Exercise for osteoporosis

So yeah, I’ve been diagnosed with osteoporosis. I need to do weight bearing exercise. It’s my lower back left hip, and both femurs.
I’m now taking Fosamax. What would be good exercise. I can’t joke that “I could break a hip” at work anymore "cause I literally could.

I’ve always heard that walking is the best exercise for osteoporosis.

I agree on walking. You want weight-bearing but limit your risk of falls. Swimming and bicycling are generally great exercises, but they don’t help much for osteoporosis. Targeted weight lifting might be good, but you’d want guidance on the right ones and proper form. How’s your balance?

I also recommend this. Start off slow and build yourself up over time. I started walking regularly two years ago as part of a weight loss program and ended up walking an average of 12 miles a day, except on really hot days. My legs were noticeable stronger as a result, but I assume that was mostly muscle growth.

I still walk a lot for someone my age, usually with my dog in wooded areas, and I average seven miles a day now. I’m not trying to lose weight anymore, I’m just trying to stay healthy.

I was inspired to read about weight-bearing exercises from this thread. I should really do some as should probably most people. Like other people I wrongly assumed ‘weight-bearing’ meant ‘carrying dumbbells in hands while walking.’ It’s a good thing I’ve never said that out loud in real life.

That would qualify as weight-bearing exercise, but so would walking without carrying weights. I often see people walking with hand weights.

I’m curious why you think that would be a stupid thing to say? It isn’t.

Note that lower back and femoral neck is just what they measure. I think that’s for a combination of greatest fracture risk and consistent data to make comparisons. You likely have reduced bone density everywhere, to some degree.

I’ve had a lot of DEXA scans in the last 30 years, and I think they’ve measured my wrists once or twice, but the rest have all been lumbar spine and femoral neck. They’ve never done a whole-body scan.

None of this alters the recommendation for weight-bearing exercise like walking.

What if walking abilities are limited?

I have been diagnosed with osteoporosis and have a Reclast infusion yearly along with daily calcium supplements. I can walk enough to do my daily activities of living but I can no longer do any sustained walking for exercise as I used to do years ago. I miss walking like that.

I occasionally do some resistance exercises but not too often.

I would think resistance exercises and weight lifting would be good when walking is limited. I’d see if you can get a referral to physical therapy and/or occupational therapy for guidance on the best exercises given your limitations, possibly improving on those limitations, and minimizing risk of injury.

Good idea. I have a doctor appointment coming up.

So walking. Not a big fan as when I work, now once a week and used to be full time, I walk and stand, that plus I’m not fond of people, is why I spend most of my time in the cooler. Yeah, there’s some weight lifting exercise right there. I guess I gotta’ do what I gotta do. Oh, and my balance isn’t what it used to be, which was very good. Now it’s… eh. Gotta’ start yoga again.

I wanted Hubster to join Planet Fitness with me so I could go and not worry about him at home. That was a big no. We have the Silver Sneakers thing, so it would be good financially. Oh, well we’ll see what we can come up with.

You could ask your doctor for a referral for physical therapy (PT). The therapist will customize the exercises for your needs and abilities.

This.

I had neck surgery with installed hardware, and the surgeon said my bones were soft and weak and I needed help with that. So I got testing and prescriptions over several years. The testing was always lower back and hips, just as a standard testing approach. It was taken as representing the neck and everything else.

I heartily concur. A physical therapist would be able to design a weight bearing exercise program for you that would work within your limitations and in conjunction with your injections and supplements. If your doctor would do a referral to a medical dietician also to maximize the calcium you get from your diet, all the better!

We started old folk CrossFit a couple of months ago (the "“Life” class). It might be a good fit. Lots of different exercises and lots of awareness of people’s injuries…

Squats.

That is, while standing with your back straight, bend at the knees until your butt is down near your shins, and then stand back up.

This is a basic exercise which works all of the muscles of the lower body, as well as the lower back. As you get better at it, you’ll find that your balance and stability improve.

For support, hold onto something secure in front of you (like a fixture, or another person’s hands) that can counterbalance your weight, and go slowly.

When you lower yourself, try to keep your posture straight. To maintain balance, you’ll find that you first have to stick your butt out, like you are getting ready to sit on a chair.

Balance will be the key. If you struggle at first, or don’t have the strength to lift yourself up, you can start by doing repetitions of sitting on a chair or couch. Do it as formally as you can (no slouching!) until you can lower yourself totally slow and under control. Then sit on the edge and practice standing up without using your hands.

You can then progress to doing them freely, with your body weight. If that becomes too easy, you could eventually add weight. But there’s no need to rush into that.

I have arthritis in my knees. I don’t know if I can even get down that far. If I can, I’d probably fall over before I was able to stand up again.

That’s why I suggested starting with sitting down and getting back up off a couch or chair. Do that several times without using your hands. It will challenge your leg muscles and your core.

Actually carrying some extra weight is the strong recommendation. Doesn’t have to be in your hands. Although that is great and is called “the farmer’s walk.” A backpack or an adjustable weighted vest (rucking) is pretty ideal for longer walks, hikes, or marches. Start empty and gradually increase the weight. Take some backward steps too. With something to hold on to if needed stand on one foot alone briefly. Balance needs to be exercised too.

You are not wrong.

There is no evidence that walking on its own improves bone mass, but there is some evidence that walking while wearing weights may help.

Stair climbing, first unweighted then wearing the progressively weighted vest. Even just stepping up and down a step repeatedly. Hold on the railing for safety if not positive about your balance.

Lunges may be easier on arthritic knees than squats. But that starting from up down in a chair is good!

Dance. Which has the advantage of creating social connections.

Tai Chi.

And best is a mix of many!

I’m going to double post to emphasize the importance of thinking beyond bone density as the only item, as important as it is. Increasing bone density, or at least limiting future loss, is of course important. You don’t want to break if you fall. But preventing the falls is also a major goal of the exercise plan.

Again some safe balance work.

And grip strength. Which some farmer’s carry and other dumbbells work will help with. When one loses balance being able to grab and steady is key to not having that turn into a tumble. There is solid data that grip strength correlates with future life expectancy and while there are many explanations possible for why, that fall risk prevention is certainly one of them.

Potentially related to the concurrent association of grip strength with bone mineral density/osteoporosis is the relationship between grip strength and fractures. In a systematic review Denk et al found that all of 11 included studies confirmed a relationship between decreased hand grip strength and the incidence of hip fractures.34 Similarly, Kim et al found that hand grip strength along with bone mineral density was associated with an increased risk of fragility fractures.27 Of course a key cause of fractures is falls. Therefore, the demonstration of an association between grip strength and falls might also be expected. Yang et al reported such an association, specifically they noted a mean grip strength of 17.6 kg in a group that had recently fallen compared to 20.7 kg in a group that had not fallen.