Reasons to start exercise may include:
(1) a person who wants to exercise but happens to have osteoporosis
(2) improvement in bone density to reduce future risk
(3) status post osteoporotic fracture
If the patient has osteoporosis:
(1) it is important for the person to avoid falls
(2) contact sports should be avoided, at least initially
(3) it may be best to avoid sports with risk of traumatic injury (skiing, bicycling, etc)
The patient evaluation should include:
(1) identification of comorbidities such as obesity, hormonal status, etc)
(2) document current medications such as corticosteroids or hormone replacement
(3) any issues with balance and risk for falls
(4) any pain that may restrict actvities
(5) if status post fracture, then the stability of the fractured bone
(6) status of deconditioning and/or frailty
Identify the group of exercises likely to benefit the patient:
(1) swimming does not improve bone mineral density.
(2) Running and weightlifting increase bone mineral density.
