Understanding how much is safe to lift with osteoporosis

Posted by jspr422 @jspr422, Mar 2 2:37pm

Seeking the wisdom of this group on finding out/understanding how much is safe to lift when one has osteoporosis in the lumbar spine. I've heard everything from no more than 10 or 15 pounds (grocery bags!) to "heavier is better" (what you might lift at the gym). This mostly from Dr. Internet as my own doctors seem to deflect the question when asked what is safe for me to do (or what I should/shouldn't be doing). I have had no fractures and no issues (I know of) from "everyday lifting" and up to 70 lbs at the gym. I don't want to make things worse yet also know resistance/strength training can be very good for the bones.

For context: newly diagnosed with OP, lumbar spine T-score is -3.2 (hip/femur are in the osteopenia range). I do a lot of walking and and do resistance/strength training 3x week (working with a trainer). Currently weighing my options for osteoporosis medications (overwhelming).

Any advice is appreciated!

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Profile picture for Helen, Volunteer Mentor @naturegirl5

@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?

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@naturegirl5 -- this is very helpful, thank you. My trainer does not have a graduate degree in exercise physiology but does have a personal interest in osteoporosis. We've been sharing a lot of information with one another and learning together. My approach is to have excellent form, avoid anything questionable, and listen to my body. (As well as continue to learn!)

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Profile picture for andieg @andieg

@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.

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@andieg -- Yes, I agree, close to the body is the way to go. I've been doing training 3x/week at the gym and then doing balance exercises and (safe) yoga on the off days.

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Profile picture for jw9 @jw9

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!

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@jw9 -- Hoping you have been able to make a decision. It is so difficult when you feel you don't have good guidance! I am not quite there yet, but will get there soon.

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Profile picture for babs10 @babs10

If interested:

Hello Wonderful bone warriors!

OsteoBoston is excited to host the infamous Lisa Moore, of Brick House Bones, Tuesday, April 7th at 7 pm EST. "How to Reach and Maintain "Brick House" Bones with Lisa Moore will be a wonderful talk on becoming more knowledgeable about what really matters with bone strength building. Lisa calls herself (and rightly so) an 'Osteoporosis Physical Therapist'. For more information, here is a link to Lisa's website: https://www.drlisamooredpt.com/

Here is your link for Tuesday at 7 pm ET, 6 pm CT, 5 pm MT, 4 pm Pacific time.
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@babs10 --Thank you for posting this info!

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Profile picture for jspr422 @jspr422

@luckypup -- Are you on any osteoporosis medication? If so, what are you taking?

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@jspr422 Not yet. Forteo has been ordered but it's going through the prior authorization process. I think it's approved but I'm getting mixed messages from the insurance/pharmacy. I'm happy about the choice of drug and nervous at the same time. It's definitely another adventure!

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Profile picture for jspr422 @jspr422

@shorty321 -- I hadn't considered a physical therapist, I will check that out! It's been difficult finding a personal trainer experienced with osteoporosis.

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@jspr422 check the Onero website which lists the certified Onero pt’s by location.

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Profile picture for gravity3 @gravity3

@luckypup

Try melioguide.com if you haven't. She is a physical therapist primarily focuses on safe exercises for those with osteoporosis.

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Margret Martin has a wonderful website with so much information. I have also bought some of her videos & workout book. She also offers consultation, a bit pricey but very much worth it.

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Profile picture for jspr422 @jspr422

@njx58 -- I agree with you on the Forteo/Tymlos/Evenity. I've learned in my research that these are all good for bone building and the order of medications is important. Unfortunately, insurance will not cover/approve me for any of these (have appealed with no luck). So I will need to start with a bisphosphonate.

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@jspr422 Consider self-pay for the medications you & your doctor want, instead of what the insurance company "prescribes". I thought that I heard others have found ways to get some drug costs reduced a bit from the full published prices, but not clear on that.

Here is a great story from @lynn59.
https://connect.mayoclinic.org/discussion/does-the-anxiety-or-fear-of-this-prognosis-ever-get-better/
For some of us the best possible drug path is truly unaffordable without insurance coverage. But I would give it a good fight before I let myself be put on anything but the best possible therapy when my time comes.

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Profile picture for callmekate @callmekate

My chiropractor (who does ultrasound and TENS on me, but no adjustments) tells me to stay away from the weights and just use resistance bands. My spine was -4.8 at last DEXA. I am on month 9 of Evenity and will have another DEXA in August. Not sure what I'll do after Evenity. Endo says Reclast, but I've read so many stories of side effects here, I am very hesitant....

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@callmekate You chiropractor may be out of date. Professor Belinda Beck explains why in this video presentation with OsteoBoston. Dr. Beck led the LIFTMOR trials. She is an engaging down-to-earth speaker with a lovely Aussie accent, so this is a fun video also.

Excerpt from about 20 minutes in:
" ... doctor is thinking well I have a patient who looks like this they're very very frail. And I've got animal researchers telling me that if I want this person to gain bone they got to load them up. That makes me very very nervous. The trouble is that nervousness makes us prescribe "safe". What we think is safe exercise for osteoporosis are exactly the kinds of exercises that ... are all low intensity exercises which the animal research has shown us does not stimulate bone. "

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I was wondering about this too because my spine is -4.1, so my doctor send me to the UBC Sports Medicine Clinic to see a specialist about exercise. I currently do light weights, resistance training (mostly planks and push-ups), and lots of walking. I was hoping to get back to jogging. He said no jogging until I'm at least -2.5 and keep up with what I'm doing. He also said the best thing I could do right now it hopping off a step, 15 times on each side, then 15 times landing on both feet. He said it will benefit my entire body. He also recommended doing the Mayo Clinic osteoporosis exercises.

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