Safe Weight Bearing

[Seacrab]

I am a 64 yo, 20 year breast cancer survivor. I was diagnosed with osteoporosis after 5 yrs on estrogen inhibitor, Tamoxifen, and immediately put on Prolia in 2014. A recent bone scan indicates treatment is no longer effective, my results indicate osteoporosis of the spine and hips. Monday I received my first infusion of Reclast (bed bound with fever, migraine and flu-like symptoms for 2 days). I need to modify my exercise regime to incorporate "weight" bearing. The articles I have read discuss jumping, jogging, dead lifts. My question: Is there a kinder, gentler weigh bearing plan? I feel vulnerable> I walk daily, plank several times a week (for a minute), and do modified push-ups. Thank you.

[Lynnel17]

I like an old exercise video from Wisconsin called “Strong Women” based on a Tufts University study. It’s available on YouTube and on PBS Passport. Except for one stretch at the end, it seems safe to me. I use heavier weights than the instructor and try to continue to add weight. But I’d recommend that you also go to a physical therapist to start and ask her to design a good home exercise program. Your doctor could specify some parameters. I don’t know that you’ll build much bone when taking anti-resorptive medications, but having strength and good posture and good alignment will be very important for keeping you from falling and should be good for your quality of life. Good luck to you! Enjoy the spring!

[FearFracture in reply to Lynnel17]

Lynnel17, how long do you think one who has taken Reclast has to “wait” before they are able to build bone via weight bearing exercise?

[Lynnel17 in reply to FearFracture]

My impression is that, whether because of antiresorptive drugs or just age, not many with OP can build bone. Maybe those doing extreme weight lifting such as the participants of Liftmore in Australia manage to build some bone. Also, people on the bone growth drugs build bone before going onto the bisphosphonates for maintenance. People who have moderate bone loss and who don't take antiresorptives, might be able to maintain their bone density through exercise for a while; that's what I am hoping to do; just to postpone the drugs for a while. I know it can feel discouraging to think one isn't building bone, but I'm coming to appreciate how very important it is to build muscle and alignment, and I'm thankful to Mother Nature that that seems to be something we don't lose the ability to do as we age, whether on drugs or not. I will share with you that while I'm trying to maintain bone right now and avoid the drugs, a little part of me will be glad to relax into the drugs and do an easier regime of long walks and less challenging weight bearing exercises. Hope this helps. I'm not a medical person, so what I'm writing is all based on my readings and what I have concluded, so please be mindful of this when reading my response. Take care!

[FearFracture in reply to Lynnel17]

I've seen a few success stories of people successfully rebuilding their bones without osteo-meds so I lean towards it's doable if you are willing to put in the work but there are many things that have to be addressed: diet, stress levels, sleep, exercise (heavier weights, and not over doing it), vitamins and minerals.

A few success stories:

betterbones.com/exercise/bu...

terrywahls.com/osteoporosis...

bonecoach.com/our-story

Building bone it building bone is building bone regardless of the starting point. Kevin Ellis was diagnosed with osteoporosis around age 30, the cause was Celiac disease. Mira Calton was also diagnosed with osteoporosis in her 30s, the cause was that her "healthy" lifestyle was actually not providing all of the nutrition that she needed. They were both able to reverse their bone loss.

One of the biggest problems that I have found with osteoporosis is that since it is consider an "old person" disease, often the treatment is geared toward women then their 70s and 80s. I'm 53. I've had no fractures. Now that COVID is "over" I have joined a gym and I'm being careful but at the same time, I feel confident that I have a good chance at reversing my bone loss without having to continue with the drugs, but I also understand your choice of relaxing a bit and just taking the meds if that is what you want to do. Take care.

[PianoPlayer88]

I'm 69 and a 25-yr BC survivor. Sherri Betz, PhD is a PT and exercise instructor that coaches people in how to do weights and exercise specifically for osteoporosis. I am accessing her preparatory videos through Kevin Ellis' BoneCoach program. The program includes how to read tests, nutrition, stress reduction and exercise. A bit pricey, but worth it for me if only for the exercise advice. You can find Sherri Betz on the Web. I am certainly not able to lift weights yet! (Old rotator cuff injury, among other things. . . .) But she is quite detailed in her instructions on how to work up to that, and also on what moves are contraindicated. Go to bonehealth.org for a printout on how to do ADL's -- washing dishes, lifting, making the bed, etc., in ways that will help prevent fracture. Great free resources there, too!

[Seacrab in reply to PianoPlayer88]

Great resources! Thank you!

[Seacrab in reply to PianoPlayer88]

(and CONGRATS on 25 years survivorship 🙏🏼)

[HeronNS]

Have they run any tests to rule out "secondary causes of osteoporosis" - like maybe hyperparathyroidism?

As for weightbearing, you could consider carrying a small weight when you walk. The best way is to get a weighted walking vest into which you can insert small weights and very slowly increase the weight. A good one is the Hypervest, because the individual weights are each only a couple of ounces so you can start with a very small amount which will be safe for you to carry. As you become accustomed to that weight you add a little bit more. It's not the total weight you carry, but the constant challenge that additional weight gives. There may be other vests which allow you to add a tiny amount, but I haven't come across them. I think most are designed to carry fewer but heavier weights. If you have a vulnerable spine you should be very careful especially at the start. Generally speaking vigorous impact exercise should probably wait. I have heard that walking downstairs is good for the bones (walking upstairs helps the cardiovascular system!). There is a slight extra impact as you descend stairs. Another exercise often recommended is heel drops.

hyperwear.com/blog/weighted...

melioguide.com/osteoporosis... (this describes the purpose and safety of the heel drop exercise and includes a little video how to do it)

[Seacrab]

Thank you! Nothing else “appears” to be going on with my body other than previously stated (which is enough!) I appreciate your input… good thoughts! Be well.

[HeronNS in reply to Seacrab]

I mentioned the possibility of further investigations because denosumab is supposed to be particularly good at improving bone density in the spine, and there are a couple of conditions which cause calcium to be leached from the bones, and if this is happening then various treatments simply don't work. Given your medical history I would hope that your doctor has already made sure that everything is functioning as it should, but it might be worth your asking. Just to mention, as an example, the hyperparathyroidism again, it is usually very treatable and bone density improves after treatment.

[Seacrab in reply to HeronNS]

Yes, I will absolutely inquire with my physicians.

[FearFracture]

If you go to osteostrong.me you can check to see if there is one near you

also you might want to search marodyne liv (low intensity vibration) platform, it looks very promising

[Seacrab in reply to FearFracture]

Osteostrong is 1.5 hrs away, but the marodyne is intriguing., I may have to invest. Thank you.

[FearFracture in reply to Seacrab]

I was in a city with an Osteostrong last week, so I scheduled a free appt (as offered on website). I had a great talk with the owner/manager at that location. I made sure he was aware that I have osteoporosis and that I had my 1st zoledronic acid infusion in November 2021.

At this location, they have ppl use a whole-body vibration platform for about 10 minutes prior to doing the machines. Then someone assists you with using the 4 pieces of equipment. On 2 of the machines, I was able to reach the osteogenic load needed to stimulate bone growth. On the other 2, I didn't quite make it and I didn't want to push too hard--I didn't walk to get hurt. The owner said my numbers were all good for a first visit.

Since there is a location just 1.5 hours away from you, my recommendation is that you request your one free visit to see what you think. I was very upfront with the owner. I told him that I wasn't planning to start the program at this time but I wanted to know how it works because I might decide to, in the future, make arrangements to stay with a relative so I can sign up.

One thing I learned while there is that that 4.2 times your body weight number that many ppl toss around as the amount needed to stimulate bone growth is only for your lower body. Per the Osteostrong program the amount needed for your upper body is around 1.5 times your body weight--that's a HUGE difference. Note, I am going from memory on the 1.5 times your body weight number so just know I might not have it exactly correct but I do know that whatever the multiple it was lots lower than 4.2 times.

Another thing that going to Osteostrong let me see/experience is what I need to emulate to stimulate bone growth. Unlike the equipment in a gym, the machines that Osteostrong uses do not "move". You aren't actually lifting the weights you are simply applying the force that would be needed to lift the weights. I now know how to tweak some of my gym routine to potentially get the results that Osteostrong says there program provides, so again, it might be worth a day trip to just see how it works. If you do decide to try it, if they try to get you to use the whole-body vibration (WBV) machines, just decline that part. WBV is not good for you.