Teresa: I think it’s important for your readers to know that osteoporosis is a silent disease. It creeps up on you insidiously. “70% of people with osteoporosis have never been screened and don’t know they have it,” according to American Bone Health, the national organization. More than half of all women over the age of 55 suffer from bone density issues, and three quarters of them won’t know until it is too late.
ZestNow: That’s scary. Are there signs we can watch for?
Teresa: After 50 or after 60, you might notice a rounding, known as kyphosis, in your upper back from those silent fractures before even realizing you have osteoporosis. You might notice waistline pain, your pants getting longer, a noted loss of height during a routine check up. Fractures that occur in the upper back are often silent and without any symptoms.
ZN: How can we find out if we actually already have bone loss?
Teresa: It’s important to be screened and if you have risk factors for the disease, you should have a DXA scan which is the gold standard for measuring bone density and diagnosing osteoporosis.
ZN: Tell me a little about the science behind bone loss.
Teresa: Bone is comprised of osteoblasts, cells that build bone, and osteoclasts, cells that break down bone. Our bones are in a constant process of remodeling throughout our life cycle, creating a shifting tide of bone building and bone breakdown. From childhood up to about age 30, life is good as the scale is tipped more toward bone building. From our 30’s till menopause there is a more even balance between bone building and bone breakdown. However, in the 5-7 years immediately following menopause after 50, there is a sharp drop in bone formation and a rise in the break down of bone due to the loss in estrogen. It’s important to have a strong foundation of bone built up during your youth, to help prevent trouble later on.
ZN: How will exercise over 50 help us with bone loss and osteoporosis?
Teresa: Americans in general are not engaging in enough physical activity and not taking in adequate nutrition for bone health. Then we have “advances” in modern conveniences and technology that have us sitting more than ever. These advances lead to decreased physical activity and decreased bone density. If you have osteoporosis, chances are your bones may break if you fall. This can have a devastating effect on quality of life. There is controversy surrounding bone medications but the one undisputed method of addressing this condition is exercise. The strength you develop in your legs, arms and core as well as the balance and improved reflexes you cultivate will decrease your risk of falling and help you recover if you do lose your balance. Should you hit the ground, you’ll have the upper body strength to decelerate, minimizing impact and avoiding a possible hip fracture. Recently a student of mine tripped and lost her balance at a wedding. She went into automatic and landed like Spider Woman, crediting her core strength and quick responses for not injuring herself or ruining her outfit!
ZN: What are the best kinds of exercises for those suffering from osteoporosis?
Teresa: In general weight training, running, dancing, tennis, soccer, backpacking and high impact aerobic exercise are all good bone building activities. Walking and low impact aerobics protect against further bone loss whereas biking and swimming have no benefit for building bone due to their lack of impact.
For those with osteoporosis, as well as osteopenia (the precursor to osteoporosis) you want to be attentive to correct alignment and avoid certain postures such as flexion. Flexion (think of touching your toes or doing crunches) may jeopardize the front of the bones of the spine that are more susceptible to fracture due to their composition. A 1984 Mayo clinic study found that flexion of the spine resulted in increased vertebral fractures for those with osteoporosis. It’s important to note that a typical Pilates or yoga class, has many flexion based moves and postures that are contraindicated for those with osteoporosis or low bone mass. If you understand the alignment precautions, with guidance, you will be able to modify your postures to participate safely in class and perform your daily tasks with improved vigor and zest. If this is new for you, it’s helpful to work with an exercise professional or physical therapist that understands bone safe exercise.
ZN: I’ll never touch my toes again! What else should we know about the right kind of exercises for women over 50?
Teresa: Contraction of muscle is vital for bone health and should be included in these 3 ways: 1. Weight bearing exercise, 2. Resistance exercise (ie; resistance band, free weights or just your own body weight) and 3. Impact exercise, to surprise the bones and promote bone growth (think running/jogging, high impact aerobics, jump roping, stomping, jumping or flamenco).
When you contract a muscle, the tendon of that muscle pulls on the bone it’s attached to, and creates mechanical stress which has a bone stimulating effect. The right kind of exercise sends messages to your bones telling them to rebuild.
Balance is also critical for preventing falls that can be devastating if you have fragile bones. A landmark study showed that standing on one leg for just one minute, 3 times a day actually improved bone density.
ZN: Is it safe to do resistance and/or strength training if you are already suffering from bone loss?
Teresa: Everyone is unique and to be safe, you should check with your medical professional, especially if you’re not a regular exerciser. With that said, I believe that inactivity is a liability! We are instinctively programmed to move, and when you are suffering from bone loss, the act of moving and stimulating your muscles and bones to create desired mechanical bone building stress in a mindful way, will protect your body and improve quality of life after 50.
I will be presenting a workshop called Pilates for Osteoporosis on Aug 17 at the IDEA World Fitness Convention in Anaheim, CA. In this workshop I’ll share my BoneSmart Pilates® method which defines bone safe exercise in a simple ABC format; A for alignment, B for Balance and C for Contraction.
You can also use the DVD I’ve created. A special for Zestnow readers, enter SAVE5 in the coupon code area at BoneSmartPilates.com to receive $5 off the purchase price.