee pain.
3. Supine Morning Stretch
Begin lying on your back with legs straight and arms down by your sides.
Reach both arms up overhead. Lengthen both legs away from you, reaching with the heels while pulling your toes up towards you. Stretch as if you are trying to elongate your body, reaching your hands and feet away from each other.
Hold for 5 seconds, then relax. Repeat 5-10 times.
This stretch helps improve length throughout the body while reducing the pressure on the spine. In addition to feeling good, it can help improve alignment.
4. Doorway Pec Stretch
Stand in an open doorway. Place your hands on either side of the door frame at shoulder height or slightly lower. Lean your trunk and chest forward through the doorway until you feel a stretch in the front of your chest and shoulders. As you hold this stretch, try to keep your shoulder blades away from your ears.
Hold for 30-60 seconds. Repeat this twice.
This stretch helps maintain an upright posture in the upper back and shoulders. It can fight the forward rounded posture often seen in older adults. It is also often prescribed to those with neck, shoulder, or upper back pain.
5. Thoracic Stretch (Standing Thoracic Spine Stretch)
Stand in front of a countertop or a chair with a high back. Place your arms on the counter or chair at shoulder width distance apart. Back up and keep your feet shoulder-width distance apart as well. Send your hips back and let your chest sink towards the floor.
Hold for 30-60 seconds. Repeat this twice.
Similar to the previous stretch, this stretch helps maintain an upright posture in the upper body. It is also often prescribed to those with neck, shoulder, or upper back pain.
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All of these stretches can help improve posture and improve range of motion in the major joints that help you stand upright. If there are any stretches you are unsure of, please ask your doctor or physical therapist if it is right for you. You and your provider know what is best for your body!
