Sometimes inspiration hits at the most unlikely times, like during this morning’s Barre class at the local YMCA. It’s not the first time the topic of this post occurred to me—I’ve had it with every pilates, yoga, and barre class I’ve taken recently. No disrespect to the instructors, but none seem knowledgeable about the necessary modifications for students with osteoporosis.
Worse, the students don’t know they should be modifying for their own safety.
I’m a defiant modifier. I won’t be the person wrapping my leg around my neck in yoga or doing C-curve crunches in pilates and barre, or any move I deem unsafe or plain stupid. Not because I can’t (well, maybe I can’t do the leg wrapping thing), but because I want to avoid injury. It’s also why I no longer do weighted lateral raises after giving myself frozen shoulder, or any weighted move not executed safely by an instructor. As an experienced weight lifter, I recognize unsafe moves more readily than the average person, and I’m continually stunned at how often they occur.
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My advice? If you suspect a move is unsafe, trust yourself, not the instructor—and modify.
QUIZ: If you have osteoporosis, which exercises do you think are safe?
Cat-cow
Sun salutations
Abdominal crunches
Seated or prone spinal twist
Windmills
If you said, NONE. You are correct. Not as taught without modification.
A study of 59 postmenopausal women with osteoporosis yielded a fracture incidence over 1 to 6 years of 89% for flexion exercises (rounding of the spine). Other exercises that put undue stress on osteoporotic spines include twisting/torsion (end-range rotation) and side bending, making all the above exercises potentially unsafe for anyone with osteoporosis in their spine.
What does a well-rounded Osteoporosis Exercise Plan look like?
In addition to the standard 150 minutes of moderate or 75 minutes of vigorous weekly exercise recommendations, other very important categories of exercise:
Strength training 2-3x / week
Flexibility training 2-3x / week
Balance training 2-3x / week (since preventing falls is important for avoiding fractures)
These can be combined as part of one exercise session. As an example, both flexibility and balance exercises can be added to the end of a strength training session.
Where can I turn for Osteoporosis-friendly exercises?
Here are some fabulous resources that I have used myself. Some have free introductory resources, but are primarily paid services (I am not compensated for referrals):
ONERO™ strength training was developed by Dr. Belinda Beck of the Bone Clinic in Australia. I’m fortunate to live close to one of the only US locations where it is taught by Dr. Claudia Tamas.
Margie Bissinger is a fellow ONERO™ weight-lifter and a physical therapist with a ton of resources, including a podcast and osteoporosis exercise videos.
Margaret Martin is a Canadian physical therapist with osteoporosis exercise videos.
Better Bones is Dr. Susan Brown’s website. I still buy some of my supplements there. I had the opportunity to meet her and Gina Galli at Kripalu a few years ago at an intensive 4-day retreat on bone health. It was a fabulous experience! Gina has developed osteoporosis-friendly exercise programs available for sale on the site.
Movement Logic has strength-training tutorials and offers a 6-month online, interactive strength training program. Sarah & Laurel also have a podcast.
Unsure if you have osteoporosis? If you are in perimenopause (average age of onset is mid-40s), it might be prudent to get a DEXA scan that includes a Trabecular Bone Score (TBS) as a baseline. The TBS part (bone quality) needs to be requested specifically, and you need to select a facility that offers it. According to the North American Menopause Society (NAMS), the average rate of bone loss is 2% annually beginning 1 to 3 years before menopause, lasting 5 to 10 years, and resulting in a potential loss of over 20%.
In closing, if you enjoy yoga, pilates, or barre, by all means, continue to enjoy them with some modification. Whether that’s defiantly or not is entirely up to you! 😉
In Health & Wellness,
Liz
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Not because I want to, but because I have to—Legal Disclaimer:
This post is provided for educational purposes only. The content, including any products and services mentioned or offered, represents my opinion based on my research and experience and does not constitute medical advice, nor is it intended as a substitute for treatment or services by a licensed healthcare provider. Any content should be taken at your sole risk and discretion. Using the content posted does not create a client-coach relationship, which can only be formed with a signed contract by both parties, nor does it create any liability.
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