Strength Training for Osteoporosis
Osteoporosis affects 55 percent of the people aged 50 and older in the United States.
Osteoporosis is diagnosed when a person has decreased bone mineral density. This diagnosis literally means “porous bone.” Therefore, instead of a bone being filled with a strong matrix inside, it is more sponge-like, causing it to become weak.
Although there are many diseases and medications that can increase your risk of Osteoporosis, the most common cause is due to the body’s hormonal changes. With decreased production of estrogen and progesterone in post-menopausal women, there is an increased rate of bone resorption and no change in the rate of bone formation, leading to weaker bones.
A majority of treatment today focuses on the change in hormone levels and acts to decrease the number of osteoclasts (i.e. cells that break down bone) to decrease the rate of bone breakdown. However, this method can often lead to secondary bone mineral loss because it interferes with the body’s natural responses.
Normally, when there are increased osteoclasts, the body will produce increased osteoblasts (i.e. cells that make more bone) in order to maintain balance. Therefore, although the medication decreases the body’s rate of breaking down bone, it can also interfere with the body’s ability to build new bone.
The most common areas of Osteoporosis include the spine and the hips, and it is important to be aware that not all those diagnosed with decreased bone mineral density will have pain. However, due to the fragility of the bones, there is a very high risk of fractures. Worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience at least one osteoporotic fracture.
As physical therapists, we are educated on Wolf’s Law, which states that a bone will adapt to the loads under which it is placed. This means the more force put through a bone, the stronger it will become, due to increased osteoblast activity.
There is substantial research showing that strength training leads to increased bone mineral density. The exercises in the studies talk about performing fewer repetitions with heavier weights. Heavier meaning weights that are “almost” maximal for someone to be able to lift. Most women over the age of 50 are not lifting heavy enough weights, if it all. In order to see changes in bone mineral density on a DEXA scan, the technology used to measure bone density, it takes about 6-8 months of heavy, consistent loading.
That is why FysioFit PT has developed a specialized program for individuals with Osteoporosis to teach foundational lifting patterns as well as provide progressive loading in a comfortable, small-group setting. The lifting component focuses on three major, functional lifts. These include the squat, overhead press, and deadlift. These movements were chosen since they are seen throughout our day-to-day activities including lifting things over our heads or picking up heavy groceries or laundry baskets. Often times, we perform these movements without thinking or moving with correct form, causing increased stress through our backs. By learning the proper lifting techniques from our PTs, there is a significant reduction in future injury risk. The FysioFit program is not only designed-by but also led by doctors of physical therapy. This ensures correct form with each lift as well as the ability to modify when needed on an individual basis.
Each class starts with a movement prep, which differs from a generalized warm-up that you see with most fitness classes. These are carefully selected movements that will help to activate the correct muscles and introduce the proper movement patterns to complete the lift for that day. In order to maximize the load put through the bones, we often use a weighted vest to directly load the spine with these various movements. A weighted vest will distribute load primarily through the spine and hips. Although dumbbells are great too, they won’t have as big of an impact through the spine and hips.
Our Phase 1: Foundations class has been a big success this past winter season. We expect to have another foundation class starting in Spring 2020. In addition, a lot of our participants will continue with Phase 2 to continue to progress in weight used as well as building confidence to perform these exercises on their own. Our program does not have to be performed as an alternative to medical treatment but rather in conjunction with for best results. In addition to strength training for building bone density, our program also focuses on loading using a yoga program. The yoga program was designed to also load the spine and hips as well as improve balance, stability, and posture. These are very important for those with Osteoporosis to decrease the risk of falls as well as improve posture to reduce the risk of compression fractures in the spine. To learn more about the yoga portion of the program, read Dr. Sarah Avery’s article on www.FysiofitPT.com.
Our comprehensive, research-based program is truly one of a kind. We cap our classes to 4 people to ensure more individualized attention as well as start the program with an evaluation of each person’s past medical history, strength, and body mobility. The program focuses on your goals and our job is to guide you there! For more information call us at 518-306-6894 or email us at Fysiofit@gmail.com.