Osteoporosis and static bike exercise

[Golf123]

I have diagnosed osteoporosis of the spine -4 and osteopenia of the hip. I would like to know if anyone has used a static bike as part of your exercise regime,and has it helped. I do walk a few times each week,follow a bone specific diet and also take a weekly Aledronic Acid (18 months.

[Kaarina]

I use a static exercise bike for just over 15 minutes each day but I do lots of walking each day too. Cycling is not weightbearing whereas walking is so the latter is a better exercise. Cycling may well be weightbearing if one stands up and cycles but that is beyond me now! I am not sure if the cycling has helped me.l I started doing it years ago when I had my first total knee replacement and continued ever since. A creature of habit!

[Met00]

Using a bike isn't weight-bearing exercise so, while it's good for overall health, it won't help your bones. Also, I'm surprised at the huge difference between your spine and hip scores. Do you use a wheelchair? Or do you have arthritis in your hips, which would give an artificially good hip score? If neither of these, it's highly unlikely that you have osteopenia in your hips but a t-score of -4 in your spine, because osteoporosis is systemic, meaning that bone loss is almost always experienced at a similar rate throughout the skeleton.

[Golf123 in reply to Met00]

I had a fall Sept 30 and needed a left hip replacement. I then had a Dexa scan. No problem with walking, although I have had to build my leg muscle via the static bike. I wasn't too sure whether this would also help my bones. Thank

[BonyM42 in reply to Met00]

I also have osteoporosis of spine and osteopenia of hips. (-3.1 and - 1.2 respectively)I put this down to the fact that my main exercise over the years (now aged 60)has been running . I now do upper body work - resistance training using weights to compensate. ....following Margaret Martin's programme. Too early to report on any results

[Met00 in reply to BonyM42]

Some experts believe that any difference between scores should not normally be greater than 1 standard deviation. My last DEXA scan gave hip -2.5 but spine -3.6. 15 months later a REMS scan put them both at -2.6. REMS has been shown to be similar to DEXA for accuracy when both are done properly, but DEXA unfortunately is much more open to error. The very fact that you can't compare scores between 2 different DEXA machines to my mind in itself makes me question the reliability of DEXA.

[Golf123 in reply to Met00]

That's very interesting . Unfortunately, my diagnosis happened at the start of Covid. I received my Dexa results by phone and was advised to take Aledronic Acid. I do wonder if there was an error as they also said I had lost height. My husband has measured me twice and there has definitely not been any loss !! When I have my next Dexa scan it will be interesting to see the score. I would possibly consider a REMS done privately.

.

[FearFracture in reply to Met00]

"The very fact that you can't compare scores between 2 different DEXA machines to my mind in itself makes me question the reliability of DEXA." I 100% agree.

This is just stupid. Imagine if you had to take your temperature with the same thermometer every time or if you had to use the same blood pressure cup every time.

It makes no sense.

It pretty much implies that if you had a DEXA scan done at one facility in the morning and later that day you went to a different facility and had another DEXA done, that you are pretty much guaranteed different results. I get wanting to have the imaging done on the same type of scanner, meaning it is easier for doctors to compare results when both scans were done on either a GE Lunar or both were done on a Hologic but the same exact piece of equipment seems highly suspect.

[FearFracture in reply to BonyM42]

Are you taking any osteo-meds or are you attempting to increase your BMD via natural means only.

My spine t-scores

2019 -3.9

2021 -3.7

Both of my hips are around -3.1ish

I got pushed toward meds and took alendronate for 1.5 yrs with very little improvement and had my 1st zoledronic acid infusion last November. After getting the infusion, COVID was "letting up" and I'd been vaccinated so in January 2022 I joined a gym. I asked my doctors what I could do exercise-wise--they all ways say ask your doctor before starting an exercise program--and they really had ZERO advice, other than been careful LOL and go slow.

I try to go to the gym every other day or at least 3 times a week and I have been slowly increasing the weights that I use. I'm now walking about .1 miles carrying two 20 lbs weights (one in each hand) aka farmer's carry and I do 3 sets of 10 reps on the back extension machine and I am up to 30 lbs.

Hopefully, I'll have my next DEXA in November of this year--I'm trying to have it as close as possible to 1 year after the zoledronic acid infusion, but if it shows improvement I won't be able to say definitely what caused the improvement, meaning my gym routine, my dietary and supplement changes, or the infusion, or a combo of all the changes that I have made including the infusing.

I'm both nervous and excited about my upcoming DEXA. I'm hopeful that it will show that my bones are improving but I am nervous that there might be no or little improvement and I don't even want to consider that possiblity of it showing that my bones have gotten worse.

Also, I'm trying to find an imaging center in my area that can do the TBS (trabecular bone scan/score) with the DEXA--I asked 2 endocrinologists and neither has a clue if any imaging centers around here have TBS capabilities. More and more I am convinced osteoporosis should be a complete separate field so doctors would specialize in the area and actually know what is going on.

[BonyM42 in reply to FearFracture]

My GP just wanted to medicate - very little knowledge on the exercise front, not even mentioning exercises to avoid e.g. crunches and touching toes. I asked so many questions he referred me to a endocrinologist ...I'm living in Ireland so the system may be a little different here. Endocrinologist told me I was in the range for prescribing but then said I may like to consider lifestyle changes and see how it goes for a couple of years. So that's the path I'm on. Always been active but have increased that and also watching calcium vit D, vit K2 intake. Totally agree with you regarding the lack of knowledge in the medical field. Can't really blame the GPs - they are too busy but I was quite shocked not to be automatically referred to a specialist . No suggestion even to visit a physio.

[FearFracture in reply to BonyM42]

Sounds like you got lucky with your endocrinologist. I’m in the US. I’ve had an endocrinologist since 2017 because I was diagnosed with Hashimoto’s thyroiditis a form of hypothyroidism. He has me on 75 mcg of levothyroxine for that.

In hindsight I know he should have sent me for a DEXA scan the minute I walked in his off. He’s also my mother’s doctor and she has osteoporosis. I’m 4’11”, I’m fair skinned and I went through an extremely early menopause.

When my DEXA came back showing osteoporosis, I asked him if there was anything I could do, natural means to reverse my bone loss, and he said walk, lift light weights and take calcium and vitamin D supplements—given that I’d been doing all these things I knew that wasn’t the answer.

When I mentioned to him that I thought my bones were strong because I’ve had a few falls and haven’t broken anything, he told me “that’s not how it works” and that my bones were “horrible” and he pushed meds.

Since I started doing my own research I learned that my having fallen and not broken in being a sign of good bone quality is how it works. I’ve also learned that there is a very good chance that my DEXA is wrong simply because of my small size and that a TBS (trabecular bone scan/score) is a better indicator of fracture risk for smaller people. Of course when I asked my endocrinologist where in my city I can get the TBS done, he has no idea.

Really feel like I’m getting very little help for the medical professionals I’ve been dealing with.

One bright spot is I saw a new OB/GYN PA a few weeks ago, and asked her if I could try HRT, and she is willing to prescribe it if I want to try it.

This November will be 1 year since I had the zoledronic acid infusion and I’ll be getting another DEXA. Once I have my results I decide which direction I want to go in. My endocrinologist is expecting me to have another infusion but I’m leaning towards skipping the infusion and possibly just continuing with my diet/exercise plan and possibly starting HRT.

If you haven’t already considered this, I recently bought a pair of XERO shoes, minimalist shoes—the soles are only about .5” thick. Wearing them is supposed to be as effective as doing foot strengthening exercises. melioguide.com/perfect-post...

[BonyM42 in reply to FearFracture]

Thank you for this link. I hope your next scan shows good results for you. The HRT sounds like a good move - there have been many advances in that area. Unfortunately I've not been prescribed this due to a earlier breast cancer event.

[FearFracture in reply to Met00]

Not related to this thread but I am trying to find someone who is familiar with the BMAD calculator courses.washington.edu/bone...

Dr. Ott uses this to "adjust" DEXA scores for smaller people.

I have plugged my numbers into the calculator but would like to ask someone about the results I am getting to see if I am understanding them correctly.

[Met00 in reply to FearFracture]

I'm aware of this calculator, but have never used it so unfortunately can't help you with it, sorry. Could you start a fresh post with your question? I've also read that DEXA scans tend to underestimate the density of small-boned people (potentially giving an erroneous score in the osteoporosis range) and overestimate the density of large-boned people. You can tell whether you're small-boned or not by wrist size combined with height: medlineplus.gov/ency/imagep...

[FearFracture in reply to Met00]

Thank you for responding. I tried to start a new post about the BMAD calculator a few months ago but I didn't get any helpful replies

I'm currently trying to find an imaging center with TBS (trabecular bone scan/score) capabilities. I don't have any fragility fractures and I'm very active and I keep wondering if I am being to aggressive with my exercising--if my lumbar spine really has a -3.7 t-score and my hips really have approximately -3.1 t-scores, meaning if my DEXA was correct, should I really be doing 100 heals drops several mornings a week, and stomping down like I am crushing a can, and back extensions with weights (I'm now up to 4 - 5 sets of 10 reps with a 30 lb weight). I am taking is slow--I started going to the gym in January and have gradually been increasing the weights but it's like who knows what will happen next or what day I might go to far 😬 I did ask a couple of doctors about my exercise program and they really didn't have any advice.

TBS is supposed to give a better indication of actual bone quality so having that number might make me feel better and would definitely help me make a decision about what I am going to do next. I'm currently scheduled for my 2nd zoledronic acid infusion in a few weeks, but I want to get another DEXA (hopefully with TBS) before having the infusion and then decide what to do. It's kind of funny because no matter what the DEXA shows, I'm leaning towards not having another infusion at least not this year. I mean, if my bones haven't improved then what is the point of getting another infusion and if my bones have improved, I won't be able to say with certainty how much of the improvement was due to the infusion vs. my new exercise regime and my dietary changes--I have made a lot of changes, including switching from regular tennis shoes to minimalist shoes--all to help with my bones.

[Met00]

Presumably they scanned your right hip?!

[Golf123]

Whoops...I meant Sept 2020. Right hip was scanned showing osteopenia.

[Met00 in reply to Golf123]

Do you have arthritis in your right hip?

[Golf123 in reply to Met00]

Not that I'm aware. No diagnosis has been made.

[Met00 in reply to Golf123]

In that case, have they given any explanation for the massive difference between your hip and spine score? If an error has been made in your spine measurement, you might not even have osteoporosis! On the other hand, if there's an error with your hip score, your might have osteoporosis there as well as in your spine. The scores should be broadly similar unless there's a specific reason for the difference.

[Nannie-C]

you could well have one if the frequent dxa errors as sadly a big difference in levels can indicate that. Plenty of reseach on line about them sadly.

Also if not done I’d want my parathyroid glands checked as a common cause of bone loss and frequently overlooked.

[Zumbablue]

I had my hip replaced 7 weeks ago. The physiotherapist recommended static bike without any tension. After one session I’m not able to give advice on how it helps. However, any exercise to rebuild muscle and ligament must be helpful.