Isometrics and Bone Health

Isometric exercise has been around for a long time in both the fitness and rehabilitation world, but is most definitely having a rebirth! After years of limited results and cumulative injury with dynamic, movement based exercise, health and fitness professionals along with a host of academic and medical journals are looking at isometric exercise as not only the safest, but most effective exercise available.

Isometric exercise is a contraction of a muscle without any visible movement occurring. It is a static exercise where the muscle is contracted in a fixed position against an immovable object. When doing workouts at the gym with free weights or machines, you are performing isotonic exercises. Both forms of exercise increase the tension of a muscle, but isotonic exercise also affects the muscle’s length. The benefits and results of an isometric exercise program have always been exceptional in increasing the tension of a muscle, but with advent of technology affecting the fitness and exercise world over the past forty years, isometric exercise has been virtually forgotten.

Now fitness experts and the most prestigious health and fitness journals in the world are publishing studies that endorse isometric exercise as an exceptional route to improving muscular strength, bone health, cardiovascular function, and athletic performance with minimal stress to joints, tendons, and the body’s other supporting structures.

Now with the focus on bone health, isometric exercise is again mentioned as a means to improve the status of your skeletal system and its bones. With that, there are two terms related to your bone health that I feel need to be clarified. That is “osteoporosis and osteopenia.” Simply put, osteoporosis suggests a disease process whereas osteopenia is a description of lowered bone density scores. Osteoporosis is not and I repeat not a normal response to aging. It is indicative of long term imbalances within the body’s systems that lead to a bone weakening disease process. When you have been diagnosed with osteoporosis, it means you have an actual disease or disorder that can be seen under the microscope. The word osteoporosis actually means “porous bones” since the bones look like Swiss cheese under closer inspection and lose their normal, healthy spongy appearance. This condition occurs when your body gets rid of more bone than it is creating. Some people are genetically prone to it having a family history. You are also more likely to get it if you are a woman. Osteopenia, on the other hand, is not a diagnosis. It’s a description of “low bone mass” and all it is doing is stating an observation that your bone mass is lower than that of someone who is in their late twenties. Someone who is at the peak of their bone building and strength.

Let’s clear up this confusion even further, osteoporosis warrants an extensive work-up looking for the cause of excess bone loss. Osteopenia may or may not be an early warning sign of bone weakening and generally does not trigger the need for a work up or conventional medical treatment with some exceptions. In fact, osteopenia is the result of statistics again comparing your bone density to the bone density of someone who is in their late twenties which is the considered the normal range.

So now the question arises, “When is osteopenia something to take seriously?” Remember, women have a higher incidence of osteoporosis and most of the studies have been done on women in their late twenties. Therefore, it only stands to reason that some amount of bone loss takes place with each passing decade. Whether or not slipping into “osteopenic” bone density range is a serious enough concern depends on each individual case. However, saying one has osteopenia does not necessarily say it is a precursor to osteoporosis. If you have ranges that have been defined as osteopenic, diet and exercise can help to change your numbers. Medication is not always warranted.

So the question then is, “What should you do if you have osteopenia? As just mentioned, diet and exercise can help your bone strength. I am not going to go into diet, but you can get information on dietary guidelines for bone health at https://americanbonehealth.org/nutrition/dietary-guidelines-for-bone-health/. As far as exercise is concerned, we are going to discuss osteogenic and isometric exercise. It is a given that bone responds to certain levels of physical strain making the bones stronger. Any type of activity that puts enough strain on bone such as gravity and ground reaction force or tensile forces from muscle tension to stimulate new bone growth is called “osteogenic loading.”

I am sure you have heard from your doctor that you need to do a weight bearing exercise program if you have been designated as osteopenic. Now, fitness experts and the most prestigious health and fitness journals in the world are publishing studies that endorse isometric exercise as an exceptional route to improving muscular strength and bone health. For example, the “Journal of the Facility of Medicine” in 2012 published that isometric exercises not only prevents reduction of bone density, but may also increase the mineral density of injured bone.

So you can see why I have become an advocate for “isometric exercise.” Therefore when treating your musculoskeletal pain and dysfunction at Terry Kern Physical Therapy, I will be using a combination of isometric and stretching exercises in order to alter the length and tension of your muscles with the goal of improving your musculoskeletal balance and health.