Indoor cycling is similar to riding a road bike; the spine is flexed over if the handlebars are set properly and the cyclist is leaning onto them. This is correct form for riding, but not considered a safe position for a spine with low bone density.
The handlebars of a road or spinning cycle can be adjusted to decrease spine flexion by raising them up, above what is considered normal. Another option is to carry out the spinning class without leaning over to the handle bars. Cycling can be performed with good posture in the spine by keeping the trunk more upright, lifting the breastbone, and keeping the chin gently tucked down to lengthen the neck.
Cycling is an excellent aerobic/cardiovascular exercise. However, since riding an outdoor or indoor bike is very low impact, it would be helpful to perform other exercises that can stimulate bone by providing some impact.
Lunges would generally be safe if done with correct form. When doing a lunge, the trunk should be in a neutral position as described above; the hip, knee and ankle should be in a straight line when looking from the front to back; and the knee should stay over the ankle when looking from the side. To determine if the additional weight is safe, a suggestion would be that you should be able to do 12-25 repetitions to the point of fatigue. If you fatigue prior to 12 repetitions, it would be considered high-intensity exercise which may be risky for a person with low bone density.
It is great that you are without fractures. If a person has lost more than 1 1/2 inches of height from their maximal recalled height, they should suspect silent fractures and speak to their healthcare provider, even if bone density is normal or in the low bone density (osteopenia) range.
Good luck with your continued efforts for bone, and general, health!View Thread
When choosing shoes, there are many things to consider. It is important to look for a shoe with a good arch support, especially if you have a low arch (overpronated or flat foot) or a high arch (supinated foot). This can help to decrease the risk of stress fractures by providing support to the many little bones within the foot.
The other thing to think about is the amount of cushion a shoe provides. If you have pain in the joints of your ankles, knees, hips or low back, you may benefit from a cushioned sole to help absorb shock, keeping it out of your joints.
If you have no joint problems, you may want to choose a shoe with a firm sole to provide some additional impact into your bones. You can get good arch support with a cushioned or less cushioned shoe. Since it is very important to avoid pain, you may need to give up some of the bone-stimulating effect of impact to protect your joints.
Exercising pain-free should be first and foremost!View Thread
Do you ever feel wobbly, unsure of your next step? Have you fallen?
Most fractures (broken bones) are the direct result of a fall. To prevent fractures, it is very important to prevent falls. There are many things that may need to be considered to prevent falls including:
-An examination of your vision and hearing -A review of you medications -An assessment of your home for safety -An evaluation of your balance
If you have problems with balance, you can likely do exercise to improve it. Since we need to have good balance when we are still and when we are moving, it is important to do both static (still) and dynamic (moving) balance exercises.
Based on the information above, do you feel like you have balance problems? What have you tried to help improve your balance?
Yesterday we discussed improving balance to prevent falls that lead to fractures. Exercise is one of the best ways to get better balance.
When you do balance exercises, you should feel a little wobbly but not as if you could lose your balance and fall. If you are unsure, practice with someone who could assist you. If you have had falls, consider working with a physical therapist to get a personalized exercise program which is safe and effective for you.
Static (still) exercises: Before you get started, find a place where you will be safe. You can stand in a corner with your back facing the corner and place a sturdy chair in front of you with your hands near the top of the chairback. Choose an exercise that makes you feel slightly wobbly. Choose the most challenging position that feels safe. Some examples of static exercises are (in order of increasing difficulty):
1. Stand with your feet tight next to each other
2. Standing with one foot in front and to the side of the other (the inside of you heel touching the side of your big toe)
3. Stand with one foot in front of the other as if on a tightrope
4. Stand on one leg with the other foot lifted off the ground
5. Stand in one of the positions where you are stable but close your eyes. Be extremely careful if you do this.
Try to stay in the position for 30 seconds. For positions 2 through 5, switch feet so the right and left legs have equal exercise.
Dynamic (moving) exercises: It is important to be able to move well in a variety of situations. During a normal day, we move on smooth and uneven surfaces, need to look to the right and left and up and down, step up and down on stairs and curbs, and perform many other body movements. You should practice various movements in a safe situation to improve your ability to move through your day.
For dynamic exercises, you can be in the corner or moving along a counter or in a narrow hallway with your hands near the surface in case you start to lose your balance. Some examples of dynamic exercises are:
1. Stand in a stable position from the list above and then turn your head from right to left or up and down.
2. Stand in a stable position and reach to the ceiling, to the right, to the left.
3. Walk down the hall heel to toe as if on a tightrope
4. Walk down a hall on your toes, then on your heels
5. Walk down a hall looking from right to left
6. Walk down the hall looking up then down
7. Walk sideways along a counter, touching for assist only as needed for safety
8. Walk along the counter crossing one foot in front of the other, behind the other, alternating in front and then in back. Be extremely careful if you do this.
For any of the exercises above, you can increase the challenge by moving from hard-soled shoes to barefoot to soft-soles shoes or by moving from a smooth floor (wood or linoleum) to a carpeted floor to a softer surface (pillow, foam cushion or balance disc).
*Before you start any exercise program, consult with your healthcare provider.View Thread
Chiropractic adjustments can place forceful stresses through the bone. However, many chiropractors are aware of this and would not perform adjustments on a person with osteoporosis. It is important to let them know that you have low bone density, have a vertebral compression fracture, and to ask if they are aware of the precautions. Many chiropractors use a tool which applies lower levels of pressure than a manual adjustment. This would allow safe adjustments for many people with low bone density. Chiropractors also use modalities (such as heat and electrical stimulation) that would relax your muscles.View Thread
I would like to join into this conversation with a few points.
The evidence about pressure on the vertebrae (the bones that make up your spine), comparing various positions, actually stems from research that looked at the spinal discs, not the bones. And, the research compared individuals who were in a relaxed sitting position to a relaxed standing position (and other positions). The research did not look at individuals who were performing exercises, such as the example in this discussion. So, it is good to keep some of the information from that research in mind, but we are not really sure about the pressure placed on the bones during this and other seated exercises.
The exercise discussed above can be done sitting or lying down. Both are good options. Proper body position, as described by Susan, is very important in either position. The picture does demonstrate how this exercise can be done safely in a sitting position with great posture. If you choose to do the exercise lying down, be sure you are in your best posture, too.
It is very important to work on balance, especially for people with low bone density/osteoporosis or an increased risk of falling. Doing balance exercises while standing will help people improve standing balance more than sitting.
But, all exercises aren't made to work on everything. If you are trying to strengthen or stretch an important area, the best exercise(s) should be chosen based on accomplishing your specific goal(s). When you try to combine things (for example, strengthening with balance or stretching with balance), one or both aspects often get short-changed. So, exercises should be chosen carefully; some with a focus on strength, some on stretching, some for balance, and some that are combination/functional exercises. An overall program, with several exercises, will generally be the best approach.
When choosing combination/functional exercises, it is helpful to think of what you could do to help your function. Some examples are to slowly stand from a chair without using your arms or climbing stairs. If you are having trouble doing your normal daily activities, consider seeing a physical therapist to get exercises that will be individualized for you.
Also, don't forget about your heart and lungs. If they don't work well, nothing else will! Aerobic exercise (such as walking or hiking) should be included in a well-rounded program.View Thread
Unfortunately, I am unable to advise you as to whether jogging is safe for you. This guidance needs to come from your doctor, physical therapist or other healthcare provider who can evaluate your risk of breaking a bone. For many people with osteoporosis, jogging is not considered safe. But, others that have osteoporosis, diagnosed by DXA, can continue jogging or running. If people have a history of fractures with little to no trauma, they should be more conservative and more likely not run/jog. Power walking or walking briskly is much safer and almost as effective for achieving the many health benefits of exercise.
Since you have been diagnosed with osteoporosis, seeing a physical therapist who is knowledgeable in this area could help you develop a safe and appropriate exercise program based on your personal medical history and individual needs. They should specifically look at your medical history, history of fractures (stress fractures and all others), and most importantly, your running form/mechanics and shoes. A shoe which is supportive but also has cushion will often be the best choice to help your mechanics but also give you some shock absorption to avoid stress to the bones and joints. I think this may be your rationale for considering beach running. Please bring this up with your PT. The beach will give you cushion but the sand may cause too much movement in your legs which could cause several problems (bone, muscle, tendon, and joint). Also, many beaches have a slant toward the water so you spend much time with an uneven stress to your body. You may do better running on a more level, predictable surface.
When kayaking is done properly, the spine is in a very upright position and the muscles of the back are doing some great strengthening. Unfortunately, it is easy to move into a forward position and to over-rotate the trunk; both of which could be harmful to the spine. With a t-score of -4.6, it is probably better to be overly cautious and avoid this possibility. Also, getting in and out of the kayak can be a bit challenging, increasing the risk of a fall and getting the kayak into the water would require awkward positions of the body. Even if someone else did this for you, there is still the risk of paddling with undue stress (as noted above). I don't like to say to avoid activities, but it is probably safer to stay away from this one.View Thread
I know you didn't ask for suggestions but I hope you don't mind if I make some. You may benefit from some physical therapy (I expect you have already had some), but specifically from someone who specializes in core stabilization exercises for the spine and who has knowledge of osteoporosis. This might take some phone call interviews to local physical therapy practices. Also, aquatic exercise might be helpful since it would take pressure off of your spine (fracture sites and discs) while you get exercise. Even people who can't swim can do well in the water. Just let the physical therapist or aquatic instructor know your situation. Exercising in the water isn't typically helpful for bone density but it provides so many other benefits.
Also, some people who have compression fractures get great pain relief from a minimally invasive surgery, either kyphoplasty or vertebroplasty. If you haven't already, you might want to investigate these options. It's important to note, however, that these options are not right for everyone. You may also want to download NOF's brochure "Protecting the Fragile Spine" with more information on this topic. It is available at http://www.nof.org/osteoandyourspine .View Thread
If your physician has prescribed Forteo, I would assume you have osteoporosis. It is always best to avoid activities that can increase the risk of a fracture. Since many fractures occur from a fall, it is best to avoid activities that do increase the risk of a fall (ice skating). Also, a hard jarring (snow tubing and water slides) could potentially cause a vertebral (spine) fracture, so these activities should also be avoided. It is best to discuss specifics for any vigorous or high risk activities with your physician since the two of you would best know your general health status and bone-specific health. It is good to remain as active as possible with low bone mass and osteoporosis, so do try to maintain all safe activities.View Thread