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osteoporosis

PDFStanding desks are great for posture and health, but many people have difficulty when they first start using them.  In this issue, Mike O’Hara, PT gives exercises that can help you stand for longer periods of time.  Watch the video for instruction on these exercises.  In his article, “The Biomechanics We All Need To Know, Mike agrees with the advice given by Stuart McGill.  Be sure to read about Fenton Fitness Member Jan Pilar and her success with her program.

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Fracture Facts For Men

osteoporosisJane Brody of the New York Times wrote a great article on the risks men have for osteoporosis related fractures.  The general public views osteoporosis as a “women’s health issue,” but management of osteoporosis and prevention of falls is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled, or die, from the fracture.

In 2012, an international team of researchers and clinicians launched Too Fit to Fracture, an initiative aimed at developing optimal exercise recommendations for individuals with osteoporosis.  In October of 2014, they released a booklet that is available through osteoporosis.ca on managing osteoporosis through exercise.  Everyone should read this booklet and osteoporosis patients should follow their exercise prescription.  Their work brings clarity to an issue that is currently clouded with poor understanding and a lot of bad fitness advice.

The Too Fit to Fracture researchers recommend that individuals with osteoporosis (with or without vertebral fractures) should engage in a multi-component exercise program that includes resistance training in combination with balance training.  Balance train for ten to twenty minutes every day of the week and strength train for 30 to 45 minutes twice a week.  Make sure your strength training teaches you how to move correctly and improves the endurance in your back muscles.  If you have mild to moderate osteoporosis, balance train and strength train first and foremost, and use any extra time on some low impact cardio training.  If you have been told you are at high risk for fracture, keep your focus exclusively on balance and strength training and keep the cardio activities to a minimum.

We know that individuals who participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a growth promoting stimulus through your skeleton.  Bone building exercises are easy to understand but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness and Fenton Physical Therapy for guidance.

-Michael S. O’Hara, P.T., OCS, CSCS
View the NY Times article here: http://www.nytimes.com/2016/10/04/well/live/men-get-osteoporosis-too.html?_r=0

This past week, I evaluated two patients with pain and mobility problems that were the result of osteoporosis related fractures. One patient fractured a lower leg bone lifting a wheelbarrow and the other sone_way_or_otheruffered two lumbar compression fractures from a ride in an all terrain vehicle. These patients are both in their early sixties and four months post injury. They report significant pain and apprehension about suffering another fracture. They have difficulty with simple daily tasks, such as getting in and out of the car, climbing stairs and walking community distances. The compression fracture patient is taking pain meds twice and day and the lower extremity fracture patient uses a cane to walk.

Continue reading

02misconception-bones-superJumboI recently received an email on an article in The New York Times.  The article stated that moderate exercise did not produce an improvement in bone density.  The article went on to state that only medications have been found to be effective at reversing bone loss.  The fitness client that sent me the email was understandably concerned because the article presented information that was dramatically different than what she had been told.  In her battle against osteoporosis, she had placed a lot of faith in exercise and dietary modification.  She had been given advice from her doctor, physical therapist, and trainer that she was on the proper path to better bone health.   I read The New York Times article, looked up the referenced research, and I have a reply.

The New York Times author is correct that moderate weight bearing activities do not produce a change in bone density.  Walking, running, yoga, and Zumba do not produce enough bone stress and muscle tension to improve Continue reading

Whether you are trying to maximize bone density at a young age or simply maintain it at an older age, your choice of exercises will be the key to your success. Select exercises that allow for large amounts of force and power to be displayed. Also, choose exercises that effectively stress multiple muscle groups as muscle preservation is highly associated with bone density.

The last two exercises in our series of six are listed below:

Power Clean

The power clean is a great exercise to stress the bones of the feet, lower/upper legs, hips, spine, clavicles, and even arms to a smaller degree. Power Cleans are a great movement for improving full body power, but they are a bit more advanced. You should probably refrain from this exercise if you have under one year of weight training experience. This exercise offers some of the highest power outputs of any exercise.

BetterBonesWk3

 

 

 

 

 

 

Split Squat

This is a good exercise for everyone, but especially for those who have low back issues (degenerative discs, bulging/herniated discs, etc.) and those at risk for osteoporosis often do. It places very little stress on the low back, incorporates a large amount of lower body muscles, works on balance and, most importantly, allows for very heavy loads to be used.

Click on the link below for step by step instructions and video demonstration on how to perform a power clean and split squat:

 

-Jeff Tirrell, B.S., CSCS, Pn1

Ten million people in the U.S. have osteoporosis. An additional 18 million are at risk to develop it. An additional 34 million are at risk to develop osteopenia, or low bone mass. These ailments lead to higher incidents of fractures which lead to lack of physical activity and a quick decline in the fitness and health of affected individuals.

Last week, we talked about the vital role our diet plays when it comes to preventing osteoporosis by providing the needed nutrients to build and maintain strong bones. It should be noted that over half of our bone mass is accumulated during adolescence (12.5 years for girls and 14 years for boys) with peak bone mass being achieved in our mid 20’s. It is, therefore, very important for people of all ages, especially younger individuals, to incorporate appropriate activities and nutrition and not wait until we are in our 50’s and beyond to start trying to modify diet and activity.

In addition to giving our bodies the needed nutrients of calcium, vitamin D, and protein, the most effective way to stimulate our bone density is through activity. Ultimately, putting our bones under large amounts of force gives them the stimulus they need to get dense and strong.como

There are two main ways we can put stress on our bones where the requisite force is being absorbed or transferred which in turn stimulates bone density. One such way is through weight bearing exercises which force your body to absorb impact. These include walking (on hard surfaces), running, sprinting, jumping, and various upper extremity plyometric exercises. The potential drawback to some of these exercises is that they can be hard on your joints (knees, hips, back, ankles), especially for those with preexisting conditions in these areas. This type of training should be used 2-3x/week for 15-30 minutes.

The second form is that of resistance training. This can be done with machines, bands, body weight, or free weights. It has been demonstrated that free weight activities using barbells, dumbbells, and kettlebells (especially at heavier weights/intensities) lead to greater force production. It would stand to reason, therefore, that utilizing primarily free weight exercises with moderate to heavy weights would be most effective at increasing/maintaining bone density. Resistance training should be performed 3-5 times per week for 30-60 minutes.

It should be noted that low/no impact activities such as swimming, water aerobics, yoga, elliptical trainers, and biking provide little stimulus for improving bone density. Also, even with the best training protocol, appropriate considerations must be made in regard to nutrition to be sure the needed nutrients are available to build up our bones.

Click on the link below to see video demonstration of one of our members in action:

-Jeff Tirrell, B.S., OCS, CSCS

Whether you are trying to maximize bone density at a young age or simply maintain it at an older age, your choice of exercises will be the key to your success. Select exercises that allow for large amounts of force and power to be displayed. Also, choose exercises that effectively stress multiple muscle groups as muscle preservation is highly associated with bone density.

Try the two exercises listed below and look for more next week.

Push Press

This exercise is one of the easier to learn “power” movements out there. It stresses the bones of your arms, clavicle, and spinal column. It is also great for developing power without the technique required for some other power movements. Most importantly, this exercise lends itself to the use of heavier weights. For those with restricted shoulder mobility, using a Landmine is a great alternative.

Better_Bones_Wk2

 

 

 

 

Hip Thrust

This exercise is fantastic for all of the lower extremity musculature, but it especially emphasizes the glutes and hamstrings. There are low amounts of stress to the low back which make it a safe exercise for most populations while still eliciting some strengthening of the lumbar vertebrae. The femur and hips will be the primary bones strengthened with this exercise. You can progress or regress this exercise to accommodate a wide range of populations but have the potential to use large loads which is important for maximum bone density.

Click on the link below for step by step instructions and video demonstration of how to perform the push press and the hip thrust:

-Jeff Tirrell, B.S.,CSCS, Pn1

Ten million people in the U.S. have osteoporosis. An additional 18 million are at risk to develop it. An additional 34 million are at risk to develop osteopenia, or low bone mass. These ailments lead to higher incidents of fractures which lead to lack of physical activity and a quick decline in the fitness and health of affected individuals.

When it comes to preventing osteoporosis, our diet plays a vital role in providing the needed nutrients to build and maintain strong bones. It should be noted that over half of our bone mass is accumulated during adolescence (12.5 years for girls, and 14 years for boys) with peak bone mass being achieved in our mid 20’s. It is, therefore, very important for people of all ages, especially younger individuals, to incorporate appropriate activities and nutrition and not wait until we are in our 50’s and beyond to start trying to modify diet and activity.

The three main nutrients responsible for building and maintaining bone density are Calcium, Vitamin D, and Protein.

Calcium: 99% of the calcium found in the human body resides in our bones which act as a reservoir, assisting in the maintenance of calcium levels indairy-fact-sheet-icon our blood. When calcium intake is low, our body must pull more calcium from our bones making them less dense and, therefore, weaker. The following foods are excellent sources of calcium: milk (and most other dairy products), broccoli, kale, sardines, almonds, and brazil nuts. For those who are lactose intolerant, look for lactose free milk options such as Lactaid. Calcium is best absorbed with Vitamin D so try to pair foods together for best results.

Vitamin D: Vitamin D assists the body in its absorption of calcium in the intestines as well as ensures the proper storage of calcium in the bone. Vitamin D is also helpful in improving muscle strength and balance which reduces fall risk. Vitamin D can be made by the skin when exposed to UVB rays from sunlight. Strive for 10-20 minutes of direct sun exposure/day on bare skin without sunblock. If you have fair skin, or the season dictates that this is not an option, the following foods have large amounts of vitamin D: salmon, mackerel, sardines, egg yolks, liver, milk, and some fortified cereals.

Protein: Protein provides the essential amino acids needed to build bones. Low protein diets diminish peak bone mass during adolescence, negatively affecting skeletal growth and the preservation of bone mass as we age. In elderly populations, low protein intake is highly associated with low bone density. Low protein diets also lead to reduced lean body mass and strength which increase your fall risk. Protein intake should be at minimum 0.5g/lb of bodyweight and may need to be as high as 1g/lb of lean body weight. As we age, we often need to be on the higher end of this range.

Other risk factors for osteoporosis include: decreased milk consumption, anorexia, being overweight or obese, drinking more than 2 alcoholic drinks/day, and having a BMI <19.

For more information on nutrition and bone health from the International Osteoporosis Foundation, click on the link below:

http://www.worldosteoporosisday.org/resources/2015/fact-sheet

-Jeff Tirrell, B.S., CSCS, Pn1

Whether you are trying to maximize bone density at a young age or simply maintain it at an older age, your choice of exercises will be the key to your success. Select exercises that allow for large amounts of force and power to be displayed. Also, choose exercises that effectively stress multiple muscle groups as muscle preservation is highly associated with bone density.

Try the two exercises listed below and look for more next week.

Push Ups

pushup

 

 

 

Building more bone density is just one more great use for the standard push up. This exercise stresses the bones of the wrists, arms, sternum, and clavicle. This is a safe exercise for almost all populations and can be modified to increase or decrease the level of difficulty.

Squat Jumps

Squatjump

 

 

 

 

This exercise is a great low risk, lower extremity power exercise. It stresses the bones of our feet all the way up to our hips and spine. It can be adapted for a range of purposes and populations. Squat jumps can be done with body weight, or you can incorporate resistance in the form of a sandbag, barbell, or resistance bands.

Click on the link below for step by step instructions and video demonstration on how to perform push ups, squat jumps, and their variations:

 

-Jeff Tirrell, B.S., CSCS, Pn1

In 2012, an international team of researchers and clinicians launched Too Fit to Fracture, an initiative aimed at synthesizing best evidence and developing recommendations for both exercise and physical activity for individuals with osteoporosis. In October of 2014, they released a booklet that is available through osteoporosis.ca on managing osteoporosis through exercise. Everyone should read this booklet and osteoporosis patients should use their suggestions on exercise. It brings clarity to an issue that is currently clouded with poor understanding and a lot of bad advice.

A valuable part of this book is the “do not do’s”. Any person with spinal changes secondary to osteoporosis needs to hear about avoiding the damaging effects of prolonged sitting. Many people consider Yoga and Pilates “gentle” fitness activities that are suitable for patients with osteoporosis. I have treated osteoporosismany osteoporosis patients with pain problems brought on by a well intentioned adventure into an inappropriate exercise class.

The Too Fit to Fracture researchers recommended that individuals with osteoporosis (with or without vertebral fractures) should engage in a multi-component exercise program that includes resistance training in combination with balance training. Balance train for ten to twenty minutes every day of the week and strength train for 30 to 45 minutes twice a week. Make sure your strength training teaches you how to move correctly and improves the endurance in your back muscles. If you have mild to moderate osteoporosis and you balance train and strength train first and foremost then spend the extra time on some cardio training. If you have been told you are at high risk for fracture, keep the cardio training at a lower intensity.

A lot of unproven and inappropriate fitness advice is published every day. We all need to consume good fitness information and not junk food. Take to the time to download the workbook and read it over. Twenty years from now your bones will thank me.

To access and download  the Too Fit to Fracture booklet, click on the link below:

http://www.osteoporosis.ca/osteoporosis-and-you/too-fit-to-fracture/

-Michael O’Hara, P.T., OCS, CSCS

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