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!

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

Profile picture for mwallj @mwallj

@lindamaegirl While I am in agreement with the general sentiment of this article, and am suspicious of the drug industry’s ties to Dexa, they lost all credibility when they stated “walking and running stimulate bone formation and increase bone density”. That is just not true, so unfortunately the rest of their arguments come into question.

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@mwallj

I am curious about the research that you have used to come to this conclusion. Can you post the links? Thanks

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Profile picture for babs10 @babs10

@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.

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@babs10 Thank you. That was very informative and helpful.

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My primary care clinician told me to lift as heavy as I could - but to build up to slowly. There is lots advice on the internet and Instagram on how to do this. You need to challenge your bones but not hurt yourself. I think the rule of thumb is if you can get to 12 reps at weight you should go up in weight. There is something called the 85% level - this is from the AI in Google search "Lifting at the 85% level refers to using 85% of your one-rep max (1RM) to challenge your skeleton. This high-intensity mechanical stress forces your bones to adapt and remodel. It is one of the most effective and research-backed methods to increase bone mineral density (BMD) and prevent age-related bone loss." So you want to lift heavy but safely and build up to it.

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Profile picture for mwallj @mwallj

@lbrown742 There are risks to heavy lifting and risks to not heavy lifting. Personally I think the risks of not doing it are worse. I am lifting with a PT who has been certified by Onero, the only one in the state of MN. I have scores of -3.3 in spine and -3.0 in hips. I’ve been doing it several months and currently lifting 125 lb deadlift, 130 lb back squat and 50 lb overhead press. I have never felt better or stronger. No injuries. I weigh 112, and am 63, BTW. (6 years ago I fractured my wrist, which is the only fracture I’ve had.)

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@mwallj
Congrats on your weight lifting! That is terrific. I did send a private message to you. I am from MN as well. I would like talk more. Thanks.

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Profile picture for Elizabeth @mainepuffin

My primary care clinician told me to lift as heavy as I could - but to build up to slowly. There is lots advice on the internet and Instagram on how to do this. You need to challenge your bones but not hurt yourself. I think the rule of thumb is if you can get to 12 reps at weight you should go up in weight. There is something called the 85% level - this is from the AI in Google search "Lifting at the 85% level refers to using 85% of your one-rep max (1RM) to challenge your skeleton. This high-intensity mechanical stress forces your bones to adapt and remodel. It is one of the most effective and research-backed methods to increase bone mineral density (BMD) and prevent age-related bone loss." So you want to lift heavy but safely and build up to it.

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@mainepuffin I agree with you, I would like to add slowly add impact exercises if it is safe. Simple heal drops to start, or stomps. Try to do 3 sets of 10 to start.

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Profile picture for dshesgreen @dshesgreen

@staceywren I just started an Onero program in D.C. - am about 4 sessions in. It feels like it's going very slow. Please do let me know about your progress and I'll follow you on Instagram. I need encouragement!

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@dshesgreen Seven other women and I started last August. We all started deadlifting with a 16 pound bar to get our form down. Everyone has progressed - some are in the 80s and the highest is at 125. Me? I'm at 110. It's definitely heavy and we all talk about fear of lifting more, but somehow and at some point, it feels like the right time to try a bit more. Wishing you and everyone else all the best.

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Profile picture for babs10 @babs10

@dshesgreen Seven other women and I started last August. We all started deadlifting with a 16 pound bar to get our form down. Everyone has progressed - some are in the 80s and the highest is at 125. Me? I'm at 110. It's definitely heavy and we all talk about fear of lifting more, but somehow and at some point, it feels like the right time to try a bit more. Wishing you and everyone else all the best.

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@babs10 Wow, that is so inspiring!! I'm at 30 pounds right now, and it's slow-going. If I can get to 110 or 125, that would be amazing - I could see how that might make a difference in bone density! Thank you for sharing.

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You're welcome. Yes, it can be slow but better slow than doing too much or with poor form. Good luck!

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Profile picture for Elizabeth @mainepuffin

My primary care clinician told me to lift as heavy as I could - but to build up to slowly. There is lots advice on the internet and Instagram on how to do this. You need to challenge your bones but not hurt yourself. I think the rule of thumb is if you can get to 12 reps at weight you should go up in weight. There is something called the 85% level - this is from the AI in Google search "Lifting at the 85% level refers to using 85% of your one-rep max (1RM) to challenge your skeleton. This high-intensity mechanical stress forces your bones to adapt and remodel. It is one of the most effective and research-backed methods to increase bone mineral density (BMD) and prevent age-related bone loss." So you want to lift heavy but safely and build up to it.

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@mainepuffin
Please give an example of the 1RM.
Also, to lift heavy per your doc, may I ask what your DEXA T score for your spine is? Mine is -3.2 and I often wonder how heavy is safe.
Thank you.

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