The wrong exercise choices can increase your risk of a fracture. This fact is not well known. When many people are told that they have osteoporosis or low bone density they are naturally concerned about their long term independence. A number of them commit themselves to an exercise program. This commitment should be encouraged.
However, problems arise when they are not given the appropriate guidance regarding their exercise program. At times, they are given vague recommendations such as “weight bearing exercises are good for building bone” or “strength training should be part of an exercise for people with osteoporosis”.
I frequently encounter very motivated people who, without the guidance of a trained professional, select exercises that increase their risk of fracture instead of decreasing the risk. For example, I recently had two male clients who had been diagnosed with osteoporosis in the last year. Both of these motivated and well-intentioned men started exercise programs because of the diagnosis. Unfortunately, the self-prescribed exercise programs they were following were increasing their fracture risk!
Dangerous Exercise Choices for Osteoporosis
Preacher Curl
Using machines that encourage flexion. This was especially true with the use of the preacher curl bench. This device forces your upper back into a rounded (or flexed) posture. At most gyms, this bench is the starting point for both the bicep curl and the tricep extension. The preacher curl bench forces you into a slouched postion – a posture that is associated with increased compression fractures of the spine.
Crunches
Crunches. I strongly advise people with low bone density not to do this exercise because it places the subject in a flexed position. Crunches are frequently done either on a mat or on a machine and neither of these variations is safe. This exercise is frequently used by people to build abdominal strength. The MelioGuide Exercise for Better Bones Program has safer alternative exercises that build strength appropriate for people with low bone density.
Hamstring Stretch
Standing and seated hamstring stretches. This is another popular exercise used during the flexibility phase of an exercise program.
The major problem with the exercise is that it encourages flexion. This is one I suggest you avoid. Instead the MelioGuide Exercise for Better Bones Program has many safe alternative exercises for flexibility.
Dumbbell Bench
Using a bench to do bench press. The problem with this exercise is that it is virtually impossible to safely get on and off a bench without flexing your spine.
The situation is even more challenging when you perform the dumbbell bench press. The dumbbell bench requires that you hold two heavy weights as you get onto the bench. The same exercise on the floor would allow you to roll down through your side and avoid the flexed position. The MelioGuide Exercise for Better Bones Program includes a list of exercise safety tips to help you perform your exercise program in a safe fashion.
Elliptical
Using the elliptical for cardio. The elliptical creates no ground force and, as a result, is does not challenge your joints and bones enough to stimulate bone building.
It also encourages flexion of the spine when performed improperly. Note in the picture that the client is having to slouch or flex forward to reach the handles.
There are many cardiovascular exercises that are safer alternatives to the elliptical. In the MelioGuide Exercise for Better Bones Program I suggest a variety of safe cardio activities based on your activity level and fracture risk.
Recommended Modifications to Their Exercise Programs
- Incorporate more free weights into your routine. This allows a more functional type of lift. You are working the main muscle but also all the smaller supportive musculature. The added bonus that free weights deliver, when done with good posture, is that they allow your deep spinal muscles to kick in and help you build stronger bones in your spine (vertebra).
- Focus on strengthening the transverse abdominus. Other than martial artists, and competitive tennis, soccer and volleyball players, few recreational athletes need to develop their rectus abdominus. The rectus abdominus is the muscle strengthened by crunches. Your focus when it comes to abdominal strengthening should be on the transverse abdominus. This muscle is your built in corset. It wraps around your torso and attaches into the fascia that is directly connected to your spine. Training your transverse abdominus will not only eliminate the potentially dangerous crunches from your program but it will also reduce dangerous torques and shearing forces that place your spine at risk.
- Eliminate stretches that place you in a flexed position. Lying flat on your back to stretch your hamstrings will reduce your tendency of bending forward at the spine to touch your toes.
- Modify your bench press position. Executing a bench press from the floor allows you to roll down and back up in a safer manner. With guidance, the use of a burst resistant ball also allows you to execute a bench press with safer ascent and decent. Replacing a bench press with a push up has the added benefit of increased loading through your wrists.
- Select a safer cardio alternative. Both men would benefit more from brisk walking either outdoors on the sidewalk or trail. When the inclement weather sets in, they could use the treadmill.
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Women and Men: Exercise for Better Bones Program
Osteoporosis exercise program that strengthens bone, reduces fracture risk, improves balance and builds confidence.
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{ 2 comments… read them below or add one }
Hi Margaret,
This is excellent. We have been doing the very same thing at Pro Motion…trying to be more specific in education about “unsupported flexion”. We are doing this through lectures and handouts and on-the-spot education. People have a hard time translating what they have learned about, to specific activities or exercises. Recently I had a patient that had been to my lecture where she learned (with examples) about avoiding spinal flexion and then proceeded to show me how well she can do that ‘plow position’ from yoga and how flexible she was in a standard seated hamstring stretch. Sheeeesh! I quickly stopped her from fully demonstrating either. We have also recently made up (for our patients) a handout about what not to do at Curves if you have bone density changes. It’s really scary to learn what some ‘accredited’ fitness intructors and personal trainers are having their clients do.
Our in-house program Osteo-Circuit is evolving again. Some new things in the works. We’ll try to keep you posted when the changes are all done. (the basics of the program are just the same as ever)
Thank you for all the good work you do.
Sue
Hi Sue,
Great to hear from you! You bring up a good point of the challenge people have in globally integrating our recommendations. We have to slow down and take the time to go through the details, even if it seems repetitive to us. I look forward to getting updates on your Osteo-Circuit class.
Keep well.
Margaret