Many patients have the misconception that if they strengthen, they will become buff like a bodybuilder or will fracture something. Strength training will not only make your muscles strong, but also your BONES! Additionally, many patients put cardio training over strength training and discount the benefits that lifting weights or doing resistance can provide.
Mastering Strength Training: Understanding Resistance and Safety Precautions
Strength training is an exercise that requires an increased form of resistance that makes your muscles work harder than they normally do. There are different forms of resistance, such as body weight, hand or ankle weights, cable column machine, gym machines, resistance bands, and kettlebells. The key is to know what you can safely do without hurting yourself. Frequently asked questions that I receive include inquiries about the number of sets and repetitions, the frequency of strength training sessions, and the appropriate weight to use.
Bones benefit from increased force, but individuals with arthritis may not. It's essential to strike a balance with strengthening exercises that do not exacerbate pain. The American College of Sports Medicine and the Bone Health and Osteoporosis Foundation’s BoneFit Training Program support progressing to 2-3 sets of 8-10 repetitions and strengthening all major muscle groups 2-3x a week.
Knowing What to Avoid for Safe Workouts
A lot of patients visit wellness centers or gyms, making it easier to understand what exercises to avoid rather than what to engage in. Generally, I recommend no abdominal crunch machines, abdominal crunch exercises, trunk twisting machines, and heavy leg press machines where you are laying on your back. The seated leg press is generally considered to be safe since less pressure is on the midback. Take caution with generalized workout classes and know your precautions of no heavy and repetitive bending, lifting, twisting, and crunching. There are modifications to these exercises, so ask an exercise professional if you have low bone mineral density.
Sometimes, too, it is beneficial to change things up. If you've been performing the same 30 sit-to-stand and hip exercises for two decades, your bones have adapted, and it might be time for a change. Many patients need education on strengthening and an individualized exercise routine; therefore, utilize your services and consider asking your doctor for a physical therapy referral. Physical therapists can customize an exercise plan for your condition to prevent injury and optimize bone health.
Aquatic therapy is a way to increase resistance in the water. While it may not directly assist in building bone, it can be a great addition to your strengthening exercise routine to help manage arthritis and pain. If aquatics is the ONLY exercise you can do, then keep it up because it is important to maintain strength and endurance with minimal pain.
New research came out last year stating that women with low bone mineral density can benefit from higher intensity resistance training, while sitting or standing. However, if you are frail, you may need to start at a lower intensity and stop when something is “somewhat hard.” Unfortunately, there is no conclusive evidence for men, but what research did conclude is that exercise is better than being sedentary. The aging population often receives inadequate doses of strength training and resistance exercises. Unfortunately, searching on the internet, often referred to as asking "Dr. Google," can yield conflicting information.
Additionally, researching whether the physical therapist or personal trainer you are working with has experience in dealing with osteopenia or osteoporosis can help minimize your risk of injury. There are also great resources, such as Get Wellen, that can create exercises for your fitness level and with equipment you have available in your home or gym. If you have financial barriers, some insurance plans may cover gym memberships or wellness programs so that you can perform strengthening. Margaret Martin has books, such as Exercise for Better Bones, available on Amazon to also guide a safe exercise routine. There are no general exercises that apply to everyone and what everyone needs is different. So, stay safe before you start and keep an eye out for signs of discomfort, but also know that every safely performed resistance exercise is putting you on a path to better bone health!
Sources
https://www.amazon.com/Exercise-Better-Bones-Effective-Osteoporosis/dp/0991912543
https://www.betterhealth.vic.gov.au/health/healthyliving/resistance-training-preventing-injury Assessed and Endorsed by the MedReport Medical Review Board