Osteoporosis & Exercise

Start with the core

by Kathleen Trotter

Due to the high rate of inactivity within modern North American society, the regularly accepted platitude is that “any exercise is better then no exercise”. The problem is that if you have osteoporosis or osteopenia, this is not necessarily true.

Before you stop reading because you think that osteoporosis is a niche issue that does not affect you, think again. 55% of people over 50 have low bone mass (either osteopenia or osteoporosis), so everyone should be aware of the condition and the corresponding safe exercise parameters.

Osteoporosis is when one or more of your bones has lower than optimal bone density, while osteopenia is when your bone density is lower than normal, but not low enough to be categorized as osteoperotic. Ultimately the categorization is based the risk of fracturing the affected area.

Knowledge is power

If you have been diagnosed with osteoporosis, it is important to ask your doctor what specific bones have been affected. Most likely not all of your bones are categorized as osteoperotic. If you know the specific osteoperotic sites you can strategically choose exercises that will build bone mass in those areas.

The main side effect of osteoporosis and its corresponding low bone density is that it puts you at a greater risk of fracturing a bone. Fractures can be a result of a fall, or of executing specific movements; sit-ups, abdominal crunches, straight leg raises, toe touches, side bending, rotation of the trunk or knee-to-chest movements can be contra-indicative and could possibly lead to a bone fracture.

Within the gym, abdominal work has the possibility of causing the most harm for people with osteoporosis because of the high percentage of core exercises that involve flexion and / or rotation of the spine.

I know what your thinking, “If I can’t flex, rotate or bend my spine how can I do abdominal work? You are crazy if you think I am going to give up doing core work, having a strong and defined core is important to me.” I hear this from people every day, but don’t worry, there are lots of ways to work your abdominals that do not involve crunching and flexing the spine. The trick is to do core exercises that maintain a neutral spine. Try exercises like plank, side plank, bird dog, hip folds and dead bugs.

Before I describe any of the above exercises, I want you to learn how to engage your deep transverse abdominals.

Deep Core Activation

-Lie on your back with your legs bent and feet on ground.

-Place your hands on your low abdominals (below your pant line but above your pubic bone).

-Inhale to prepare and then as you exhale draw your abdominals away from your hands.

-Hold for 2-3 seconds and then relax.

-Repeat 3-5 times.

-As you do this breathing exercise make sure you do not tilt your pelvis, rotate your pelvis, or flatten your back onto the ground.

Exercise descriptions

Dead Bug / Happy Baby

-Lie on your back.

-Bring your right knee to a 90 degree ankle and your left arm straight up over your shoulder and perpendicular to your body.

-Inhale as your right knee and left arm go out to the side. Exhale and use the deep core activation from above to pull your arm and leg back to the starting position.

-Use your deep core to pull the arm and leg back in to the starting position and keep the rest of your body still.

-Repeat 10 times and then switch sides.

Plank

-Lie down on a mat on your stomach. Come up into a plank position with your knees and forearms on the ground. Make a straight line from your shoulders to your knees.

-Make sure your elbows are directly under your shoulders and your bum is not up in the air.

-Activate your deep core and hold the position for between 10 seconds and 1 minute, depending on your fitness level.

Side Plank

-Come down onto your side on a mat. Keep your knees and forearm on the mat as you lift your hips off the ground.

-Make sure your shoulder is directly over top of your elbow and your hips and knees are in line with your shoulders.

-Activate your deep core and hold the position for between 10 seconds and 1 minute, depending on your fitness level.

-Switch and repeat on the opposite side.

Kathleen Trotter is a personal trainer and Pilates equipment specialist located in downtown Toronto. She is currently completing a Masters degree at the University of Toronto in Exercise Science. Visit kathleentrotter.com.

Fittest over-50s

How to strengthen your knees

Here are three exercises to strengthen the small stabilizing muscles around the knee. Please remember this: the less you do, the less you are able to do.

Three great exercises for the knee

All you need for these exercises is a solid, stable chair. For the third one, you’ll also need a ball.

1. Quad / hamstring / glute squeeze

Sit in a chair with your legs hip distance apart and feet on the floor. Place your hands on the inside of the knee (usually this is the weakest part of the knee muscles). Squeeze all the muscles in your lower body (your bum and front and back of legs), but really focus on that inner knee muscle. Do two sets of 25 repetitions.

2. Leg Extensions

Stay seated in the chair. Keep your left foot on the floor and straighten your right leg. As you straighten that right leg squeeze all the muscles in the front of your leg above the knee, focusing on ‘turning on’ that inner knee muscle discussed in the above exercise. Repeat 20 times.

Small ball roll

Sit in a chair. Place a small Pilates ball underneath your right foot. (You can buy these balls at the ‘dollar’ store. They are slightly smaller then a basketball, plastic on the outside and filled with air). Start with the ball under your toe. Slowly straighten your leg and roll your foot out on the ball so the ball ends up under your heel. Roll it back to the starting position. Repeat 20 times.

Keep moving too

The exercises covered within this series are strength exercises. Cardiovascular exercise is also a vital component of any exercise routine. If you want to supplement the above strength exercises with cardiovascular activity but your joints hurt when you walk, pool aerobics can be a great way to get the benefits of cardiovascular activity with minimal joint pain. Performing your aerobic activity in the pool can maintain or improve joint range of motion, burn calories, help you stay active, and maintain or improve your cardiovascular health. Try joining a local aquafit class or go to the local pool and do your own workout.

In-pool ideas:

-walk back and forth across the shallow section of the pool

-walk sideways back and forth across the shallow section of the pool

-march in place and play around with different hand motions – for example push and pull the water with your hands

-grab and noodle or a life preserver and “run” in the deep water.

Kathleen Trotter is a personal trainer and Pilates equipment specialist located in downtown Toronto. She is currently completing a Masters degree at the University of Toronto in Exercise Science. Visit kathleentrotter.com.