Sit-ups are a HUGE no-no for low bone density

HI, Everyone,
Sit-ups (this includes crunches!) should NOT be done if you have low bone density or low back pain. Here's why:
Imagine your spine is like a wicker chair. A spine of normal bone density is just like the chair: flexible and a relatively solid network of fibers. A spine with low bone density no longer has flexible fibers but has brittle fibers that break easily. There are also a lot of fibers missing from the chair.
So... would you stand on a new wicker chair if you needed to change a light bulb? Maybe. You might fall off but you wouldn't fall through. Would you stand on an old wicker chair? No, of course not.
A spine with low bone density does not tolerate pressure and stresses either. Too much pressure will create a fracture. It might only be one small part of the bone that fractures and it will leave you with a nagging back pain at first until other portions of the bone begin to fracture.
I recently (okay, two minutes ago) related the story of being in class with a woman who was doing sit-ups and I heard her spine crack... ugh. not a pretty sound. You know what she said? "I don't understand. I always do sit-ups." I asked her if she had low bone density. "yes". So why did her spine fracture on that day? It's hard to say. Maybe her back was tight that day and the muscles were pulling harder than usual in the other direction. Maybe she reached that 'point' in her bone loss where the spine couldn't take any more. It's hard to say. But if you are doing sit-ups or roll-overs (plough in yoga), Please consider modification. It really isn't worth it. A bone fracture that should heal in 6-8 weeks can take years if you have low bone density. It can change the shape of your spine and it can change the quality of life. So stop doing sit ups and do planks (push-up position) instead. If those are too hard, let me know and I'll describe a different exercise for you.
wishing you great health, Karena
www.osteopilates.com

By pgreene
Posted July 16, 2009 at 9:27 pm
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Does anyone know if the Bender Ball system would be safe? You can see it at www.benderball.com. I picked it up in Walmart. Are crunches using the Bender Ball safe? What about crunches on a large exercise ball? Are they also unsafe?

I have a little bit of added strength in my back as I am fused from T4-L4 with one long rod, and then from L1-sacrum with more rods and screws and bolts into the pelvis. I'm not sure if I have enough flexibility to fracture a vertebra below T4.

Thanks for input,
Peggy

By karenatheklineback
Posted July 16, 2009 at 10:20 pm
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I would not recommend the Bender BAll for someone with a fused spine. You will be increasing the flexion of the part of spine that is not fused and even if you did not have low bone density, this would not be a great thing. It puts a lot of stress on the joints that are still able to flex. I would definitely not recommend crunches on the ball for anyone with low bone density. They are also unsafe. You combine a crunch which is bad enough with creating a situation that is easier to fall and then fracture from. No more crunches. You can have really strong abs without crunches. When I first started Pilates I didn't do crunches of any kind for three years. I had abs of steel. No crunches necessary for strong abs. Plank positioning and great posture take care of all your abs strength needs.

By pgreene
Posted July 16, 2009 at 11:18 pm
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Thanks, Karena. The PA that works for my spinal surgeon thought the Bender Ball would be fine for me. I was surprised as I thought it would be too much pressure on my spine. It goes to show that she didn't know much about the force of exercise. I just had the fusion extension done two years ago, and I lost a lot of core strength. I'm doing some yoga now but I will have to look into your Pilates DVDs as yoga isn't weight bearing exercise.

Peggy

By Alli
Posted July 17, 2009 at 8:04 am
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Karena I understood your explanation of low density spine and sit ups for the first time.... your comparison to a wicker chair... thank you for your sharing your knowledge.. I would love to have your cd's to guide me.

By SusanRae
Posted July 17, 2009 at 4:53 pm
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Hello Karenna ~

I "Googled" the plank position. I can't put much weight on my right elbow, due to breaking it about 3 years ago. Ditto left wrist.

Any other suggestions for abs? I have difficulty doing any exercises on the floor because my knees hurt getting down and getting up, and I can't pull myself up because of my elbow. Dang! Mostly, my only exercise right now is walking--aiming for 10,000 steps (getting to 8500 +/-). Also, weeding the garden which involves bending down. (I know I probably shouldn't be doing that, but someone has to weed and I can't afford to pay anyone.)

When I was in the Army in Basic Training, I was the Sit Up Queen. We had to do a certain amount to get out of Basic. . . I wonder if they still require that given the knowledge we have today?

Thank you, Susan

By karenatheklineback
Posted July 17, 2009 at 5:01 pm
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HI, Susan
Yes, they still require all of those sit-ups in the Army. Funny, huh? I am working with a young man right now with a trashed back, in the army and trying to make the best of it.
No problem, if you can't do planks. Lie on your back and bring your legs to 90/90. That means your hips are at 90 degree angle (knees up to the ceiling) and the knees are at 90 degrees feet pointing at the wall on the other side of the room. Your legs should look like a table top. without changing the angle of the knee (only the hip) take the toe of one leg down to tap the floor. bring it back up and alternate side to side. Keep your stomach muscles strong. If you imagine you are bracing for a little punch that will keep your abs strong. My dvd has a bunch of exercises that might help if you happen to run across it. K

By Alli
Posted July 17, 2009 at 10:07 pm
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sdivas i checked out the book at the book store nearest me but i have to order it which i will.... I have never done Pilates but thats my challenge I am certainly going to try the exercises by Karena.

By sdivas
Posted July 17, 2009 at 11:26 pm
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Alli, have you asked your doctor for a referral to work with a physical therapist that has knowledge of bone loss. It is beneficial to have an overall evaluation with a physical therapist. Since Pilates is new for you, you may want to also check NOF's book "Boning Up On Osteoporosis" as well as Sara Meek's book "Walk Tall". Please keep in mind that osteoporosis is a silent disease. We don't get twinges of discomfort to let us know we are about to fracture. I know that many community members will go on their own and use dvds/books ..... but please err on the side of safety and ask questions if in doubt about any movement.

By Alli
Posted July 18, 2009 at 7:29 am
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Thank you sdivas for your helpful advice. I am seeing a physical therapist at the present time just maintenence so I will check it out for sure. I have had a spine fracture in the past roughly two years ago and do not EVER want to go there again! I just feel I need some that i can do and enjoy on my own with DVD.. gentle movements. I am ready for some challenge now.

By gishy
Posted July 18, 2009 at 8:23 am
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Thank you Karen for sharing this info.

I have awful scores, -3.5 in hips, -6.85 in spine. I remain active but wanted an Abs. excerices to build my core. I will try the one you gave, first time I have seen this.
Thanks again.

By AnnieO
Posted July 18, 2009 at 9:18 am
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Hi Karena - thank you for sharing your informational wealth with us.

Could you please tell me what yoga or gentle pilates exercises would be good for strengthening the lower back and hips?

My DEXA was clouded around the L4 due to arthritis and I've suffered with lower back problems for years - luckily it's intermittent. I have osteopenia of the spine and osteoporosis of the hips. Oddly enough, it feels really good when I stretch forward from my hips and curve my spine while tipping my pelvis. Is that dangerous?

Thank you for all your help.

AnnieO

By sharonusa
Posted July 18, 2009 at 10:36 am
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AnnieO, They have machines at my gym but I have duplicated it at home by sitting upright on the floor with my back against the front sofa framework and just resist against it with my lower back muscles and hold it there for three sets of a count of 15....I think it is important to strengthen the muscles around where we are weak. Flexes the good ole butt muscles too. If your feet slip while you brace against the sofa then change shoes. Rubber type soles.

By karenatheklineback
Posted July 18, 2009 at 11:23 am
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hello, Gishy
Please be sure that your doctor has ok'd the exercises. You're right your T-Scores are alarming but it sounds like you have been able to keep yourself safe and sound. Now THAT is inspiring!

By karenatheklineback
Posted July 18, 2009 at 11:29 am
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Hello, Annie O,
yes, stretching forward is dangerous for low bone density, it makes back pain worse generally in the long run and YES it does feel good. This is probably one of the most counter-intuitive rules of back pain. Do NOT stretch the low back muscles by bending over the hips. A safer way to go (even though I don't like this stretch either) would be to lie on your back and hug one knee (not both) to the chest while the other leg is stretched out long and straight on the floor. It's safer but equally as ineffective for reducing back pain. I know it feels good. I have done it. But if the back muscles are tight than stretching them helps for the moment but when you stop they tend to pull back even harder. I'll write a post in the next week or so about stretches for preventing back pain. you'll be surprised. I certainly was.
As for your Pilates exercise question..... I have put safe exercises for osteoporosis in my book,OsteoPilates, and in my DVD, Pilates for Healthy Bodies. Best of Health! Karena

By karenatheklineback
Posted July 18, 2009 at 11:33 am
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HI, SharonUSA,
Sounds like a great exercise that you have come up with! And it's easy to do at home. I love that. Are you doing this isometrically? with no movement or very little movement? That would probably be the best universally. And you are right about the butt muscles. Strengthening those butt muscles are essential for reducing back pain (not to mention it's nice when they don't drag on the back of the knees). :-)
Best of Health,
Karena

By gishy
Posted July 18, 2009 at 11:49 am
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I live in Spain Karen, isn't anyone around with enough knowledge to OK that exercise. I will try it and see how if feels.

I am rather tempted to get my next DEXA done in the UK.

Visualizing doing it, I reckon I have to keep my lower back firmly on the floor.
Gish

By karenatheklineback
Posted July 18, 2009 at 12:01 pm
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HI, Gishy,
Yes, firmly would be an understatement. :-) Yes, keep the low back pressed to the floor. And glad to hear from Spain so early in the morning. I'm in Southern California and just got back from walking the dog. It's going to be 110 today so we had to leave early. I just watched the Tour de France pass through Spain a week or so ago. Did you see it? Was it near you? Karena

By gishy
Posted July 18, 2009 at 12:06 pm
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Hi Karen

I am on the Northern Costa Blanca, temps. around 90, next week predicted to hit the 100's, the price I pay for 10 months of Blissful weather, July/August are great for the Tourists from cold countries, UK, Ireland, Germany, Northern Italy and France, Belguim, Holland etc.

Do you get the Bull Running at St Fermin (Pamploma) out there in the USA?

Welcome to Inspire!

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