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    What is weight-bearing exercise?
    Karen Kemmis, PT, DPT, MS posted:
    Like your muscles, your bones get stronger when you make them work. Weight-bearing exercises are important for building strong bones when you are younger and keeping them strong when you are older. You should try to get about 30 minutes of weight-bearing exercise on most days of the week.

    Weight-bearing exercises include activities that make you move against gravity while being upright. They include both high-impact, moderate-impact and low-impact activities. Some examples of high-impact weight-bearing activities are:

    ? Basketball
    ? Jogging or Running
    ? Jumping Rope
    ? Racquet Sports
    ? Soccer
    ? Step Aerobics
    ? Downhill Skiing
    ? Tennis

    Some moderate-impact weight-bearing activities are:

    ? Aerobic Dancing
    ? Dancing
    ? Hiking
    ? Stair Climbing

    If you can?t do high-impact or moderate-impact weight-bearing activities, try one of the lower-impact ones. Some examples are:

    ? Cross-Country Ski Machines*
    ? Cross-Country Skiing*
    ? Elliptical Training Machines
    ? Low-Impact Aerobics
    ? Stair-Step Machines
    ? Treadmill Walking
    ? Walking

    *Avoid if you have balance problems and are at risk of falls.

    Biking and swimming are not weight-bearing exercises, so they don?t help your bones as much. If you like these activities, try to add other activities to your exercise routine that work your bones.

    All individuals should check with their healthcare provider before beginning a new program. Once you have your healthcare provider?s approval, start slowly. If you?ve broken bones in the spine due to osteoporosis, be very careful to avoid activities that require reaching down, bending forward, rapid twisting, heavy lifting and those that increase your chance of a fall. If you have any chest pain, stop exercising and see your healthcare provider immediately.
    Django4 responded:
    Thanks for your post. This is really helpful. I am a bit confused, however, isn't weight lifting a form of "weight-bearing" exercise?
    bonebabe replied to Django4's response:
    Weight bearing refers to bearing your body's weight, thus anything done on your feet.
    Karen Kemmis, PT, DPT, MS replied to Django4's response:
    Weight lifting is another form of exercise that can be helpful to our bones and can be considered weight-bearing exercise in general terms. When we lift weights, we are bearing weight through the bones which can help them become stronger. I tend to separate weight lifting from other weight-bearing exercises (such as the ones I have listed) because we do them differently. Activities like walking, dancing, and low-impact aerobics put weight through the bones as we work against gravity. The goal for bone health is to do this type of activity for 30 minutes each day beyond what we do in our normal routine.

    Another way to put pressure through the bones is by working the muscles that are along the bones. This can be done by lifting weights, using exercise bands, or using weight machines to name a few. Let"019s call this "01Cweight training."01D Weight training is typically done by moving the resistance through a motion until the muscle we are working tires out. For example, we can strengthen the upper arm by lifting a weight from our side to our shoulder, bending the elbow. To strengthen muscles and bones, the resistance should be enough that you feel fatigue in the area after 10 or 20 repetitions. Weight training for bone health and general health should include exercises for the major areas of the body. If you have osteoporosis or are frail, you should work with a physical therapist to be sure you are doing your exercises safely.
    MMCR7 responded:
    I have a -4.5 DEXA T-score and so am reluctant to start lifting heavy weights! I don't know of a trainer skilled enough to direct me! In the meantime I'm doing specific yoga exercises, dancercise, and wearing a weightvest for walks. Any input on the weightlifting thing? I just started fosamax and am getting hormone saliva testing to consider low dose of bioidentical help with bone strengthening. So many studies recommend weightlifting but I'm reluctant to risk a compression fracture of vertebrae. Any input? Many thanks.
    bonebabe replied to MMCR7's response:
    With a -4.5 T-score, I don't think anybody is going to recommend you lift any weights. In fact, the yoga is iffy. If you were our patient, we'd probably advise you to give it up. I also wouldn't wear the weightvest.

    At this point, I'd stick to walking and ask your doctor for a referral for PT for activities of daily living. If there are any osteoporosis rehab and education classes in your area, get a referral for that also. It's very important that you not bend from the waist or do repetitive movements that put your weight on your spine.

    Has your doctor talked to you about Forteo instead of Fosamax?
    Karen Kemmis, PT, DPT, MS replied to MMCR7's response:
    Lifting weights would not be wise with your t-score. You have a healthy fear regarding your spine health with weight training. You are getting weight-bearing with your dancercise and, as a bonus, this is probably helpful for your balance to avoid falls. When practicing yoga, people with osteoporosis should avoid spine flexion or curling. In yoga, the instruction is often "arching your back." Full trunk rotation in sitting and standing should also be avoided. It would be helpful to work with the yoga instructor individually and a physical therapist to determine if you are in a safe position for your spine, avoiding these positions by adapting some movements and positions. To read more about yoga poses you may need to avoid or modify, take a look at the Winter 2008 issue of the Osteoporosis Report at:

    Also, there are various types of weighted vests. People with low bone density should be sure that the vest is snug with most of the weight on the top of the pelvis/hip area. Care should be taken to avoid downward pressure on the shoulders which can put the spine in a flexed, at-risk position. Also, it is important for people with very low bone density to work with their healthcare provider to determine if there is a cause that has not yet been addressed. If something is found, treatment of the cause may help raise bone density and improve bone strength.
    H3ath0r responded:
    Any suggestions for those of us with bunions?
    I have always enjoyed biking because it does not aggravate my bunion. But now that my treatment for breast cancer has induced menopause at age 40, I'm looking to my future and thinking that I must find a way to incorporate more weight bearing.
    phototaker replied to H3ath0r's response:
    Could you do weight lifting? That probably wouldn't affect your bunion. It would depend on how advanced you were with osteoporosis I would imagine. If you have oseopenia, that might help.
    phototaker replied to Karen Kemmis, PT, DPT, MS's response:
    Also, swimming, which would be perfect for you feet isn't weightbearing, BUT will give you another workout good for your heart. I do swim aerobics in the deep end twice a week, but get in dancing twice a week, walking once or twice, and Zumba, which is dancing to music, twice a week, too. I like to do a variety of things. I'm also looking into weightbearing exercises like weightlifting. I used to do that years ago.
    Karen Kemmis, PT, DPT, MS replied to H3ath0r's response:
    Have you tried using an elliptical machine? There is still weight through the bones as you are vertical against gravity making it more weight bearing than bicycling but it doesn't create so much movement through your foot since your foot remains on the stable foot plate. This may be reasonable for your bunions. You can keep up with the biking and try to include some hills or increase the resistance on a stationary bike. These changes will increase the work your muscles are doing and increase the positive stresses to the bones.

    Strength training is also a great option and can be done for all parts of the body to work on your bone health. It's important, however, that you learn how to do muscle-strengthening exercises correctly. If you can, work with a physical therapist who can teach you proper form. If you work with another exercise professional, let them know if you have low bone density or osteoporosis and discuss any modifications that may be appropriate for you.

    Always make sure to obtain clearance from your healthcare provider before beginning a new exercise program.

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