Weight training for Osteoporosis

The other day when I was at work a patient asked me if there is anything she should do for her “osteopenia”. Besides being intrigued by her knowledge in radiological terminology, I was caught by surprise.  After taking a split second to think it through, I hollered back, “Lift heavy things.” She didn’t like that idea because she has postmenopausal osteoporosis, which makes lifting a more challenging experience. Research states that 33% of women will experience this condition at some point in their lifetime.

Here’s why: After 35 years of age, bone mass decreases owing to the reduction of the cells responsible for generating new bone. The process continues to deplete cortical bone (outer aspect of the bone) at a rate of 1% per year until 20-40% has been lost by the age of 65. Trabecular bone (inner aspect of bone) depletes even faster, at a rate of 2% per year. At menopause, the average rate of bone depleted accelerates to 6% of bone density. Osteoporosis is the reduction in bone quantity, NOT the quality.

In their book, Healing Moves, Carol and Mitchell Krucoff, MD state, "Physical impact and weight-bearing exercise stimulates bone formation. Just as a muscle gets stronger and bigger the more you use it, a bone becomes stronger and denser when you regularly place demands upon it” (p. 144).  This idea of bone following the stress placed upon it is not new. In the 19^th Century, Julius Wolff postulated the exact biomechanics mentioned by Krucoff. His work eventually became so popular and accurate that it was inevitably dubbed, "Wolff's Law". 

Treatment Options for Osteoporosis

1.Bisphophonates, such as Fosamax, improve the bone density by increasing the quantity of the bone, but drastically reduce the quality of the bone. This leads to pathological fractures, commonly in the femoral neck of the hip. This is one of those scenarios where you wonder if the fall broke their hip, or the broken hip caused the fall…

2. Calcium supplements simply just aren’t enough anymore. Contrary to popular belief, calcium is not the end-all-be-all to prevent osteoporosis. Nutritional biochemist Dr. Neil Orenstein believes that “no amount of calcium supplementation will prevent osteoporosis” (Keeton, page 120). Oh, and that goes for milk, too. No amount of milk will prevent osteoporosis. (Have you even stopped to think about who benefits the most from cow's milk?? It's baby cows...not people, but that's a post for another day.) 

3. Maximal strength training (MST) on postmenopausal women (according to the research) seems to be the most effective at laying down new bone formation. An October 2013 issue of the Journal of Strength and Conditioning Research found that postmenopausal women had an average of 5% bone mineral content increase after a 12-week maximal strength training program. The best part of the research article is that the participants were told only to squat. Within three months the training group also showed increases in their 1 repetition maximum (1RM) by an average of 154 pounds (Mosti, Kaehler, et al.).

The best exercises are weight bearing ones, such as squatting or lunging, but could also be started off with walking. Any stress placed on bone will stimulate new bone formation, which is crucial for osteoporotic bones. It is also important to seek advice on the program that fits you. Hire a personal trainer or group instructor to write you a program. It is important to lift properly, so maybe hire a certified trainer a few days a week until you get the form down. Remember, the benefits of maximal weight training is in the amount you are lifting. You need to be lifting your max!

4. Dr. Joseph Mercola suggests coupling Vitamin D3 with Vitamin K2 to help protect your bones. Mercola is well known for his stances on exercise and nutrition and makes no exception for osteoporosis. He firmly believes in a balanced lifestyle with weight bearing exercise and a diet rich in fresh, raw whole foods.

Conclusion

If you want the benefits, you have to put in the work. Avoiding exercise that can potential help your bone density will lead to postural changes and weak, frail bones. It is important to stay active with weight bearing exercises, with the squat being of utmost importance. 

 References

Keeton, K. “Bone density sharply enhanced by weight training, even in the elderly.”

            August 2005. Natural News Online

             http://www.naturalnews.com/010528_bone_density_mineral.html#ixzz2nlFdo5e  d

Firooznia H, Golimbu C, Rafi M, et al.: Rate of spinal trabecular bone loss in normal

            perimenopausal women: CT measurement. Radiology 161:735, 1986.

Mosti, MP, N. Kaehler, AK Stunes, and Syversen U. "Maximal Strength Training in

            Postmenopausal Women with Osteoporosis or Osteopenia." National Center for

            Biotechnology Information. U.S. National Library of Medicine, n.d. Web.04 Dec.

            2013.

Howe Et Al. "Exercise for Preventing and Treating Osteoporosis in Postmenopausal

            Women." National Center for Biotechnology Information. U.S. National Library

            of Medicine, n.d. 4 Dec. 2013.

Mercola, Joseph. “The Key Vitamin to Use with Vitamin D to Help Reduce

            Osteoporosis by 25 Percent.” Mercola.com

            http://articles.mercola.com/sites/articles/archive/2012/05/16/vitamins-d-and-k2-

            reduce-osteoporosis.aspx