Understanding Bone Density: signs, solutions, and the role of physiotherapy.

By Beth LewisThe Swiss Touch Physiotherapy

Bone health is something we often take for granted. It’s only when problems arise do I see people start to take action. One of the most important yet under discussed aspects of musculoskeletal health is bone density. Low bone density can lead to conditions like osteopenia and osteoporosis, significantly increasing the risk of fractures, especially as we age.Osteopenia: A condition where bone mineral density is lower than normal but not low enough to be classified as osteoporosis. It indicates an increased risk of developing osteoporosis.Osteoporosis: A disease characterized by significantly low bone mineral density and deterioration of bone tissue, leading to increased bone fragility and risk of fractures.

What is Bone Density?

Bone density refers to the amount of mineral content (primarily calcium and phosphorus) in your bones. Higher bone density means stronger bones. A DEXA scan (dual-energy x-ray absorptiometry) is the most accurate way to measure this (Kanis et al., 2019).

Signs of Low Bone Density

Low bone density often progresses without noticeable symptoms until one day, a fracture happens! However, some early warning signs and risk factors include:

• Frequent fractures or breaks from minor incidents (e.g., coughing or tripping)

• Loss of height over time

• A stooped posture (increased kyphosis) or back pain

• Family history of osteoporosis

• Being post-menopausal in women or over age 65

• Poor nutrition, especially low calcium or vitamin D intake

• Inactivity or prolonged immobility

• Smoking or excessive alcohol consumption

• Chronic use of corticosteroids

If you’re at risk or have been diagnosed with low bone density:

1. Get a bone density scan (DEXA): This will confirm the diagnosis and establish a baseline.

2. Consult your healthcare team: This may include your GP, endocrinologist, or physiotherapist.

3. Prioritise nutrition: Ensure adequate intake of calcium and vitamin D through diet or supplements.

4. Stop smoking and limit alcohol: These can weaken bones over time.

5. Exercise regularly: But not just any exercise. Weightbearing and resistance exercises are key (Watson et al., 2015).

The Role of Physiotherapy in Bone Health

Physiotherapy plays a vital role in both preventing and managing low bone density.

A physiotherapist can help by:

• Designing a safe, progressive strength and balance programme

• Teaching fall prevention strategies

• Addressing any existing pain or postural issues

• Encouraging consistent weightbearing activity

What is ONERO™ Bone Density Training?

ONERO™ is an evidence-based exercise programme developed for individuals with low bone density, based on high-quality clinical trials. Originating in Australia and led by Professor Belinda Beck, ONERO™ is designed to:

• Improve bone strength

• Reduce fracture risk

• Enhance balance and functional mobility

The ONERO™ programme includes:

• High-intensity resistance training

• Impact-loading exercises

• Individualised programming and supervision

• Proven safety and effectiveness, even in older adults

In a landmark trial, supervised high intensity resistance and impact training led to significant improvements in bone mineral density, functional performance, and posture in postmenopausal women with low bone mass (Watson et al., 2015).

Physiotherapists trained in ONERO™ are qualified to adapt and deliver this program safely and effectively, helping you regain confidence and strength. I am the first physiotherapist in the UK that is trained to deliver the ONERO™ programme at out Mayfair clinic! 

Final Thoughts

Bone density isn’t just a concern for the elderly, it should be a lifelong focus. By recognising the signs early and taking proactive steps through exercise, nutrition, and professional support, you can maintain strong, healthy bones well into later life. If you’re concerned about your bone health or would like to know whether the ONERO™ programme is right for you, contact a The Swiss Touch to get on top of your osteoporosis management.