Here’s a scary statistic: If you’re over 50, you have a 1 in 2 chance of an osteoporosis-related fracture. Exercise is a top way to build bones, and it’s never too late – or too early – to start. Exercise physiologist Nicole Dorsey shows you how to work out safely…
As you age, the odds of breaking bones from osteoporosis rise.
Osteoporosis weakens bones and leaves victims vulnerable to fractures (most likely in the hip, spine and wrist). The disease, which rarely shows symptoms, is triggered by genetics, diet, age, hormones and lifestyle factors, such as smoking.
But exercise can ward off this disease's bone-thinning effects. Weight-bearing workouts, in particular, build skeletal strength, stimulating bone-cell activity, says Chantal Donnelly, a physical therapist in Pasadena, Calif., and creator of the workout DVD Pain Free at Work (Body Insight).
Weight training stresses the body, so it “strengthens the bone to prevent further injury,” she says.
It also “improves bone density about 1% per year,” says Felicia Cosman, M.D., medical director of the Clinical Research Center at Helen Hayes Hospital in Haverstra, N.Y., and a spokeswoman for the National Osteoporosis Foundation (NOF). “In 10 years that’s 10%.”
The NOF recommends weight-bearing aerobic activity five days a week, and muscle-strengthening exercises. Also include stretching at least three days a week, for at least 20 minutes per session.
To challenge muscles without strain or additional joint inflammation, Donnelly designed the following workout for Lifescript.
(Before starting any exercise program, consult a physician about your fracture risk.)
Exercise Rx: Guidelines for Lifting Weights
Many studies have shown that strength training increases bone mass, especially in the spine. According to a 2009 study by Canada’s McMaster University, an intensive, year-long weight-training program increased spinal bone mass in postmenopausal women by 9%.
How to lift weights safely: Do 8-12 slow, steady repetitions in a row and then stop, according to NOF guidelines. Rest for 30-60 seconds between each set. Start slowly, with one set 2-3 times a week, and gradually work up to 3 sets over several months.
If you can’t do 8 repetitions in a row, the weight is too heavy or resistance too high. If you can do more than 10 repetitions, increase the weight or resistance. Start by lifting 2-5 pound dumbbells and gradually increase the weight as you get stronger.
Special considerations: At first, your muscles may feel sore for a day or two after you exercise. If soreness lasts longer, you’re working too hard and need to ease up.
If you have osteoporosis or are frail, do 10-15 repetitions of a lighter weight – or use no weight at all.
If you face a high fracture risk, work with a physical therapist to develop a safe exercise program.
Women with osteoporosis typically complain of pain in the mid-back, lower back, hips and wrists, so modify your weightlifting if a particular body part is sore.
Exercise Rx: Standing hip abduction
“Effective yet gentle exercises for osteoporosis sufferers include standing leg lifts that work the muscles around the hip,” Donnelly says.
The standing hip abduction strengthens the outer hip and thigh muscles, and lubricates hip joints, which are most likely to break in osteoporosis sufferers.
How to do it:
Exercise barefoot or in socks so there’s no added weight from a sneaker or shoe stressing joints or bones.
Place a sturdy, high-backed chair about 12 inches from your right side.
Grasp the top of the chair with your right hand. Stand with feet hip-width apart, knees bent and belly firm.
Carefully lift your right leg out to the side and about 6 inches off the ground, keeping it straight. Slightly point the toes and hold leg up for 3 seconds.
Slowly lower foot to the floor.
Repeat lifting and lowering 8-12 times.
Rest briefly, then switch sides and repeat with your left leg.
Special considerations: Don't tilt to one side; you should feel both hips working during this exercise, not just the one in the air. If you’ve suffered a recent hip or leg fracture, talk to your doctor about alternative exercises.
Exercise Rx: Standing hip extension
Another hip helper, this move builds lower-body strength and helps ease daily activities like getting in and out of cars or rising from chairs.
How to do it:
Stand 2 feet in front of a sturdy, high-backed chair or kitchen counter. Lightly place both hands on the top for support.
Shift your weight onto your left leg and lean slightly forward from the waist.
Extend your nearly straight right leg in back of your body slowly, and lift to just under hip height.
Hold for 3 seconds, keeping your belly muscles contracted.
With controlled movement, slowly lower your right leg back to the floor.
Lift and lower for 8-12 repetitions.
Rest for 30-60 seconds, and then repeat with your left leg.
Special considerations: Keep both hips squarely to the front and tighten your belly to protect your lower back during this exercise. If you’ve suffered a recent fracture, talk to your doctor about alternative exercises.
Exercise Rx: Resistance band step-outs
An affordable, lightweight resistance band is one of the best flexibility-enhancing and strength-building tools, says Donnelly. Weight training with them is usually safe even with osteoporosis.
“Bands work your muscles without taxing your joints – because you hold the contraction rather than lifting and lowering, which may cause inflammation,” she says.
Exercises that contract hip muscles and those along the outer thighs and lower back are very good for osteoporosis sufferers, she adds.
How to do it :
Tie a resistance band into a knot so it sits loosely around your mid-thighs just above the knees. There should be some give in the band when you start.
Place your arms alongside your body or on hips, and bend both knees.
Contract your abdominals and slowly lower your hips into a half-squat, keeping belly muscles firm. Contract your buttocks muscles slightly.
Take a giant, slow step out to the right side with your right foot.
Remain in the half-squat position, and step the left foot together with the right foot. Slowly step out again with the right leg and continue step-outs to the right side 8 times.
After one set leading with the right leg, switch direction and legs. Continue stepping out to the left 8 times.
Special considerations : If the exercises feel too intense, use a lighter band: Most sporting-goods stores carry models with easy, medium and difficult resistance.
Exercise Rx: Superman exercise
This Pilates-based move strengthens and stretches muscles along the vertebrae and stabilizes your spine, Donnelly says.
How to do it:
Spread a yoga mat or thick towel on the floor.
Lie face down on the floor without shoes on. If it feels comfortable, place your forehead lightly on the towel or mat.
Extend legs straight behind you and keep thighs close together, squeezing inner thigh muscles.
Reach both arms overhead so pinkies touch the floor and palms face one another.
Lift right arm forward and off the floor 2 inches, hold for 3 seconds, and then lower it.
Reach left arm forward and up, hold for 3 seconds, then lower it.
Lift right leg up 2 inches off the floor, hold for 3 seconds, then lower it.
Finally, lift left leg up for 3 seconds, then lower it.
Now, lift the opposing right arm and left leg, hold for 3 seconds, and lower them. Switch sides to repeat while keeping your forehead on the floor.
When the repetitions become easy, add a 1-pound weight to each hand or lift all limbs off the floor simultaneously.
Special considerations: Avoid this exercise if you have acute lower-back pain and/or degeneration of lower back vertebrae. If you’re not sure, ask a doctor or physical therapist.
Exercise Rx: Take a walk
To help prevent osteoporosis and build stronger bones, the NOF recommends 30 minutes of cardiovascular exercise at least 5 days a week with an activity where you support your own weight.
“That means you’re steadily moving your own body weight through the air, so choose walking over biking and hiking over swimming,” says Cosman.
Aerobic exercise also lowers your risk of heart disease and high blood pressure. (Plus, it trims thighs and mellows your mood!)
How to do it:
Wear walking shoes with ankle support.
Allow bent arms to swing naturally at your sides.
Land on your heel first, roll to the mid-foot and push off with the ball of the foot.
Avoid jutting your chin out over the ground; keep your chin and jaw relaxed.
Take smaller, quicker steps to quicken your pace rather than longer steps.
Special considerations : Unless you’ve suffered a recent bone break, nearly everyone with osteoporosis should walk regularly. If you’re in good shape, experts urge you to walk as often – and as far – as you comfortably can.
Skip these moves
If you’re at high risk of developing osteoporosis, or have the disease, avoid movements that compress the vertebrae and increase the likelihood of fracture, Donnelly says.
Exercises to avoid include:
Traditional sit-ups, or ab crunches
Bicycle crunches, in which you lie on a mat and touch your elbow to the opposite knee.
Moves that place stress on your neck (such as the Plow Pose in yoga or Rolling Like a Ball in Pilates)
Any exercise in which you reach for your toes rapidly (such as a seated stretch with legs extended)
High-impact aerobics, or explosive exercises, in which you jump to switch legs
Skating and skiing because they raise the risk of fractures from falls.
Nicole Dorsey is a Los Angeles-based exercise physiologist and sports nutritionist who has provided wellness and lifestyle programming to the NYC Police Department, Prevention, Aol.com, Shape, and Ladies Home Journal. She's been featured in radio spots and on television nationwide, including "20/20," “EXTRA!” and NBC’s "Weekend Today." Find her on nicoledorseyonline.com.
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