Weight bearing exercises promote strong healthy bones.
Some weight bearing exercises increase the risk of prolapse worsening (and bone fracture)!
This creates a dilemma for women with pelvic floor problems seeking to strengthen their bones with weight bearing exercises.
Read on now to learn how to choose the best weight bearing exercises for strong bones and protect your pelvic floor:
- What are weight bearing exercises?
- Best weight bearing exercises to choose (for women at risk)
- Unsafe weight bearing exercises to avoid (for women at risk)
- Daily guidelines for pelvic floor safe osteoporosis exercises
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What are Weight Bearing Exercises?
Weight bearing exercises are exercises that involve supporting your body weight through your feet during exercise.
Weight bearing exercises help you load your bones, stimulate bone building and prevent bone loss.
The most effective weight bearing exercises for building strong bones are high impact exercises that involve landing heavily e.g. running and jumping.
High impact exercises are more effective than low impact exercises for building new bone.1 Unfortunately high impact weight bearing exercises are not appropriate for women with prolapse and/or high risk of bone fracture with osteoporosis.
Best Weight Bearing Exercises to Choose
a. Low to Moderate Risk of Injury
Women at risk of prolapse worsening with low to moderate risk of bone fracture can often continue to exercise safely and effectively by avoiding high impact exercises in favor of lower impact weight bearing moderate bone building (osteogenic) exercises.
Low impact exercises involve keeping at least one foot on the ground at all times during exercise.
Moderate osteogenic exercises2 include:
- Brisk walking
- Stair climbing
- Low impact dancing (e.g. ballroom dancing, low impact aerobics)
- Specific resistance training exercises
b. Moderate to High Risk of Injury
Women at high risk prolapse worsening and/or bone fracture may find some of the moderate osteogenic exercises listed above unsuitable. These women often find low osteogenic exercises manageable.
Every woman is different in terms of the exercises best suited to their pelvic floor support and bone strength.
If your fracture risk is high seek exercise guidance from a suitably qualified health professional.
Low osteogenic exercises2 include:
- Slow walking
- Tai Chi
- Lawn bowls
- Supervised resistance exercises
Non osteogenic exercises:
Water-based exercises and safe cycling exercise have excellent health and fitness benefits and are usually pelvic floor friendly, however they do not load bones sufficiently for bone building.
If you cycle or swim, try to include osteogenic weight bearing exercises and resistance training to promote your bone health.
Unsafe Weight Bearing Exercises (for some women)
High impact exercises are excellent bone building exercises during childhood, adolescence and before menopause in women without pelvic floor problems.
After menopause the focus of bone health exercise shifts to maintaining bone strength and preventing or slowing bone loss.2
High impact exercises are unsuitable for women with or at moderate to high risk of bone fracture. These exercises have the potential to overload weak brittle bones with the high impact landing forces increasing the risk of bone fracture. Exercise for osteoporosis must be appropriate for a woman’s existing bone strength.
High impact exercises are unsuitable for women with or at risk of prolapse worsening. These exercises have potential to overload weak pelvic floor tissues with heavy landing contributing to stretch and strain of the pelvic floor tissue supports and worsening prolapse symptoms especially with repeated exercise.
High impact weight bearing exercises include:
- High impact dancing (e.g. quick step, step aerobics with high step/jump downs)
Guidelines for Effective Pelvic Floor Safe Osteoporosis Exercises
Promote your effective bone health exercise with:
- Exercise on at least 3 days/week
- Regular short bouts of weight bearing exercise more effectively load bones than one long session – include short intense (hard working) exercise sessions in your routine especially if you are time poor
- Pelvic floor safe weight bearing exercises, appropriate resistance exercises and balance exercises
- A variety of exercises and avoiding the same exercises
- Progression of the amount and intensity of exercise gradually over time
- Avoiding prolonged inactivity
Key Points for Safe Weight Bearing Exercises
High impact weight bearing exercises are effective bone loading and bone building exercises. Unfortunately the impact associated with heavy landing can increase the risk of bone fracture and worsening prolapse in women already at risk of these problems.
Many women with prolapse and/or osteoporosis can continue to exercise effectively to promote their bone health by regularly performing a variety of low to moderate osteogenic weight bearing exercises, appropriate resistance and balance training exercises.
1 Bennell K, Khan K, McKay H (2000) The role of physiotherapy in the prevention and treatment of osteoporosis Manual Therapy 5(4), 198-213.
2 Osteoporosis Australia Medical & Scientific Advisory Committee (2014) Exercise Medical Guide Osteoporosis Australia (2nd edition, May).