Understanding how much is safe to lift with osteoporosis

The key is to be careful about bending over or curling/twisting the spine. You don't want to do crunches, for example. You don't want, under any circumstances, to bend at the waist and pick up something heavy. Beyond that, it's ok to add weight gradually. Just be extra careful with movements involving the spine.

If you haven't been on any medication yet, then Forteo/Tymlos/Evenity are your best bets. You're already doing strength training, and I hope you are paying attention to vitamin D3 and K2. If the doctor hasn't done so yet, check your hormone levels.

@jspr422. Since you lift at the gym, and have had no fractures, I'd say what and how much you lift is something still to explore. I had osteoporosis and am now in the osteopenia range. My greatest loss was in lumbar spine but I've gained considerable bone density back through medication (12 months of Evenity followed by Reclast infusion) and continuing with weightlifting. I've been lifting weights at the gym and focusing on axial lifts since the 1990s which was before I had the osteoporosis diagnosis. I now work with a personal trainer. I lift about 80 pounds with Zercher lifts and Romanian Dead Lifts as well as other lifting. I do abdominal crunches and do twisting motions with weights under the guidance of my trainer. I'm very careful about lifting anything outside the gym and make sure that I squat and do not bend.

You already work with a trainer. Does the trainer have a background or graduate degree in exercise physiology and so can advise you on this?

I’ve been lifting since 2012. Currently, I do 80 lbs on the Romanian deadlift, 40 lb shoulder press, 40 lb squats (weights balanced on my shoulders), 25 lb sumo squats and kettlebell swings, plus a bunch of other chest, arm, and shoulder exercises ranging from 5 lbs to 20 lbs.

My only fracture resulted from bending over a bathtub (dorsiflexion) and pressing down hard on my ribcage attempting to get my head under the faucet.

I am very careful not to flex or twist and lift at the same time (as has been pointed out by others).

I am female, 5’ 3” tall. I’d assume someone bigger might be able to lift more.

@jspr422 I learned a valuable lesson on how much I can lift recently. For context, I have severe osteoporosis in my spine. My doctor said lift no more than 30lbs. So I learned, under 30lbs is an issue if you lift it with arms outstretched. It feels like a “no duh” now, but I felt the object I was lifting was much lighter than what I’ve lifted recently so wasn’t really thinking. But I can tell you with confidence it’s every bit about how you are doing the lifting as it is about the weight itself. Of course you should engage the core (lower abs, straight back, bend the knees, etc.) but lift/carry the weight close to the body if you have osteoporosis of the spine. Always good to have your physical therapists input. And hopefully you are also doing your physical therapy exercises 3x/week to maintain balance and strength.

This is me too: overwhelmed for months trying to make a decision from 3 meds my rheumatologist named. It would be good to have a doctor's guidance, but I have to make the decision anyway. I'm following this discussion. Also have different exercise ideas. Something tells me I better get going with both decisions!

You can read about the 2 LIFTMOR trials to learn more about people with OP lifting. Over the course of 1 or 2 months the people in this random control trail build up to full movement and full weight of 80-85% of each person's own personal 1-rep-max.

But all of the exercise was done under close supervision by experts. The most important thing is to lift anything, including just yourself, with proper form. Slowly building up the weight and movement is also important. Because you are working with a trainer you most likely know all that and keep that proper form, but I mention it for anyone else reading this tread and to keep it in the forefront of my own mind.

Since starting to do more free weights at the gym I find that it is more "automatic" that I do things outside of the gym in good form. Formerly I thought I was careful, but I had to remember to be careful. After all this practice in the gym I now have "muscle memory" to keep a straight spine and not to twist at the spine when lifting any weight, including just my own body weight. For example, in yoga classes I no longer come out of a forward fold using the "roll up from the spine" that the instructor sometimes cues.

This depends on your medical situation. I have a few, lol, and my docs have me using lighter weights with more reps. Three different docs on my team have all said the same. So that’s what I do. Absolutely no jumping but they recommended ankle weights, which I use along with dumbbells that have wide grips taped on them so I can grab. They also have me on balance exercises, and certain yoga, as well as,pool yoga. I am also a huge swimmer and have been for years. I have to say I think all these are working because I tripped on a curb recently and instead of a fall, took three big leap steps and righted myself. Again, talk to your doctor, don’t listen to some internet rando say if you aren’t jumping you’re doomed. I had someone on one of these boards tell me that ankle weights aren’t going to help me. Pfft, sorry I will go with what my DOCTORS tell me (including my sports medicine doc). Get medical advice!

@njx58 many of us do weights because it makes these 10-15 pound things easier to handle…they don’t have to be really heavy, just do several times a week.

@kfhoz I have had an identical experience.

Form is everything!!!

@nycmusic, Yes, this is largely true. That said, bone tissue responds to mechanical stress through a process called "Wolff's Law," which means that bones adapt and become stronger when the muscles pull on them during weight-bearing or resistance exercise.

When you lift weights, the contraction of the muscles places stress on the bones at their attachment points, which the signals bone-forming cells to maintain or increase bone density. Because the body adapts to repeated stress, continuing to use the exact same weight eventually provides less stimulus to the bones.

Gradually increasing the challenge over time (progressive overload) helps to maintain that stimulus so bones continue to receive the strengthening signal. This progression doesn't mean lifting very heavy weights; it can include modest increases in weight, additional repetitions or sets, greater resistance from bands, or more challenging movements that load the vulnerable areas - the hips, spine, and legs.

For those of us with osteoporosis, the most important factors are consistent weight-bearing and resistance exercise performed with good form and safe spinal alignment, with gradual progression rather than aggressive increases in load - but the load does need to increase over time.