Osteoporosis diagnosis? Take control.

“Don’t lift too heavy, or you may hurt yourself.”

“Don’t take risks or you may fall and break a bone.”

“I’m afraid to play because I don’t want to break anything.”

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Do any of these statements sound familiar? Aging does not have to equal fear and frailty. As a physical therapist, I educate my clients so they can stay strong and robust by incorporating these three things into their exercise plans: weight training, high velocity power training and weight bearing exercises that impact joints and bones.

Osteoporosis is the most common bone disease and is characterized by weakening of bone tissue, bone structure and strength. People with osteoporosis are more likely to develop fractures. Osteoporosis is diagnosed via a DXA (Dual-Energy X-ray Absorptiometry) scan of the spine or femur, or if someone has a minimal fall and fractures a bone. Women are more likely to have low bone mass because of a drop in estrogen that happens during menopause.

Weight training is a powerful tool in combating osteoporosis. Lifting progressively heavier weights exposes your body to stress, which tells your bones to build more bone. Weight training pulls on the muscles, which attach to bones. These forces cause bones to deposit more bone.

Just because you have been diagnosed with osteoporosis, you need not be afraid of lifting weights. In fact, it is even more important that you lift progressively heavier weights so that you can stimulate bone growth. I typically start people with three sets of the submax amount that they can lift. If you are nervous, start a little lighter and then gradually increase the amount of weight you lift to see how your body feels the next day. My rule of thumb is, if you can lift 12-15 repetitions easily, it is time to increase the weight.

Weight training should be both comfortable and challenging. If something hurts, stop. However, progressing the weight over time is what helps you continue to make strength gains. If you have been lifting the same amount of weight for a long time, your body does not perceive it as a “stress” and the benefits of gaining strength and bone density plateau. The muscle may improve endurance or the amount of time it can lift that weight, but it needs to be continually stressed to gain strength, as does bone.

I wear a weighted vest during my walks and jogs to add extra weight to my spine, as I have low bone mineral density in my spine. Weighted vests range from four pounds to more than 50 pounds. I started with four pounds, increased to six pounds and now I’m up to eight pounds.

High velocity power training involves moving quickly with a lot of force, such as jumping or hopping. As we age, muscle strength and power decrease over time. It is important to continue to practice moving quickly so that you do not lose this ability. Not only is it important in maintaining strong bones, but moving quickly is also important to prevent falls. Tripping and slipping require you to catch yourself by stepping rapidly. Playing tennis, pickleball, plyometrics, jumping rope, jumping on a mini trampoline, or jumping jacks are all ways that you can practice. If these seem daunting, start by putting your hands on the seat of a chair or your bed and practice jumping your legs out like a jumping jack to take off some of the weight. Gradually raise the surface of your hands so you are eventually upright.

Finally, impact is what helps to build bone. If you love to bike or swim, those activities are wonderful for endurance, but they do not help to build bone. According to Newton’s Laws of Motion, for every action, there is an equal and opposite reaction. This includes building bone.

Here are some exercises that are easy and will give you a big bang for your buck in terms of impact on your bones: heel drops (raise up on your toes and let your heels drop rapidly to make a noise); marching by stomping your feet to make noise (both sitting and standing work); dropping down from a stair; plyometrics; and dancing. Make sure that you bend your knees to absorb some of the impact and gradually increase the amount of force you produce.

According to Dr. Nami Safai, an endocrinologist, geriatrician and osteoporosis researcher at UPMC, “Aging doesn’t mean you should expect to have fractures. There are lifestyle changes, exercises, dietary adjustments and medical treatments that can help prevent fractures. It’s important to work closely with your healthcare providers to screen for osteoporosis and implement these changes, just as you would for other conditions like high blood pressure or high cholesterol.”

Having a diagnosis of osteoporosis or osteopenia should drive you to take control and try weight training, high -velocity training and impact exercises. As with all exercise, contact your doctor for clearance, and ask a physical therapist for help in setting up a program to beat frailty and build stronger bones. PJC

Jessica Neiss is a physical therapist with 20 years of experience. She owns To Life! Therapy & Wellness, a Center in Squirrel Hill that offers physical therapy, occupational therapy and exercise classes for older adults and people with neurological conditions such as Parkinson’s or multiple sclerosis. tolifefitness.com