1. < Osteoporosis & Bone Health

Conflicting advice on exercise

Posted by sheilad1 @sheilad1, Dec 9, 2022

I was told exercise must be weight bearing and impact like walking dancing and marching in place. This says weight bearing but easy on the impact.
https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989
Is weight bearing but not impact ok? My knees would appreciate that.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Rubyslippers | @triciaot | Jan 16 4:42pm
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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I’d suggest to request a prescription for physical therapy. Before you schedule an appointment with a PT call the facility and make sure you are seeing a therapist that has experience with osteoporosis. Just as in any broad field, like medicine, people specialize. There are sports, hand, geriatric, rehab, inpatient, outpatient specialists. It is not insulting to the therapist to ask about their background; it is actually a recognition that their specialized knowledge is appreciated.
My understanding of the PT research on building bone strength is that all of the regular exercise is good for maintaining bone (unless you’re under 18 and still growing). To really BUILD bone requires that the bone be stressed to the point of causing very minor fractures. New bone cells fill in the fracture and makes the bone stronger.
Two problems for some of us - some of us aren’t building bone as normal, we’re losing bone. So stressing the bone might not get filled in with new cells. The other is that stressing bone with osteoporosis may cause more damage than expected. That’s why having a knowledgeable PT design the exercises and then follow-up to monitor is important.
I don’t think everyone needs to see a PT. I have been at osteoporosis level for 3 years and have not wanted to stress my bones - I’ve always done enough exercise. My osteoporosis is not because I need more weight training, it’s because of some chemical, metabolic, or nutrition issue. I did a Reclast infusion last summer and my bones have just moved up into osteopenia level.

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1 reply
windyshores | @windyshores | Jan 16 6:36pm
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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Margaret Martin has a book and a website with lots of resources, videos etc. at melioguide.com. I have yet to find a therapist who is good with osteoporosis, personally, but I have fractures and PT's are afraid of me!

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ans | @ans | Jan 17 6:11am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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Margaret Martin is where I started . She does have a ton of stuff out there !!! But there are others and I’ll name a few . Sherri Betz PT - excellent!!! presented on the osteoporosis summit that’s being offered this very week. morebonehealth.byhealthmeans.com
She presented on Monday and will present again later this week. The presentation on Monday will be the more information packed one .
Don’t be dismayed if you missed this opportunity as you can purchase the 7 days worth of osteoporosis experts talks for $79 .
She works as Bone Coach’s exercise person , but she does her own stuff , has info on line , and you can hook up with her on your own , I understand.
There are other PT’s on the summit as well to hear from Sara Meeks, Robin Eisen, and the host of the summit is a PT herself , Margie Bissinger . And know Margie also does podcasts all the time with people talking about different things that impact on osteoporosis!!!! Take advantage of these outlets!!!

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dooshie | @dooshie | Jan 17 7:25am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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Good morning. This journey with osteoporosis is not an easy one and deciding on the proper protocol is different for everyone. I have done so much research on the subject that I feel I can write a book. I was diagnosed with severe osteoporosis over 4 years ago. It rocked my world. I was told to immediately begin a course of treatment with Tymlos to rebuild bone. As a very active person, I rejected the recommendation and tried, for 2 years to do whatever I could to improve my bone density. Nothing worked. My doctor told me if I didn’t begin a regimen with Tymlos, I’d be fracturing and likely wheelchair bound in the future. Scary! I was also recommended to begin bone loading exercises at an Osteo Strong facility. I have been on Tymlos for 1-l/2,years and the bone density in my spine has improved by 11%. I did attend Osteo Strong for a month but it’s pretty expensive and insurance doesn’t cover any of the costs. I wish it did because I believe it works. So, I lift weights, play pickleball, walk stairs and do as much bone loading exercise as I can do in local classes and at home.
I will continue Tymlos until June and then have to decide on another medication to maintain my gains.
Research as much as possible because this is your body and your choice. Not every protocol is right for everyone. And the decision is not an easy one.
I prayed alot before I gave in to medication. It seems to have been the right one for me and for many women in our shoes. Wishing you peace on this journey. Rose 🌹

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dooshie | @dooshie | Jan 17 7:38am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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Just another point I forgot to mention…Tymlos and Forteo rebuild bone, Prolia does not. It does maintain bone as I understand, and can protect from fractures…but for me, my bone loss was so severe, it would have done me no good. It was not even a recommendation from my rheumatologist and endocrinologist. Including my primary doc, they all insisted on Tymlos. I don’t know how severe ur bone loss is but my numbers were in the -4’s. Pretty bad. Ur exercise protocol seems to have you on the right track…I pray you see improvements in your numbers and the future looks strong and healthy.

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tetris | @tetris | Jan 17 8:07am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

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I take online classes through TheraPilates, Sherri Betz’s studio. She’s a DPT , specializes in PT for persons with osteoporosis, super knowledgeable, and a natural born teacher. She’s just terrific. Her live online classes and exercises are based on the Liftmor program (she has an extensive video library too). TheraPilates has a class everyday except Sundays; beginning strength training classes are on Fri mornings. https://www.drsherribetz.com/
Dr. Betz has two presentations at this week’s free online osteoporosis and bone health summit. If you missed one or both, I believe both will be available all day on Sun (or purchase the summit’s entire content for $79). Try to watch Dr. Belinda Beck’s presentation too. She’s a principal investigator of the Liftmor clinical trial. I think it’ll be available on the online summit on Sat and Sun.
Also, take a look at the PT-related presentation on the OsteoBoston YouTube channel.

REPLY
teb | @teb | Jan 17 8:21am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

Jump to this post

If you can find a PT well versed in osteoporosis, that would be great for a re-education on how to move and exercise safely. They are hard to find! Online resources such as Sherri Betz and Margaret Martin are both excellent and have lots of you tube video demonstrations for you to follow. The main movement adjustments you might want to incorporate are avoidance of crunches or forward bending in a spinal curve as well as twisting to your end range. Forward bending should be done with a flat back, bending your knees and hingeing at the hips. So in your exercise class (or anywhere else), it's really best to avoid those crunches. Once you get used to using your back that way, you'll find that you incorporate it into all aspects of life; loading the dishwasher, taking things out of the oven, picking something up off the floor. Bending that way requires a squat so you're also using your quads and glutes which is helpful for building strength, stability and balance.

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1 reply
Moderator
Justin McClanahan, Moderator | @JustinMcClanahan | Jan 17 9:50am
In reply to @diane0329 "I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia..." + (show)
@diane0329

I was diagnosed with severe osteoporosis primarily in the lumbar spine last year. I started Prolia in December 2023 and am working with a nutritionist to ensure adequate dietary protein. I'm 5'4" and weigh 110 pounds. I walk at least 3 miles a day and currently am taking an exercise class which promises increase in strength and bone health by bringing muscles "to failure" once a week! (forearm plank, side planks, bicep curls, triceps exercise, crunches, etc.) I'm now thinking this sounds too good to be true and that I should in fact find a program which incorporates, balance, strength and high intensity intervals several times a week. I can ask my PCP but wondered if you all have any suggestions? There are numerous gym facilities nearby but I want to ensure I undertake the best program for my condition. Thank you!

Jump to this post

Hello @diane0329, I combined your discussion with an existing discussion titled, "Conflicting advice on exercise" https://connect.mayoclinic.org/discussion/conflicting-advice-on-exercise/. I did this so you could meet the many members who are also confused by the influx of information and conflicting advice on exercising with osteoporosis.

@sheilad1, @ans, @timely, and @tsc have all shared similar questions regarding osteoporosis and exercising.

@diane0329, it sounds like you have a really good plan for moving forward by also keeping your PCP involved why you research the best gym and exercise program to take part in. How are you doing in your current exercise class? Are you enjoying it, but wanting to make sure you find the best possible class?

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1 reply
diane0329 | @diane0329 | Jan 17 9:39pm
In reply to @JustinMcClanahan "Hello @diane0329, I combined your discussion with an existing discussion titled, "Conflicting advice on exercise" https://connect.mayoclinic.org/discussion/conflicting-advice-on-exercise/...." + (show)
@JustinMcClanahan

Hello @diane0329, I combined your discussion with an existing discussion titled, "Conflicting advice on exercise" https://connect.mayoclinic.org/discussion/conflicting-advice-on-exercise/. I did this so you could meet the many members who are also confused by the influx of information and conflicting advice on exercising with osteoporosis.

@sheilad1, @ans, @timely, and @tsc have all shared similar questions regarding osteoporosis and exercising.

@diane0329, it sounds like you have a really good plan for moving forward by also keeping your PCP involved why you research the best gym and exercise program to take part in. How are you doing in your current exercise class? Are you enjoying it, but wanting to make sure you find the best possible class?

Jump to this post

Thank you so much, Justin! It's terrific to have this resource and to be able to share experience and knowledge with others in the group. I stopped in to my PCP's office today and asked for a call or appt to discuss exercise. I do enjoy my current class but as the instructor cautions to do only 1x per week I question whether that's accurate...I've reached out to a local personal trainer/physical therapist today too and am waiting to hear back about her options. I'll delve into the conversation link you provided tomorrow...again, I'm very grateful!

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diane0329 | @diane0329 | Jan 17 9:42pm
In reply to @triciaot "I’d suggest to request a prescription for physical therapy. Before you schedule an appointment with a..." + (show)
@triciaot

I’d suggest to request a prescription for physical therapy. Before you schedule an appointment with a PT call the facility and make sure you are seeing a therapist that has experience with osteoporosis. Just as in any broad field, like medicine, people specialize. There are sports, hand, geriatric, rehab, inpatient, outpatient specialists. It is not insulting to the therapist to ask about their background; it is actually a recognition that their specialized knowledge is appreciated.
My understanding of the PT research on building bone strength is that all of the regular exercise is good for maintaining bone (unless you’re under 18 and still growing). To really BUILD bone requires that the bone be stressed to the point of causing very minor fractures. New bone cells fill in the fracture and makes the bone stronger.
Two problems for some of us - some of us aren’t building bone as normal, we’re losing bone. So stressing the bone might not get filled in with new cells. The other is that stressing bone with osteoporosis may cause more damage than expected. That’s why having a knowledgeable PT design the exercises and then follow-up to monitor is important.
I don’t think everyone needs to see a PT. I have been at osteoporosis level for 3 years and have not wanted to stress my bones - I’ve always done enough exercise. My osteoporosis is not because I need more weight training, it’s because of some chemical, metabolic, or nutrition issue. I did a Reclast infusion last summer and my bones have just moved up into osteopenia level.

Jump to this post

This is SO very helpful. I'm afraid I've gotten to my desk to late to read thoroughly but I'll be back tomorrow to peruse. So terrific to have this information and support!

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