Thickening the trabeculae versus increasing the trabecular number

I wonder if this will offer something useful.
https://academic.oup.com/jbmr/article/40/2/193/7917137

@gravity3 Thanks for sharing this article on the effects of Romosozumab on the trabecular bone score in postmenopausal women with osteoporosis.

I hope to be starting Abaloparatide in a few weeks time.

As for exercises, I wonder whether it's better or safer to start trainings meant to make the trabecular number higher before starting any high impact training for thickening the trabeculae?

@wilweten

I am a patient and not a physician or very knowledgeable about exercise for osteoporosis. I wonder if melioguide.com might have some info on that or links to specific resources. I imagine there might be someone here on Connect who can direct you to resources. Have you asked the physician who is treating you if they might? Please let us know what you discover.

@gravity3 Yes, I've already started watching melioguide's videos.

My internist is focused on what might have caused this situation and we discussed which medicine would be best for me.

I've been waiting for a physiotherapist to call me back for some sessions, but they seem rather busy at the moment (or on holidays).

Yes, I'll share what I discover.

@wilweten I finally found a PT who has extra osteopathic training and can focus on my individual best path for bones, while dealing with back pain., a tall order !

@gravity3 I agree Melioguide/Margaret Martin has the best information and exercises modified by yiur FRAX fracture risk. She is a physiotherapist specializing in osteoporosis. Lots of free information on her FB, website and YouTube.

@wilweten Margaret Martin/MelioGuide website also has lots of articles and interviews with top Osteoporosis doctors (eg., endocrinologists) etc about Osteoporosis pharmaceutical treatments too. This might also help you develop your questions for your doctor about your treatment. Fyi the type of bone in our hips and femur neck does not respond as well to treatment as does our spine. But frim the research I have done, Evenity has had the most success relative to other pharmaceuticals.

Wilweten,
The trouble is that if your remaining trabeculae are weakened, they may fracture with exercise
Both impact exercise and resistance lifting can be destructive to remaining bone. While our struts or spiculae shift shape according to the exercise we employ, nothing can reconnect the lost connections in those struts better than Forteo or Tymlos.
Wister Rat studies are difficult to translate into human terms; the rats were hung by the tails to induce the loss (which isn't the usual reason humans lose bone) and it's unlikely that humans would or could swim for eight hours. The potential for trabecular renewal through muscle contraction is interesting. Interesting too that the increase is vertebral with swimming, but not in the hips or femur.
Trabecular bone score would yield a better idea of which exercises are safe for you.
With a T score of -3.9 a person would wisely be careful about the choice and intensity of exercise except swimming.

I so like your question.

@gently Thanks for your comment.
I agree: "Both impact exercise and resistance lifting can be destructive to remaining bone." Yesterday, I spoke to a physiotherapist and he said more or less the same. I showed him the pictures of my Dexa and VFA scan and he said that because of my several vertebral compression fractures we would have to be careful when designing a program to improve my bone health and there's always a risk of a next fracture.

I asked him about specific exercises for the thickening of trabecular bones versus increasing the trabecular number, but he avoided my question and said that in next session, we would explore my possibilities for safely exercising.

My exercise of the last few months has been walking twice a day for 30-45 minutes with Nordic walking poles with a for me more or less natural speed of 2 miles an hour. I got the impression the physio thought that heavier shocks to my hips and vertebrae were needed to actually help build stronger bones.

In the mean time, I found this article: Bone Health and Physical Activity - The Complex Mechanism at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12539549/

It says e.g. "This article discusses matters concerning the mechanism of physical activity affecting bone tissue and factors modifying its response to mechanical loads, the knowledge of which may be of importance in the prevention of bone fractures associated with heavy training loads or osteoporotic changes."

Wilweten, great link out of Poland.
It has interesting application for the choice of medications, as does your question--one that I've long pondered.
The information about communication canaliculi in the hips exposes the significance of lower bone density with the use of Forteo and Tymlos as they recreate the strongest bone by reestablishing canaliculi.
Medications that add bone while preventing or limiting the dissolution of fissured bone (that is modeled bone rather than the remodeled bone with the pth 1-34 Forteo and Tymlos) yield the strength of density. Not a strength to be scorned but not the one scored by Dexa.
Thanks for the link. I'm glad you'll be starting Tymlos soon, that your doctor is looking for secondary cause, that your PT is cautious, that you'll be telling us everything you find out and that you are here on Connect.
If you haven't, you might look at kyphoplasty and the spine jack by Stryker. I don't think jumping is safe for your spine. bless your bones