How severe is the risk of bone fractures during exercise?

• By SequoiaHealth
• Posted June 19, 2009 at 8:15 am
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Hi rmchavin:
Your suggestions on exercise will not be beneficial for most people. 100% of maximum is unreasonable for anyone except world class athletes. 33% is not going to make that much change in metabolism or bone health. Quite frankly, most people already exercise at about 50% of their capacity. One of my jobs is to help them safely increase that number to 65% or 70%. The risk of injury is almost non-existent if you understand how your body works and don’t try to make–up for lost time when you start. Clinically I have been doing this for 25 years and have only had one client injure themselves.

Intensity has nothing to do with your sustainability. People continue to exercise because they see results a.k.a. they feel better or because it is fun and social and they look forward to that personal interaction time. Less intensity only means that it will be harder to see results in a reasonable amount of time. I suggest to all my clients that they take my instruction, find a partner and go have some fun. Good for your bones; good for your health.

As for risk, if you really want to live your life based on risk numbers, don't drive a car or take a medication. 50,000 people a year die from car accidents and 100,000 die from drug interactions. Not very good odds.

Woody McMahon
NOVA Osteoporosis Support Group

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• By rmchavin
• Posted June 19, 2009 at 9:27 am
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Dear SequoiaHealth:

Thanks for your input on this issue. It's always a good idea for people to hear both sides of any controversy before deciding what they should do.

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• By debbie59
• Posted June 19, 2009 at 11:10 am
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It would also help with the extreme obesity you, yourself have said to be. I have moderate copd and severe osteoporosis. I quit smoking 3 years ago and was told to walk on my treadmill 30 minutes a day. I do that and when I think about how unfun it is, I just tell myself it's the best thing I can do for myself along with NEVER smoking again and maintaining a proper BMI. Also eating a well rounded diet. Also as far as I know there is no controversy about low impact-weight bearing exercise for osteoporosis and that the majority of people do not get enough exercise. I think with my regular routine (housework,cooking etc.) and the walking I even get more than 33% of recommended exercise!! Even with the added copd problem. By the way, I was told to do the walking for both these conditions. Rm I am not a Dr. but I'd venture to guess that your biggest problem is your weight. It probably even contributed to your osteoporosis and contrary to past posts of yours that the thinner you are the less well nourished you are is hog wash! You can be morbidly obese and still suffer from malnutrition. Eating a wide variety of foods and maintaining a good BMI is the way to go. So I've been told, actually it's common sense.

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• By Caff55
• Posted June 19, 2009 at 1:02 pm
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Despite a lifetime of exercise I was found to have osteoporosis. My hips etc were in the osteopenia range (maybe due to the influence of the exercise). My spine, however, was -3.9 (almost that of an old man).

The doctor suggested it wasn't a good idea to continue such my outdoor activites of mountain walking and mountain biking. After some thought I decided to continue. This year I've fallen off my mountian bike, carried heavy backpacks up mountains with, fingers crossed, no ill effect.

To try and improve my spine I've also started weight training and am probably pulling weights heavier than would be recommended.

It's somewhat of a mystery to me why I haven't broken anything because I keep hearing of people with better DEXA scores than myself that have had collapses of the spine. Then again DEXA scores don't say anything apparently.

I did go to see a specialist and I told him about my activities. His reply was different from my doctor.
His reply was, "Well you have to live your life, don't you!"

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• By kitsie
• Posted June 19, 2009 at 5:31 pm
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Yes! I find good information on this blog, but sometimes it just makes me worry more. For me, I am going to try to "get out there" but do the things that will improve my osteoporosis.

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• By kitsie
• Posted June 20, 2009 at 1:51 am
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Sdivas--Yes your idea of a notebook when reading blogs is a good one; I had not read a blog before; I worked in customer service in an academic library which purchased databases that were strictly academic and professional--no anecdotal experiences, no blogs.I am just learning to sift through the information and glean from it what helps me; I am like you though in age, experience and outlook. Thanks for the wise words!

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• By Char42
• Posted June 20, 2009 at 8:16 am
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I have always done heavy activity/exercise, did not realize it might not be safe until I joined this forum. Still will keep with my activities, it no longer includes speed skating. But only because of the medication Warfarin and no skating places in my area of Florida.
Have never suffered a fracture and Osteoporosis has been in my life the last 17 years.
I will keep up with doing zigzag biking, walking, weight lifting, stepper, stretching, etc. But I did stop jumping hurdles. Recently I bought the self-help book The Trigger Point Therapy Workbook, helps me with the soreness that I get from activities. (such as shin splints and now gone)
None of it is a waste of time and I actually feel better the more intense I do the above activities/exercise.

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• By rmchavin
• Posted June 20, 2009 at 12:43 pm
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Dear Char42:

If I had the same genetic blood clotting disorder that you had, I would try to talk my medical doctor into letting me use high doses of fish oil and/or krill oil and/or ground flaxseed meal first. I would only be willing to add aspirin or Coumadin (warfarin) as a last resort and the dosage that I would need would probably be much lower because of the omega-3 fatty acids acting as natural anticoagulants. Warfarin has been linked to bone loss and increased fracture risk in some studies, possibly because of its effect on bone-friendly vitamin K and its associated bone proteins (undercarboxylated osteocalcin). Most medical doctors are reluctant to replace warfarin with fish oil, partly because they are not fully aware of the spectacular health benefits of EPA and DHA, and partly because it would be inconvenient for them to recalibrate the necessary dosage of warfarin after a suddenly increased dietary omega-3 fatty acid consumption by the patient. Here are some relevant web addresses: http://en.wikipedia.org/wiki/Warfarin http://lpi.oregonstate.edu/infocenter/vitamins/vitaminK/ http://www.ncbi.nlm.nih.gov/pubmed/10550464 http://www.ncbi.nlm.nih.gov/pubmed/10448778 http://www.ncbi.nlm.nih.gov/pubmed/15133779 http://www.ncbi.nlm.nih.gov/pubmed/17278182 http://www.ncbi.nlm.nih.gov/pubmed/16432096 http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/a dvantages-of-getting-your-vitamin-d-from-high-fat-fish-instead-of-pills/

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• By Char42
• Posted June 20, 2009 at 3:55 pm
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Hey rmchavin, I had osteoporosis long before the DVT/PE (lung blood clots) (Feb 08) therefore that is a moot point. But I am low dose Warfarin along with aspirin, fish oil, flaxseed oil and other alternatives, which enhance Warfarin anticoagulation. Do my own INR blood work with my own monitor, I really do not keep to a very low Vitamin K diet, but I do not over do the Vit K.
DVT/PE is very life threatening and alternatives alone would not keep my blood at a level to prevent blood clots. My Hematologist was not reluctant to have me on low dose Warfarin along with the alternatives, so far so good. I am a lifer on Warfarin and individuals that only take alternatives alone are playing Russian roulette.
Normal blood INR for coagulation is .9 to 1.2 I keep my INR 1.6 to 2.0, but target is 2.0 to 3.0, I am a retired RN.
I have been researching other alternatives such as Nattokinase.
Thanks

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• By SaraMeeks
• Posted June 23, 2009 at 7:18 am
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Interesting discussion on exercise. I'd like to add a few points.
1. Exercise for osteoporosis should not be "self-selected." If you have been diagnosed with osteoporosis/osteopenia, you should seek out an exercise professional/physical therapist with training in osteoporosis management.
2. Exercise should be as site-specific as possible--targeting the areas of the body most in need for prevention of the compression and other fractures that can occur. This is not easy to do by yourself. One of the main muscles to target is the back extensors--after years of reviewing books, DVDs etc, I have found no program, other than mine, that targets this most important muscle group. Other prime muscles are the diaphragm, abdominals (deep postural, core ones,) pelvic floor, and the hip stabilizers of the gluteus medius and maximus. Once the "core" has been strengthened, including the back extensors, then one could consider more activity.
3. Weight-bearing activity is necessary to bring forces into the bones themselves. Walking is unparalled in its simplicity and should be started slowly and regularly (for those who are not doing any) to build strength for more vigorous exercise. Consider the use of walking poles for support to get started.
Again, professional advice is recommended. I have sent out many lists of exercises and therapists to members of this group and am willing to continue to do so. Contact me through the friends section or privately at sara@sarameekspt.com. I travel and teach extensively so, if I don't answer right away, don't despair. I eventually will answer.
Books I recommend are The Osteoporosis Solution by Carl Germano, Food For Your Bones by Anne Marie Colbin, Better Bones, Better Body by Susan Brown for starters. For exercise, I have a book WALK TALL!; however, it will soon be out of print as I prepare for the second edition.
If you choose the book The Myth of Osteoporosis--just remember Osteoporosis is no myth. It is, however, under-diagnosed, mis-diagnosed, overly-medicated etc.
Exercise that is contraindicated includes abdominal crunches, knee-to-chest, toe touches, straight leg raising etc. They compress the spine and are known to increase fracture risk. Golf, tennis, bowling are the big no-no's (despite Sally Field's wanting to play golf) as they include bending and twisting motions of the spine and there is a quite large injury rate among participants of these activities.
One needs to pick their exercise path wisely and with counsel.

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