Hi everyone, here is a great article that explains what we mean by "weight-bearing exercise" in terms of an exercise "prescription" to prevent and treat low bone density and osteoporosis.
"Specifically, activity needs to provide rapid impacts of at least twice your body weight, and it needs to get progressively harder as your fitness improves and your bones adapt.
"What does this mean for you?
"ESSA’s “exercise prescription” for bone health includes impact, resistance and balance training, with some modifications based on whether or not someone already has osteoporosis."
Written by
Mark_ABH
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Hi Mark. I was also surprised when I learned the same thing about what actually builds bone. I am trying to reverse my osteopenia ( or at least keep it from progressing into osteoporosis) by using the OsteoStrong program. It utilizes 4 stations that provide that stress to the bones in a way that simulates impact. I feel lucky to have it available in my area and to be able to afford it. Although it probably doesn't cost much more than all the meds. Check out osteostrong.me if you are interested in learning more about it.
Foodie2shoes, I am really interested in the OsteoStrong program, but unfortunately, the closest location is approximately 250 miles from my home. Note, I'm willing to drive up to 100 miles (200 miles round trip) to try/use their program but 250 miles means an overnight stay.
Would you mind sharing a bit more about your experience with OsteoStrong.
- How long have you been gone?
- Have you seen increases in your BMD since starting the program? If yes, will you share
your increases?
- Are you doing any exercising outside of the OsteoStrong program? If yes, will you please share what other exercising you are doing.
- And lastly, hope you don't find my asking this rude, you mentioned the cost, and their website doesn't specifically mention what the weekly visits cost. I think it only says it's less or comparable to many insurance co-pay. If you don't mind sharing, what is the cost of their program?
This article correlates exactly to what my fitness trainer says. When I work out on my own compared to a fitness trainer session, I realize I need to up my dumbbell weights when working out at home.
As I was already at the gym taking Pilates and barre classes, I signed up for ten 30-minute training sessions with a trainer. One session was using barbells, TRX, cable cross, elevate squat machine; another session was only using TRX combined with lunges/squats; another session using ball and band doing squats/leg raises, chest/leg machines, etc. each session covers all muscle groups and I’ve started increasing weights by 5# as I become stronger. The trainer writes down routines after our session so I can do them on my own. If I can do 15 reps easily I know it is time to increase the weight. I do weight training twice a week along with my group classes and walking.
It seems to me that if someone were taking bisphosohonates, it would be best not to do the impact exercises, only the strength, because not much bone repair would be going on with the drug. I’m always surprised that there’s not a distinction made between exercises for those taking bisphosphonates and those people not on them. Interested on others’ thoughts on this.
That's an interesting point, as bisphosphonates interrupt the normal bone cycle, meaning that old bone is held on to and the formation of new bone reduced or prevented.
I have been wondering about this and my doctor never mentioned it and frankly, I doubt that he knows the answer. I had my 1st and potentially last zoledronic acid infusion in November 2021 and I have added in a lot more jumping around in a varied of ways:
- stomping each foot, as if I am crushing a can, 4 times, twice a day.
- heel drops.
- jumping jacks, not necessary every day but a couple of days week for variety
- and instead of just walking, I'm slowing turning one of my 2 daily walks into a daily jog.
The lack of clear info/guidance is rather annoying.
FearFracture, Glad I'm not alone in wondering this! Now if we can just get a researcher to pay attention! Or just any medical people to put some thought into this! I bring it up on these blogs in the hope that more people will ask for an answer, because it seems like a potentially important issue. I've decided that if I go onto bisphosphonates, I will focus on rigorous strength training, balance, and posture, but not engage in jarring, foot striking activities. That's what common sense tells me I should do in the absence of medical advice.
I have debated what exactly I should and should not be doing. If bisphosphonates inhibit osteoblasts as well as osteoclasts, then even strength training might not be the best option. When you lift heavier weights that is force on your bones.
In December 2021, I asked an orthopedics doctor this question:
If I want to build muscle in both arms, I have to lift weights with both arms, meaning lifting weight in my right arm will not build muscle in my left arm. But if I want to lose fat around my mid-section, there is no way to actually target that one area. All I can do is try to shape up. So how does bone formation work, is it site specific like building muscle or is it global like trying to lose fat.
His response: That's a good question.
He never answered. That's an orthopedics doctor!
Note, I have since found the answer on my own: building bone is site specific, which I assumed was correct the answer, but I had wanted a medical professional to confirm what I believed to be the case. Unfortunately, he couldn't.
Additionally, I'm not sure what to believe and what not to believe from the bisphosphonate data regarding inhibiting bone formation. Does that mean it has a dampening effect or does it block it altogether?
I took bisphosphonates partially because my endocrinologist scared me into it. He literally said, "Your bones are horrible." 2.5 years later, I discovered he has never even seen my full DEXA scans. Yes, I am mad about this. He's a doctor, I'm not. I didn't know that the summary wasn't the entire report.
When I was 1st diagnosed, I point blank asked my endo if there were any natural ways to treat osteoporosis. The only options he gave were lift light weights, walk, take calcium and vitamin D. He never even mentioned vitamin K, but he strongly recommended bisphosphonates. Unfortunately, I had a lot going on at the time and I trusted his advice.
When I started doing my own research, I discovered the Marodyne LiV platform, the prune study, an almond study, and the LiftMor study. My endo mentioned NONE of these to me. During my last appt with him, I asked him about the Marodyne LiV platform and he said low intensity vibration therapy sounds promising and has shown results but can be expensive. So, he knew about it but never bother to mention it to me until I asked.
Since I have the zoledronic acid in me now, I am using it to "buy time" and to basically just get in the habit of going to the gym. I want to at least be building muscle because muscle alone can help strengthen your body and support your skeleton. I am not trying to greatly increase what I lift, at this time, because if my body can't form new bone right now but I get to the point where I am lifting 4x more weight, then doesn't that mean that if/when I skip my next zoledronic acid infusion, when my body (hopefully) is able to start building bone again, I will have to lift even heavier weights to build bone. Not sure if this makes sense, but it makes sense to me.
There is another part of me that thinks the studies showing that bisphosphonates inhibit osteoblasts may not fully apply for people who are more active. For instance, the studies may have been done on folks that weren't trying to increase the weights they lift.
I will either have a DEXA scan in July 2022 or November 2022 (haven't decided yet if I want to get it 1 year after my last scan, which would be in July, or 1 year after my 1st zoledronic acid infusion, which would be in November). I've had so many issues with the facility that did my scans that I have to find another facility to use. I know that they recommend using the same DEXA machine each time but dealing with the incompetence at the facility I used for my 2019 and 2021 scan is not good for my happiness so I don't care, I am leaving them. After my next scan I will sort of re-evaluate.
This article is interesting but also depressing and (might I say) rather unrealistic. The majority of the demographic that has osteoporosis is not one that is going to be doing gymnastics and sticking a landing, engaging in racquetball, deadlifts, bounding in different directions or jumping off high objects. I am troubled by the fact that so many of us have been told that walking is great weight bearing exercise, only to now be told that it is not.
I agree. I find the way the medical "professionals" completely ignored my risk of developing osteoporosis at a younger age (I went through a very early menopause) and the fact that they continue to give outdated advice, simply wrong. I was diagnosed at 50, and if any of my doctors were worth the paper their diplomas are printed on, my bone loss would have been caught decades ago. They all failed me. I should have been sent for a DEXA scan decades ago and if any of them had done their jobs, I would have learned about my bone loss when it was at a more manageable state. I only recently learned that the endocrinologist, who has been treating my osteoporosis since I diagnosed, never even looked at a copy of my full DEXA report. I finally got copies of my full DEXA reports, which I had to fight with the facility that did the scans to get, even I can see there are errors.
The article you posted states "activity needs to provide rapid impacts of at least twice your body weight, and it needs to get progressively harder as your fitness improves and your bones adapt."
The American Bone Health website states "Scientists in the United Kingdom, using accelerometers, did a cross-sectional study in teens and determined that the amount of loading required to stimulate the bone-building process equals 4.2 times body weight."
And on BetterBones.com, Dr. Brown specifically mentions a patient, Cindi, who successfully reversed her osteoporosis without meds, via exercise and diet. The routine Cindi used can be found at betterbones.com/exercise/bu... Cindi started lifting 45 lbs (Romanian Deadlift) and increased that to 135 lbs. Although Cindi's weight is not listed in the post, if you just assume that she weights 120 lbs., 120 * 4.2 = 567 lbs and she didn't have to lift that much to see improvements.
The 2 times one's body weight seems much more achievable than 4.2 times one's body weight.
I'm sorry, I really don't believe this. I wore a weighted vest, carrying at the time between 5 and 7 pounds, as I gradually increased the weights over a year, and with the other things I was doing my bone density improved from -2 to -1.6. No medication. Just moderate physical activity and a good diet with calcium, Vitamin D and Vitamin K2. I could not do more vigorous or stressful weightlifting as I have polymyalgia and am on corticosteroids. Yes, improved DXA scan results anyway!
So, I understand what the article is saying, but does that mean if I am told repeatedly by physicians that I need to take reclast (can't take fosomax because of Acid Reflux) that I dont need to do that, rather start a better exercise program as mentioned in the article.I have broken my pelvis from slipping on ice in January. I am not fully healed yet but they want me to start the reclast now.
I always worked out. But now I have torn meniscus. And other joint issues. I can not use heavey weights. I use only light weights. When I increase weight, I hurt knee. Any suggestions? I also now have fracture (moderate) . Spine.Thank You.
Hope at some point you got some answers. Depending on your condition before you start exercising, and what you have been accustomed to already, you probably should get some advice from your doctor and/or a physiotherapist with some knowledge of low bone mass. Basically you want to improve your strength, which involves improving your balance (avoid falls) and challenging your bones to become more dense which involves some light sress, as in: tai chi, Nordic pole walking, regular walking (going upstairs is good for your heart, going down is good for your bones) even a short walk every day, perhaps introducing a weighted vest if you are so inclined. Even swimming is helpful although not loadbearing as it makes your muscles stronger, which means they exert more stress on the bones, which in turn makes the bones work on getting more dense. Note that cycling is one exercise which will not improve bone density so if you bike you will want to also add some load-bearing exercise.
This is very confusing. I've read that running and jumping are not good for OP. Brisk walking - 30 minutes a day- 3 miles and hour. I am sooo confused!
It all depends on your own bone health. For those who are able, running and jumping are extremely good for the bones, but if you're at high risk of fracture, especially if you've already fractured, they might be the worst thing you can do.
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