Newly Diagnosed With Osteoporosis or Osteopenia? Resources for Safer Exercise
Today, I received an email from a woman recently diagnosed with osteoporosis of the spine at age 62. She is very active with yoga, walking and hiking, bicycling, gardening and tennis. She wanted to know what adaptations she should make to road biking. As a nurse practitioner, she is disappointed that, “…the medical profession does not give more information to people when giving someone this diagnosis.” I think that is changing for the better. My own doctor passes out a list of osteoporosis exercise recommendations, including strength training and weight bearing cardio…but no specific safety precautions, other than referring them to my classes!
Here’s a post by an NOF affiliated physical therapist on WebMD about spinning and road biking. (Scroll down, it’s the 4th post.)
For basic moves to avoid, see my video clip on safety precautions.
I always recommend the National Osteoporosis Prevention’s (NOF) Moving Safely sections.
The NOF also has a free webinar series, with an excellent one on Safe Pilates and Yoga for Bone Health.
This excellent article, “Protecting the Spine Through Exercise,” is written by Karen Kemmis, a physical therapist affiliated with the NOF.
The NOF has a good little book called, Boning Up on Osteoporosis: A Guide to Prevention and Treatment. With shipping, it’s around $6.
Believe me, even as an exercise professional, it has been a journey getting the right information for safe movement with those with bone loss. The National Osteoporosis Foundation (NOF) “… has organized a group of exercise and bone health experts to perform a comprehensive review of all of the data that is available and to publish this information in a peer-reviewed journal article. These experts are currently looking at the risks and benefits of different forms of exercises in different age groups and genders.” I’m very grateful to the physical therapists, associated with the NOF, who through the years have answered my many questions about safe movement.
You might check out some of my recent posts on the NOF online Support Community. Many resist adapting their exercise when diagnosed with osteoporosis, but we never know who is going to fracture or when. Many can live without fracturing and I hope that all of you reading this blog will heed the precautions and have a better chance to be among those who don’t fracture!
Do you know someone with bone loss? Please share this information with them!
Keep moving, but move safely!
–Susie
Hi Susie,
My gym is now offering Body Pump classes. It looks like a great class but because of my osteoporosis I am hesitant to try it. I was curious about your thoughts on this type of class. One move that particularly concerns me is that I observed an exercise that involved placing the bar (with weights) behind the neck/on the shoulders.Thank you for any thoughts you might have.
Joan
Dear Joan,
Many Body Pump exercises are basic strengthening moves, some of which I do in my own classes. But I never do the deadlift, because it’s hard keep good form and NOT round the spine. With bone loss, the National Osteoporosis Foundation recommends NOT bending over with a heavy load, even if you hinge at the hips with a neutral spine. Abdominal curls aren’t safe with bone loss or disc problems. With some of the other exercises, the only problem might be simply the way of getting into the starting position. Using too much weight could be a problem, especially when it’s sitting right on the spine, like you asked. I wouldn’t do that one at all! See *Precautions below….
I prefer to use dumbbells instead of barbells because it’s easier to keep your wrists in their normal alignment with your arm. With a barbell, you need to turn your hands slightly to hold the bar, so it could be a strain on your muscles and tendons. Bending wrists back adds to the instability and puts too much pressure on the small wrist bones.
Here are some precautions for the Les Mills Body Pump program. The exercise examples on their website are basic strengthening/body building moves geared toward a healthy person with no bone loss.
The moves that are demonstrated can be risky for people with osteoporosis or low bone density either in the move itself, getting in and out of the move, or the way a weight is held or the amount of weight.
Here’s the link if you want to see what I’m referring to: https://w3.lesmills.com/global/en/classes/bodypump/learn-the-moves/
*Precautions:
In general, their philosophy of, “Go Hard or Go Home,” could take a person beyond what is appropriate for their fitness level. It’s safer to listen to your body and stay at an intensity level that works for you and won’t cause injury. Working with a fitness professional or physical therapist can help you find that right level of not too hard or not too easy.
“…800 repetitions in an average workout…” could be problematic for repetitive stress injuries.
With any weight lifting program, get guidance from your doctor or physical therapist on a weight limit for you, individually. The National Osteoporosis Foundation recommends a limit of 10 pounds, that’s 5 pounds in each hand, for those with bone loss and to check with your doctor for the weight limit that is right for you.
Risky moves for those with bone loss in the Les Mills Body Pump program:
Squat: Even though they bend the knees and hinge back with the hips, which is a good way to squat, having that large barbell resting on the upper back puts too much pressure on the spine.
Chest press: It’s a stable move that strengthens the arms, chest, and shoulders, but getting into the starting position while holding a barbell is risky because your spine is in a forward flexion. Too much weight would also be an issue.
(Anytime that you need to lie on your back, lower yourself onto your side, then turn onto your back, keeping the spine in a neutral position and don’t twist. Another way to get down is walking out on hands and knees until prone, then rolling onto your back, keeping a neutral spine throughout the move.)
Dead row: As I’ve mentioned before, physical therapists feel that bending forward with the barbell is too risky for the spine, even if hinging from the hips. There are many other exercise options to strengthen the back side of the body without bending forward with weights.
Clean and Press: Quick moves increase the risk of fracture with bone loss, especially with a heavy barbell in the “catch” phase. Plus, it’s risky for the ligaments and tendons to have the wrists bent back, especially with excessive weight on them.
Press pullover combo: Lying back into the starting position holding a barbell is risky, as is too much weight.
Lunges: Done correctly, lunges are wonderful moves, but a barbell resting on the upper back is risky.
Reverse Curl Ab Move: Abdominal curls of any kind are risky for the spine.
You’d have to adapt many of the moves if you take the Body Pump class, so take care!
Hello,
I’m a very physically fit 34 year old and was diagnosed with osteoporosis in my lumbar spine and osteopenia in my hips in February.
I had no pain or associated symptoms- it was diagnosed by chance through a routine DXA scan. I already did all the right things to prevent – trained 4 -6 time per week (mix of circuits, les mills combat, body sculpt, shred, Pilates / body balance) and had a good diet with right level of calcium.
Now I’m trying to understand the right types of exercise, level of weights and frequency to maintain my fitness programme and level. However most advice is geared either towards older women or people who are in pain or are unused to intense exercise. I don’t want to put myself at risk of fractures but I don’t want to undertrain either. I’ve worked hard to get to where I am and don’t want to lose it.
Please can you advise?
Thank you so much for your help
Charly
Charly, my very best suggestion would be to get a referral from your doctor to a physical therapist who could work with you, one-on-one. A PT in a university sports medicine department could be ideal. The PT could develop an exercise program, specific to you, to help you keep your high level of fitness, but work within the parameters of keeping a neutral spine to keep your vertebrae safe. A good physical therapist can do wonders. PT should be covered by insurance and is worth the time and effort.
Making a few adaptations to positioning during movement will help you keep a firm base of support so you can stay active and lessen any risk.
The NOF’s Proper Body Alignment article has information about keeping a neutral spine while moving and exercising with bone loss. https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/proper-body-alignment/
The Exercise/Safe Movement NOF article has more Resources at the bottom of the page. Scroll down to Resources and Click on “Show More+” to access them.
https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/
There are specific exercises to be avoided in Pilates. Watch the “Safe Pilates and Yoga for Bone Health” webinar.
https://nof.peachnewmedia.com/streaming/interface-v7.php?topic=27804&band=1
It’s a free webinar from the National Osteoporosis Foundation and has a wealth of information, with numerous ways to modify and avoid unsafe forward bending, deep twists, and side bends.
It features Sherri Betz, PT, and Matthew Taylor, PT, PhD.
Click on the link below to instantly access it. Click on the play arrow and make sure your sound is on. It takes a few seconds to start playing.
Best wishes,
Susie
Lots of good info! Thanks.