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    What are muscle-strengthening exercises?
    Karen Kemmis, PT, DPT, MS posted:
    Muscle-strengthening exercises include activities where you move your body against gravity or move a weight or some other resistance. They are also called resistance exercises.

    Muscle-strengthening exercises include lifting weights, using elastic exercise bands, using weight machines or lifting your own body weight. Yoga and Pilates are also muscle-strengthening exercises. However, people with osteoporosis may need to avoid or modify certain positions in these activities. If you've broken bones in the spine due to osteoporosis or notice that you have lost height from what you recall as your young adulthood height, be very careful to avoid activities that require reaching far, bending forward, rapid twisting, heavy lifting and those that increase your chance of a fall.

    Muscle-strengthening exercises should be done two to three days a week. You should try to do at least one exercise for each major muscle group. Some of the major muscle groups include:

    ? Upper back
    ? Middle back
    ? Lower back
    ? Shoulders
    ? Upper arms
    ? Forearms (wrists)
    ? Chest
    ? Abdominals
    ? Hips
    ? Thighs
    ? Calves (lower legs)

    You should do one or two sets of 8 to 10 repetitions for each exercise. If you lift a weight 10 times in a row and then stop, you have completed one set of 10 repetitions. If you can't do 8 in a row, the weight is too heavy or resistance is too much. If you can do more than 10 in a row, you should probably increase the weight or resistance. If you have osteoporosis or are frail, it may be better to do 12 to 15 repetitions with a lighter weight.

    As you get started, your muscles may feel sore for a day or two after you exercise. If the soreness lasts longer, you may be working too hard and need to ease up. Exercises should be done in a pain-free range of motion.
    cococy responded:
    I have a compression fracture of T8 and know I should be exercising. Last year I did a class at the senior center and could really tell a difference in my stomach, the exercise was a pilates type which was similar to a crunch - you did 100 (probably 5 sets of 20) head and knees raised and your arms/hands make a patting motion. It is a pretty standard pilates exercise but I don't know the name of it. Anyway, I'm wondering if that is really a good exercise for me as it is so repetitive. thanks.
    Karen Kemmis, PT, DPT, MS replied to cococy's response:
    While it's important to exercise for your bone health, you will need to take certain precautions to help prevent additional compression fractures. People with osteoporosis should avoid or modify many exercises in Pilates in order to prevent fractures of the spine. NOF published an article with many of these Pilates modifications in the Summer 2009 issue of the "The Osteoporosis Report." You can download a copy by visiting .
    I believe the exercise you are describing is "the hundred." This was considered a warm-up/breathing exercise by Joseph Pilates and is likely the most known exercise in his repertoire. It is a perfect example of an exercise that can be nicely modified to be safe for those with low bone mass, history of a compression fracture, or the diagnosis of osteoporosis.

    To do this exercise safely, you would leave your head down on the floor while you do the exercise. Don't be surprised when the exercise becomes more challenging when you lower your head. You can make up for this by raising your legs up or flexing your knees and hips (into a table top position). The instructor can probably help you modify this.

    The Pilates article referenced above also includes instructions and photos for modifying the Hundred exercise. All exercises done with the head and neck flexed up should be modified like this. Then, you will get great exercise without putting your bones at risk.

    In addition, to protect the spine, people with osteoporosis should avoid doing toe-touches, sit-ups and abdominal crunches, as well as the following:

    * Bending forward from the waist
    * Twisting of the spine to a point of strain
    * Twisting the trunk and bending forward when doing activities such as coughing, sneezing, vacuuming or lifting
    * Anything that requires you to reach far. An example is reaching up for items on high shelves when you could lose your balance and fall.
    * Having a slumped, head-forward posture

    To learn more about exercising and moving safely to protect the spine, you can contact NOF by visiting and completing the online request form or by calling NOF at 1 (800) 231-4222. NOF will send you information for free by e-mail or regular mail.
    cococy replied to Karen Kemmis, PT, DPT, MS's response:
    Thank you so much for sending the information which I'll be reading soon! and for all your helpful hints which I'll put to good use immediately as I'm working in the yard today.

    The dx of compression fracture of T8 was termed a moderate wedge, it was revealed on the LVA as part of the dxa test. This is a complete surprise as my Tscore has always been in normal range and still is 0.0. I've not had any trauma to my spine. My blood calcium has been a bit low but, amazingly, my Vit. D level is above normal at 86. If the bone density if the measurement for osteoporosis and mine is fine, then do I note on health questionair that I have osteoporosis? It is all a bit confusing...

    Granted I do not do any regular exercise program, but if firewood needs to be brought in (or wood split) in the winter or yardwork needs doing in the summer - I'm the one to do it. I've never thought of myself as a fragile woman at all even though I'm less than 5' tall and weigh 115.

    Thanks so much for the information - now to put it to good use and get back out to the weeding.

    Karen Kemmis, PT, DPT, MS replied to cococy's response:
    If you are age 50 or older and experience a low trauma fracture, regardless of bone density, this usually places you in the osteoporosis category. A low trauma fracture occurs when a person breaks a bone from a fall from standing height or less or when a fracture occurs without a known incident, as in your case.

    While bone density correlates well with fracture risk, it only gives quantity of bone but not the quality. Some people can have normal bone density but decreased bone quality. For example, people with diabetes and those who take steroid medications often experience low trauma fractures with normal bone density. Unfortunately, there is no easy way to measure bone quality.

    It's important to discuss with your healthcare provider what tests you may need to determine if you have an underlying condition or other risk factor that contributed to your compression fracture. A wedge fracture would typically occur during a movement where your spine is flexed (or rounded). It is very important to carry out exercise and activities with your spine in an upright position, without flexion. If you can, work with a physical therapist to learn how you can move safely, strengthen your back muscles, and prevent future fractures.
    domitchel replied to Karen Kemmis, PT, DPT, MS's response:
    Great information. Having osteopenia (sp?) I suppose my yoga practice should also conform to these standards. There is a lot of forward bends and twists even in the "gentle yoga" class.
    Signoret responded:
    What are some exercises to strengthen the hips?
    Signoret responded:
    I may not have asked this question at the right place, but what are good exercises to strengthen the hips? I do have arthritis, and jarring exercises cause me pain, but I'm able to walk comfortable at 3 miles per hour on the treadmill for extended periods of time. Someone I know recommended holding a weight of about 7 lbs. on your thigh, and then lifting the leg, knee bent, five times, then alternate legs, and keep increasing the number of lifts as you proceed. Would this help?
    An_223945 responded:
    Hello there. I was just wondering if you could be more specific as to what the actual exercises would be? This would be for my mom who is 74 years old and has osteopenia. Thanks in advance.
    bonebabe replied to Signoret's response:
    Walking is the probably the best exercise you can do for your hips. Speed is not important, length of time on your feet is what we count. Jarring exercises are best avoided because they can cause minute spinal fractures within the vertebra. You can do the weight thing on the thigh if you want and it doesn't cause pain. Stick to the walking.
    Signoret replied to bonebabe's response:
    Is 40 minutes a day a reasonable amount of time?
    bonebabe replied to Signoret's response:
    Karen Kemmis, PT, DPT, MS replied to Signoret's response:
    Walking on the treadmill at 3 miles per hour is still good exercise for bone and general health. To focus on your hips, strengthening exercises are a very good option. The exercise you describe can help hip flexion strength (proper form, however, is very important).

    Other exercises to strengthen the hip can be found in Chapter 6 of NOF's publication "Boning Up on Osteoporosis: A Guide to Prevention and Treatment." These exercises include illustrations and step-by-step instructions. To purchase a copy, go to and click on "Consumer Resources" or call toll-free to 1 (877) 868-4520.

    Also, climbing stairs is a great way to strengthen the hip region.
    Karen Kemmis, PT, DPT, MS replied to domitchel's response:
    Yes. It is good to follow the precautions for osteoporosis if a person has osteopenia. Unfortunately, people with low bone density (osteopenia) can have fractures so it is better to be safe. It is a good time to adjust your yoga practice to movements that avoid spine flexion or rounding. But, hinging at the hips is okay so you can do most movements. Also, full, forced rotation should be avoided but moving into rotation without forcing it at the end will help you stay flexible.
    SquashBlossom responded:
    I have seen advice given on the maximum amount of weight that a person with osteoporosis should lift is no more than 20 to 25 pounds. I know several women in their 50s and 60s with osteoporosis who are working on their bone density and are able to do chest presses with 20 and 25 pound dumbbells and biceps curls with 15 pound dumbbells. For them, lifting a 12 pound weight is way to easy.
    Is the 20 to 25 pound advice supported by research?
    What is your opinion of this advice?
    Does this advice mean total weight or can each arm have a 25 pound dumbbell?
    Does it depend on a woman's age?

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