Can Exercise Help Prevent Spinal Fracture?

Fractures, including spinal fractures (eg, vertebral compression fracture), are a major medical risk for postmenopausal women. When bone-protecting estrogen drops, the risk for fracture skyrockets. The findings from a recent research study can help you with your doctor’s guidance to craft your exercise plan to help prevent painful spinal fractures.

Exercise is an important piece to the prevention puzzle, and researchers behind a 2019 study titled, Association of Physical Activity and Fracture Risk Among Postmenopausal Women, sought to answer whether the intensity and type of exercise was linked to “site-specific” fracture risk (eg, bone fractures in your hip, wrist, knee, spine).
Researchers asked study participants how many days a week they engaged in physical activity, for how long and to identify the intensity of their exercise. Photo Source: iStock.com.

Fracture Risk: What Women Need to Know

Each year, American women report suffering from 1.5 million fractures—with 14% of those being hip fractures.¹ The bones in your spine can break as well, and spinal fractures can cause serious problems, as they may affect your spinal cord.

Several risk factors increase the likelihood that you’ll experience a fracture. Low bone mineral density, which is associated with osteoporosis, increases the chances you’ll experience a vertebral fracture in your spine or fracture in another bone in your body. Fractures are also linked to falls and reduced physical function (such as reduced mobility, muscle strength, range of motion, and balance).

We know that physical activity and exercise can reduce or eliminate some of the risk factors associated with fractures. Does the amount and type of physical activity linked to site-specific fractures, including those in the spine, also play a role in postmenopausal women? The researchers discovered that they do.

A Look Inside the Study

The study followed the physical activity habits of more than 77,200 postmenopausal women between the ages of 50 and 79. The average follow up period was 14 years, and the research team found that about 33% of women reported a first incident fracture.

To understand the physical activity habits of the study participants, researchers asked the women to complete questionnaires about their physical activity and sedentary behaviors. The researchers asked how many days a week participants engaged in physical activity and for how long. They also asked participants to identify the intensity of their physical activity:

• Strenuous physical activity: Exercise that causes sweating and elevated heartbeat (eg, aerobics, jogging)

• Moderate physical activity: Lower impact exercises (eg, elliptical exercise machine use, gentle swimming)

• Mild physical activity: Lowest impact activities (eg, golf, bowling)

Walking was not included in the intensity categories and was assessed separately. Specific to walking, questions included:

• How often do you walk outside the home for more than 10 minutes without stopping?

• When you walk outside the home for more than 10 minutes without stopping, for how many minutes do you usually walk?

• What is your usual walking speed?

The researchers also asked about activities including household cleaning (eg, washing floors) and yard work (eg, raking leaves).

In addition to understanding the activities the women engaged in, they also measured inactivity by asking about sedentary behaviors, or time spent sitting or lying down. The questions included how much time the women spent sitting during work, while eating and while commuting.

For fractures specific to the spine, the researchers found that mild activity was associated with lower risks of clinical vertebral fracture. A clinical vertebral fracture is a spinal fracture that was detected and diagnosed by a doctor in a clinical setting (eg, hospital, doctor’s office). For example, back pain may be the result of a fall that led to a vertebral compression fracture.

• Note that the study did not distinguish between the types of vertebral fractures (eg, burst, compression).

Study findings related to other site-specific fractures include:

• Any level and type of physical activity was significantly associated with lower hip fracture risk.

• Moderate to vigorous physical activity was associated with reduced wrist and forearm fractures.

• Higher total physical activity was associated higher knee fracture risk.

Overall, the researchers found that reduced sedentary time and regular physical activity—even if the activity is light in intensity—were associated with lower fracture risk.

What It Means for You: Physical Activity’s Role in Preventing Vertebral Fractures

Breaking a bone in your spine can cause severe pain and may even threaten your spinal cord, so preventing a vertebral fracture is extremely important. The study findings showed that incorporating mild, low impact activities and limiting your sedentary time are associated with reduced spinal fracture risk.

Although this research focused on postmenopausal women, it’s important to understand that fracture prevention measures are important for all adults—even if you’re not at risk for bone loss or have osteopenia or osteoporosis. Incorporating light physical activity as part of your daily routine may go a long way toward preventing falls, strengthening your muscles, and improving your balance.