Hello, I have Severe Osteoporsis according to DEXA scans done in 2021 and 2022. Instead of going on a osteoporsis drug, I want to incorporate more weight-bearing exercises into my weekly routine to see if that helps. I already do cardio exercise several days a week on a treadmill which I read is good to do. I am having trouble finding solid information on what weight machines are safe to use and how to use then properly (how much weight/how many reps/correct posture) if you have severe osteoporsis to reduce the risk of causing a fracture. Does anyone have any good books or websites that they could suggest to me on this topic? Thank you.
Weight Machines for Severe Osteoporosis - Osteoporosis Support
Weight Machines for Severe Osteoporosis
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DiscoLover
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Well I would be terribly careful if you have severe osteoporosis. Have a look at this website melioguide.com Margaret is a Canadian physical therapist. She always strikes me as someone who is full of common sense.
The last thing you want is to work with someone with no experience of working with people with osteoporosis, especially with weights, you could end up seriously damaging yourself. Margaret’s YouTube is very good as are her books and videos. I’m not sure how she feels about weight machines but I think you need to be very careful, sometimes less is more - especially if done the right way.
Thank you very much. I will definitely check out the website.
I have severe osteoporosis and I was terrified to fracture in my vertebrae at the gym and I joined planet fitness and started first the elliptical for about two weeks or a month then with like 5 lbs on different machines and I kept improving got up to like 35 lbs on some machines. Never had a problem . Now I do stairs machine too. Just go in baby steps. Even you can start with low weights at home 1, 2 , 3 lbs etc. and carry your own milk and groceries don’t let others do things like that - I used to get others to carry things but now I do as much as I safely can on my own.
Thank you for the response. It is nice to hear from someone else who has severe osteoporosis that has successfully started and maintained a weight-bearing exercise routine without fracturing any bones. I will definitely take your suggestions to heart and start out slowly with low weights and work my way up. I am retiring in less than 5 months after a 38 career with the FBI and my husband and I are moving to Ocala, Florida. Our retirement home is already under construction. We decided to have our home built in a Retirement Community after visiting several times and seeing all that they offered. One nice thing is that there are several gyms and pools I will have full access to within the community that I plan on using on a very regular basis. I heard that exercising in the water is very good for people with osteoporosis. Once I am there, I plan on checking into whether the community offers any exercise/balancing/yoga classes specifically for people with osteoporosis. I’m betting since it is a retirement community they will offer classes like that. They may even have personal trainers available in the gyms to help me figure out which weight machines are the safest for me to use. Thank you again for your response.
You are welcome - gentle polite hint - get no slip water shoes for safety around the pool. People wear them in the pool too.
Also have you considered Osteostrong?
What a great idea. Thank you so much.
By the way I am on Tymlos daily injections too. I did get side effects but I am managing them with taking electrolytes before the shot. As bad as side effects are -
Fractures are worse so I made the decision from the gains are bigger than the side effects.
I remember Ocala as a sleepy little city with a couple of main boulevards, orange groves, and a few tourist attractions. (Silver Springs and Ross Allen Reptile Gardens) It has changed a lot.
You will be near enough to Tampa (about an hour and a half) to take advantage of some of the osteoporosis programs prevented by Healthy Bones Tampa Bay.
Tampa has the highest fracture rate in the US -- and has created a coalition to address the issue. They also partner with Tampa General Hospital and Nova University on programs.
Also, you might look for someone who is BoneFit-certified. There are half a dozen in Florida including one in Tampa at Tampa General.
Just a few things I would like to comment on. I too have osteoporosis and the workouts that I focuson are weight bearing exercises with weights. Depending on your fitness level, you can start as low as two pounds (or none) and move up. Also depends on the exercise. As a rule try to stay active, doing posture exercises and workouts that incorporate balance and mobility. I do believe that although swimming and water exercises are fantastic for other reasons, I don’t believe they are beneficial for bone density. But do a variety of all for general health and well being. Our bodies need all of the things. I don’t know your fitness level and I have watched YouTube with Margaret and Melioguide but I would really love to suggest Fitness with PJ on You Tube! She has osteoporosis modifications. You can subscribe (or not) to her channel and find those workouts. She also has a paid workout program strictly for osteoporosis but I don’t feel that I need that. It’s a bit of a learning curve to familiarize yourself with the workouts ( as with any online workout programs) but I just love her. Margaret from melioguide is very knowledgeable but when you’re ready to move on, try PJ. And she makes the workouts fun! One little secret I have found with the YouTube videos is that you can go into settings and reduce the speed from normal to .75 or even slower. This allows you to not rush through the workout to try to keep up, which prevents injury and helps keep your form. It’s all about form. Enjoy all things that keep you moving and are safe for general well being. I got really hung up and scared to do my normal workouts or anything else that I do on a day to day basis after being diagnosed, but then learned to just live my live (as my osteoporosis doc said) stay active, do all things as long as they are safe. Try to eat plenty of calcium rich foods, protein and as I learned through this forum long ago, Vit K MK 7. I cannot take calcium supplements as it is not good for my kidneys. Good luck. Enjoy retirement! You’re going to be fine!
Wow, thank you for all the good advice. I just watched a few of PJ’s Osteoporosis Safe videos and she is really fun to watch. I will definitely try out some of her workout routines.
Hi, I am a retired advanced practice RN with osteoporosis of the spine who has cared for folks with osteoporosis in the hospital, as a visiting nurse and running an assisted living facility. I love P J Wren's Osteoporosis Program and her Over fifty fitness videos that are osteoporosis safe. However, I can't stress enough how valuable some sessions with a physical therapist can be especially is your osteoporosis is severe. A PT can assess you, devise a home exercise program for your needs, and most importantly make sure you use safe, proper form. PJ gives great tips and cues while doing the exercises, but she can't see what you are doing. Even PJ suggests seeing a PT. Also, my personal experience has not found many personal trainers very knowledgable in osteoporosis, let alone certified as an osteoporosis trainer. I believe it is getting better, though, as more of us "baby boomers" are needing this type of help. Osteoporosis safe exercise has made my back feel much better and given me more confidence and hope!
Thank you. I am hoping once I move to Florida in 5-6 months to find a qualified PT within my local area, or perhaps within the Retirement Community I will be living in, who is certified or has a lot of experience dealing with people with osteoporosis. Until then, I plan on being very careful with my exercises.
I'm having trouble finding a personal trainer that is trained in osteoporosis and Parkinson's. Any suggestions? I do exercises with Margaret and some other programs on YouTube. Parkinson's exercises involve twisting and bending ., which are probably not good for osteoporosis. Dr. Wanted to put me on medication. When I read the side effects I decided against medicine. I am working with a chiropractor and naturopath/pharmacist with supplements. I follow Dr.Doug Luas on YouTube. Appreciate any suggestions. Thanks in advance!
One of the big problems with many gym machines is the ergonomics. They are designed for the body dimensions of some mythical, "average," male person. Some machines are just not going to fit you properly -- don't use them. And some my requires very careful adjustments and additional props to get you into the right alignment.
NEVER compromise correct form!
I used them regularly into my 60s. But now don't have a nearby facility that I like. So it's now free weights and body weight exercises.
Do you do online weight classes ?
I sometimes sub in a Gentle Exercise class online. No weights. Most of my teaching these days is Tai Chi and Yoga for Healthy Aging.
Are you on medication?
See if there is an Osteostong location near you...osteostrong.me
How does osteostrong work to import 4.2g? How long before it shows bone density improvement? Website does not talk about it, so bewildered.
OsteoStrong has never been able to produce the clinically significant evidence.
Thank you. I was wondering about that with the lack of information on their site - if it had credible and scientific findings, it would be front and center for marketing. I find that our own program of high intensity training, resistance weights, and other weight-bearing programs is a proven approach.
Thank you for the suggestion. I checked and there is a Osteostrong location 45 minutes from where I will be living in Florida. Between now and when I move, I will be doing more research to see if it is a Good option for me. It is expensive so I have to make sure the chance of results are worth the cost.
You can try Osteostrong if they have a free consult or or trial but in my opinion it’s not worth the money. My two cents.
The phrase "severe osteoporosis" immediately suggests that you need the help of a PT or an exercise professional with a knowledge of osteoporosis in designing a program.
There was a new research report published last year in APTA Geriatrics -- based on a Delphi study -- that is now the official guidance for PTs with patients with osteoporosis. "Essential Components of Physical Therapist Management of Patients with Osteoporosis: A Delphi Study."
I have a great deal of respect for Margaret Martin, but she is not YOUR physical therapist.
You need an individualized program with someone who will show you what to do safely and correct the movements that might be dangerous.
Diet and exercise are a baseline requirement for all individuals who want to remain healthy or regain health. It may improve chronic diseases of aging, but it does not "cure" them.
If you pre-menopausal and just passing the osteoporosis threshold committed diet and exercise porgrams might be able to push back across the threshold. If you are post-menopausal with severe OP, they won't be. (Imagine trying to run up the down-escalator....)
Ethel Siris, former president of Bone Health and Osteoporosis Foundation, has this formula
Diet + Exercise + Don't Fracture (lifestyle modification + fall prevention) + Medication (if necessary, based on fracture risk)
I’ve been thinking a lot about the term ‘severe osteoporosis’ recently - for example on these osteoporosis sites (this and the U.K. Bone Health site) some people are saying they have ‘severe osteoporosis’ and others (like me) just say they have ‘osteoporosis’.
Where does osteoporosis stop and severe osteoporosis kick in?
That's a really good question. I've been noticing a few references to "severe osteoporosis" too and have been wondering whether some doctors are using scare tactics! In my opinion, osteoporosis can only be classed as severe if you've had at least one fragility fracture and with a high probability of further fractures. Too many doctors seem to use the word "severe" based on one low score (eg spine -3), even if the other score is OK (eg hip -2.5) and there are no fractures.
The technical definition from the World Health Organization is T-score less than -2.5 AND history of fracture.
I don't think people posting to this board are using the technical definition.
As used here, I think the defintion is largely in the mind (and risk tolerance/aversion) of the patient. And that is individual.
Met00 and yogalibrarian, I think what you have both said is interesting. I fractured my wrist in January 2020 and then my sacrum in 2021. I’d say both events were freak accidents and although I didn’t fall from a great height or at a great speed I landed with a lot of force on very hard surfaces on both occasions.
My spine is -3 and neck of femurs -2.7 hip is only -2.1. So by those definitions I imagine I could probably say I have severe osteoporosis but I would never think of myself as being in that category and I would agree with Met00 that it sounds like scare tactics may well be being used.
Consider this... any fracture puts you at risk of additional fractures. Although bone density can contribute to fractures there are other factors to consider.
1. Bone are not meant to fracture. They break when the load exceeds the strength. A person falling from a building will probably fracture no matter what BMD. Loads exceeds strength. But you don't expect a fall from standing height at low velocity to break bones. (Would everyone who had that same kind fall fracture?)
2. Also you need to consider what caused the fall to begin with. In osteoporosis, it is fracture that concerns us most.
3. An article in JAMA (I think) a couple years ago showed that a fracture anywhere weakens bones everywhere in the body. It was attributed to the inflammatory response everywhere in the body.
4. A fracture (especially during healing) puts you "out of kilter." (A great phrase from my grandmother.) Alignment, balance, strength, reaction time, etc. are just "off," making it harder to avert a fall that can lead to a fracture. We used to say that fractures of fingers and toes and skulls didn't count in the prediction of additional fractures. But a specialist on a recent webinar said the shoulder and upper arm fractures increase the risk of hip fractures because they throw off movement and balance.
So I don't think it's a scare tactic. I would be appalled if a doctor did not prescibe treatment after a heart attack. And I would be equally appalled by failing to treat after a fracture.
The best medical practice these days is a Fracture Liaison Service which works to prevent the "second fracture."
After reading the comments, I agree that my doctor was just trying to scare me into agreeing to start osteoporosis medication. Since I have not had a fracture (that I know of), even though my DEXA scores are so bad, with almost no other risk factors other than being petite, I probably don’t fall into the clinical category of SEVERE osteoporosis. I’m still highly concerned about my DEXA scores and am making lifestyle adjustments to see if I can improve them without medication. Just started using weight machines yesterday. I started with very low weights and concentrated on form, getting use to how to comfortably adjust the machines and keeping my posture good and my back straight during all the exercises. I plan on using the weight machines 3 days a week and cardio (treadmill walking) 4 days a week while I am still working and then once I retire I can work more things into my weekly routine like floor exercises and balancing classes and resistance exercises. Having a plan gives me some peace of mind.
Good idea to have a plan. Im almost an excessive planner, I can remember sitting in bed in hospital after I’d had a C-section making a list of things for my husband to do and I’ve just gone on from there. I make notes for what I’m intending to do the following day - I might not always do everything but you can’t beat a good plan 😉 if you look at Margaret Martin’s exercise books she tells you what exercises to avoid and she talks a lot about ‘ form’
I am definitely a planner. In all aspects of my life. I have done all the vacation planning for my family since the kids were little. In fact, I’m planning everything for a cruise my husband and I are taking right after I retire next year (I’m calling it my Retirement Cruise😁). I also put lots of “Reminders” in my phone for pretty much every day. I have some reminders set for years from now like renew drivers license/passports/car registration, etc. I have others set for every day to remind me to do things like take my supplements at different times of the day. I don’t have the best memory so the reminders help me not forget important things. I assume as I age my memory will probably get worse so getting used to setting reminders will be even more helpful then.
I was diagnosed with a -3.5 a few years ago. I was scared to move. I had shoulder surgery a couple years ago and the surgeon said the inside of my bone showed no deterioration. I know this may not be the case in my spine, but it still gives me hope. I am not a fan of medicine. I am an Occupational therapist assistant with a BS in community health. I am a big advocate for exercise appropriate for each individual tolerance and my doctor said to get my nutrients from food. Though I know we must make our own decisions and communicate with our doctors. Its hard to make a decision sometimes based on all the conflicting information we receive. Be your own advocate and stay informed. Best Wishes.
I live in a 55+ community in SC and we have three gyms, and six pools (3 indoor and 3 outdoor). Our fitness centers have personal trainers as well as numerous classes. The classes are reasonable. The personal trainers are all excellent and hope you are as fortunate. Good luck on the move and finding exercise programs that are safe for you!
Lucky! You get to retire while you still have lots of life to live!
I'm still relatively new to this osteoporosis diagnosis; first DEXA was in January of this year, age 61, about 5 (?) years too late.
I was an active person whose mentality was "go big or go home". Note I say "was". I'm fairly certain at least part of why I'm in as bad a shape as I'm in now is related to my efforts to get stronger, stay active. I didn't know why I kept injuring my back but I thought the answer was "strengthening my core."
Here's what I've learned in the last 9 months (I'm sure we've only scratched the surface,):
1) You can fracture and not know it.
2) You can think you've fractured, get an x-ray, and it won't show it.
3) Doctors are clueless.
4) If you "look healthy", are still functional, and aren't afraid to try things, even the most conscientious personal trainer/physical therapist can push you where you shouldn't have gone.
5) Everyone is clueless around "severe" osteoporosis, at least if you're young, which you are. I think the fact of having reasonable functionality is a curse in severe osteoporosis.
I'm going to get a functionality assessment from a facility where I've gotten physical therapy in the past, just to compare notes, try to determine what I've lost. My guess is that if I do this next week, 3 1/2 weeks in to my latest fracture, with the added treat of (I think) "strained intercostal muscles", I'm still going to be able to do everything she asks of me...because...I've got lots of compensatory mechanisms, I've continued to push myself to stay reasonably fit even though it hurts, and I don't like to appear "unable".
Reality is, I'm nowhere near as functional as I was. There's a lot I won't even try, now, and things I have to do, (especially if it requires repeated motions,) I'll be doing through gritted teeth and possibly tears. (I'm a hairdresser; after two hours of holding my arms out in front of me, my upper back is sparking (nerve involvement?); after 4 hours, I want to kill the next person who walks through the door. I won't work more than four hours at a time now, and I will spend the evening after that non-functional. I now know I have had two fractures in my upper back; I'm not sure how I got them, but given the ease with which I've acquired fractures I do know about, I wouldn't be surprised if I got them FROM doing hair. Just the grind of that position over time?)
A 20 minute mobility assessment isn't going to show that, and maybe it shouldn't--maybe it only "really matters" if you can't move at all. But at that point, isn't it a bit late?
All to say, be very careful.
in reply to josephinius1
I am so sorry for what you have been and are going through. I was mid 50s when my severe osteoporosis was diagnosed by suffering 5 pelvic & sacral fragility fractures while doing home PT exercises many months after discharge from formal PT. Just typical core strengthening & resistance band exercises. Life has never been the same. My DEXA was in osteopenic range except one number at -2.5. After starting Tymlos I learned about TBS scans & found a clinic that had the TBS software on their DEXA. (TBS provides an indirect measure of bone quality/microarchitecture). My TBS scores were -4s to -5s. Probably why I fractures doing normal exercises I had done hundreds of times prior. I have not found one PT facility in my area with therapists experienced in severe osteoporosis w/many prior fragility fractures. I need PT for another issue but am scared to try. Orthopedic surgeons are clueless too. A young DPT may theoretically be trained in to work with osteoporosis but they have no clue how to safely work with those with severe osteoporosis *with multiple prior fragility fractures.* I've done 2 years of Tymlos, 1year of Evenity & 1 Reclast infusion - all that just maintaining the crummy bone I already have. 😞 Definitely be careful in doing PT. I wish you the best and hope you find some help & relief.
(I don't do hair but I stopped having my hair colored and stopped blowdrying & straightening my hair years ago because it hurt my midback so terribly. I only can imagine your pain doing those things for hours.😢)
DiscoLover in reply to
WOW, 5 fragility fractures. I’m so sorry that happened to you, Now I really want to find a facility that has the TBS Sofware on their DEXA machine so I can see if those readings are even worse than my regular DEXA scores so I know to rethink what types of PT exercises to do. May I ask how you did on Eventity? That is the drug my Rheumatologist was pushing me HARD to start but it is relatively new with not a long time to do lengthy trails to see the long term effects so I was to scared to go on it. Also, since it has a black box warning on it stating it increases the risk of heart attack and strokes and should not be used by anyone with heart valve issues, I did not want to take the risk since I have had mitral valve prolapse. However, Evenity is the best osteoporosis drug based on reported claims to actually rebuild healthy bone tissue. From your response, it did not seem to help with increasing your bone density. What did your doctor say about that? By the way, I plan on cutting my hair (it has been very long most of my life) once I retire to Florida in 5-6 months because it is becoming tiresome to dry and flat iron it and I don’t want to risk injuring myself by having to hold a hair dryer or flat iron above my shoulders for 20-30 minutes every time I wash my hair. Plus, Florida is inherently HOT all the time so I figure I will be a lot more comfortable with shorter (shoulder length) hair anyway. I also will stop dying my hair and just embrace the GREY. I started getting grey hair in my 20s and by the time I was in my 30s I was almost totally grey but I did not want to look like I was in my 70s so I have been dying it regularly. I went grey early due to a inherited condition passed down through the women in my family. Since I will be living in a Retirement Community where the majority of people will have grey hair and I won’t feel the need to dye my hair to “fit in”.
in reply to DiscoLover
Hi - I did not have a measurable response to any of the 2 anabolic treatments I used (Tymlos & Evenity) per DXA w/TBS and BTMs (bone turnover markers). I did not have further fractures (so far). So while no one knows why I do not grow bone (one of my fragility fractures is a nonunion), I am not considered a treatment failure overall. I did not have any significant side effects from Evenity - I did request a complete cardiac workup before initiating as my family has a lot of CVD history. Tymlos gave me no issues except brief spells of racing heart sometimes. Each person needs to speak with their providers about their own personal & family risk factors. I do remain vigilant in regards to not falling, taking appropriate supplements, trying to get enough protein most days. I just cannot do the exercise part sadly. I am a nurse by background so no one was more stunned than I was when all of this happened to me.
josephinius1 in reply to
Wow, thanks so much for sharing your story. You know a lot more about osteoporosis/meds than I do at this point, and you might be the first person I've encountered who's admitted "doing hair" (even your own,) hurts.
I'm sorry for what you've gone through too. How did you discover your sacral and pelvic fractures? My sacrum was my first clue that something was really, really wrong, but x-rays have shown absolutely nothing. I've watched a couple of "doctor to doctor" youtube videos on sacral fractures and the doctor doing the teaching said they can be very hard to find. Yet, I've read/watched that sacral fractures aren't even that uncommon in runners, and I took up running at age 49, trained for and completed one marathon, one Olympic distance triathlon, several half marathons, and three relays (where you run about 15-16 miles in a 24-36 hour period, depending on how fast your team is.) I mean, osteoporosis aside, I put some wear and tear on that puppy all post-menopausally. Not saying it was a bad idea to run--it brought a lot to my life when I was feeling pretty low--but I also had no idea it could impact my back. Yet, oh my goodness, when I first "did something" to it, it was dreadful. I didn't see a doctor, but that is when I got myself physical therapy. (It had mostly healed by the time I got in, though.)
Anyway, I still don't know what I did that first time, but I was a lot more careful after that, until two years later, when I did it again. that's when I knew I'd reached a turning point, that even if I recovered from this event, pain and pain management seemed destined to define my future (and I had no idea why. It actually IS good to have a diagnosis.) I've reinjured my sacrum four or five times since then, once trying to play pickleball with my 82 year old mom and her 80 and 90 year old friends. That was a fun day. (I didn't even make it into a game; my first practice backhand took me out. Some ladies were walking over to start a game, saw me go "ohhhhh", turned around and walked away, like "Yeah, we're here to play." Even my mom was all, "Oh no, this isn't going to affect my game is it?" I just said no worries, play, I'll go for a walk. (In my experience, initially whatever is happening doesn't really hurt--it's more like a sickening feeling. It's not until later that it starts to hurt.)
Did yours hurt? I thought it might be "joint instability" and it still could be, but no one is willing to venture a guess. My (new) primary care person said "it's just arthritis" but the physiatrist said, "You don't have arthritis at all." Jolly good fun when medical professionals can't agree.
So you haven't broken any other bones besides those 5 sacral/pelvic fractures? What's a nonunion fracture? (I can look it up.) I'm truly interested if you are willing to spare the effort to write.
I broke my wrist the same year as the first incident with my sacrum, and I'm pretty sure I broke a bone in my foot shortly after the second incident. I know, most people might go to the doctor, but..now that I HAVE gone, I don't think I would've learned much. Even breaking my wrist, no one said a word about getting a bone scan/osteoporosis.
Your experience with drugs is what I'm afraid will be mine. I was prescribed Evenity too, but our insurance denied it. I'm currently taking the fosamax they default prescribed back in January, but I think I've already burned a hole in my esophagus. Endo said don't take it but PCP said it would help with pain, so, I'm taking it, but I just FEEL like my bones are worse. I've never heard of TBS, and no one has done bone markers, but, like you, it just seems like my body is bent on not making bone, and based on other tests, no one has any idea why. (At least I have ruled out cancer.)
One complication for me is Hashimotos. Do you have anything like that going on? I guess--of course, this is all from Dr Google, I've received exactly zero education on Hashimotos from my doctors--Hashimotos can affect a lot of systems.
But I think the bottom line is stress. No one can totally avoid it, but I've known for awhile I don't do stress well--it's just always affected me such that I'd feel I was "breaking down" and now look--I really am!
What do you think? Have you made any connections of that nature?
Sorry, I write a lot, but it's just so nice to hear from someone who's had some similar experiences. It seems like for a lot of people, it's kind of academic; like they say, osteoporosis doesn't hurt (unless you fracture,) and though I've read differing statistics, one article I read suggested the incidence of fracture is about 15%. (Others say something like 1 in 3 by the age of 80, so I don't know.) So most people seem to be dealing in prevention--which is good! Prevent if you can! You don't want to be at this place if you can help it!
I am an occupational therapist assistant who has worked in rehabilitation for many years. Exercise within individual tolerance is good as well as good nutrition. That being said too much of a good thing can not be a good thing. Our bodies need rest as well. Give yourself some TLC and if you only take small walks daily that is good for mobility and circulation. We don't have to be all or none. I walk everyday and do gentle exercises to stay strong without too much stress on these fragile bones. I have nothing to prove and just want to be the best I can for me. Take care and respect those bones.
Oh! One more thing, forgot to add: I'm seeing a physiatrist, only have seen him twice but so far he seems to be the most attuned to what actually is happening in my body. He is recommending aquatherapy. It's not good for building bones, (I honestly think that ship has sailed, for me; plus, I was doing it all and I still ended up with severe osteoporosis,) but HE said it would still strengthen my back with much less chance of injury. The trick is going to be finding a physical therapist who does water therapy.
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