lifting with osteoporosis

[red hot moon]

I'm wondering if anyone here can give tips for someone with osteoporosis who wants to get involved in weightlifting.

I'm 30 years old and have recently been diagnosed with osteoporosis. My worst bone densitometry score is for the neck of the femur with T-Score -2.6 and Z-Score -2.2. A GP told me this means my bone density compares to that of a 50-60 year old.

I'm still being tested to try to establish the reason/s behind my bone loss.

I'm very interested in getting into weightlifting both to promote bone growth and to fill the void left by having to quit the sport I was already competing in (as it had high risk of impact and falls). The official literature around osteoporosis suggests light weightbearing exercise (some basic light dumbell exercises included)... but... I think this is targeted at an audience 70+ who would not have the mobility or fitness that I have.

I'm wondering if I should get into weightlifting as anyone else my age would (including guidance from a trainer or coach) but be careful to increase weights in the smallest possible increments. I'm also wondering if I should be leaning towards lower weights higher reps (although I've read there is better muscle gain with higher weights lower reps - and muscle gain is needed for bone gain).

Has anyone got any experience in this area - either yourself, someone you've coached, training partner etc?

I've also been pondering if I should train like the average 50-60 year old would given that I'd have a similar bone profile... but what are the key differences when a 50-60 year old picks up the sport as opposed to say a 30 year old?

[ColoWayno]

Non-professional very humble opinion:
My wife has this and she has trained with me since being diagnosed. I would follow the regular novice program starting conservatively and adding weight more slowly. You'll want small plates right away. If you aren't 100% confident that you are getting the form then you need a coach or another experienced lifter to walk you through the lifts until you are confident.
Your muscles will outpace your bones in increased capacity, but to some extent that is alright since they'll be better at their job of supporting your spine and other structures as you get stronger.
That being said, slow and consistent progress is (in my humble opinion) going to be the best thing for you.
I'm not sure if you have lifted much before, so the following is a hypothetical:
Even if you are only adding 2.5 pounds to a lift per week, that's 25 pounds in 10 weeks, more than 125 pounds in a year. Let's say you make a goal to add 100 lbs (allowing for resets, etc)
If you go from a 65 pound squat to 165 pounds in a year you will have accomplished something very cool and you will have made everything stronger. With proper nutrition, attention to recovery and good training habits that or more is within the realm of possibility.

Happy lifting!

(edit) you might consider getting your dead lift and squats fairly strong before trying power cleans.

[red hot moon]

Thanks ColoWayno. I'm interested in knowing more about your wife's situation if you're comfortable sharing. I'm wondering about the extent of her bone loss before starting weight training. Has she been training as you described? Has she added weights to her lifts at the sort of pace you described? Does she focus on compound exercises, isolations or both?

Your description of adding 2.5 pounds per week put things in perspective in terms of small increments adding up and looking pretty positive if you look at how far you can go in a year with that method. As far as what you said about muscles outpacing bones to some extent... I have heard of a person with (presumed) good bone density overdoing it at the gym and fracturing bones just through lifting heavy weights too much. So I gather muscles outpacing bones is necessary but there's a limit to what even a healthy bone can handle so this is why I'm trying to find info on how far I can push my own less dense bones.

I'm curious too - has your wife had a scan since she has started weightlifting? Just wondering what sort of improvement (hopefully) she is seeing for her efforts.

[ColoWayno]

Thanks ColoWayno. I'm interested in knowing more about your wife's situation if you're comfortable sharing. I'm wondering about the extent of her bone loss before starting weight training. Has she been training as you described? Has she added weights to her lifts at the sort of pace you described? Does she focus on compound exercises, isolations or both?

Your description of adding 2.5 pounds per week put things in perspective in terms of small increments adding up and looking pretty positive if you look at how far you can go in a year with that method. As far as what you said about muscles outpacing bones to some extent... I have heard of a person with assumed good bone density overdoing it at the gym and fracturing bones just through lifting heavy weights too much. So I gather muscles outpacing bones is necessary but there's a limit to what even a healthy bone can handle so this is why I'm trying to find info on how far I can push my own less dense bones.

I'm curious too - has your wife had a scan since she has started weightlifting? Just wondering what sort of improvement (hopefully) she is seeing for her efforts.

Remember, you are an experiment of one, and I'm not any kind of expert.
That said; I'd read as much as I can from this site, paying special attention to advice for older lifters, but in the end you'll have to figure out what works. In general I'd say if you can perform the lifts, even with a 20lb bar, you can progress in a responsible way.

The question about bone adaptation might be a good question for ol' Rip himself. Make sure you try the search function first.

My wife has been finishing her masters degree so after a few months of decent progress (we were learning the lifts together) she kind of got off track. I was hoping she would have kept it up for a whole year, doing progressive loads so it would be a factor in her next density test but it wasn't to be. She was really happy with the overall results when she was doing the program (no scan during that time). Unfortunately her next scan showed more bone loss so they started her on drug therapy. That therapy is being reevaluated because of some problems she was having with the drug.

I guess the deal is to find a level of overload that will spur growth but not increase your risk of fracture to an unacceptable level. I'm sure your doctors probably wouldn't recommend any of this so there's probably no use asking them.
I imagine the same advice given to older lifters would apply to you. Here's a couple of points I can remember:
Use smaller increments when doing progressive loading
Be ready to move to a modified intermediate program when you stall.
(don't wait until you stall three times, and modify the intermediate program to use fewer sets or reps)
Intermediate programs are really designed to allow for more recovery from a more intense workout since at some point adding weight every workout, or even every week is too hard. On the intermediate program you will make slower progress than on the novice, which isn't a bad thing. It's just adjusting your plan to what you can reasonably be expected to adapt to.
I'm going to try to coax my wife back under the bar when I get home later this summer.
You should start a log for the next experiment of one to read. I'll try to get my wife to do the same.

[red hot moon]

I think you make some good logical points. You are right about doctors but it goes further - I have seen three and none of them would make any concrete recommendations. I'm assuming osteoporosis is not something that most GPs understand due to the lack of confidence on the topic that I have seen. They all know the mantra "good eating habits and weight bearing exercise" but ask them to define either and they tell you they've run out of time (even when I paid for a 30 minute appointment and had only seen the doctor for 10 minutes).

I think as much as anyone else in the world they are worried about liability so they are not about to advise you to go push your bones to the limit to encourage bone growth/renewal even if its the best possible treatment. Further to this - obviously we are all different - different reasons for bone loss, different levels of bone loss, different stability levels, different joint health and probably different potential for improvement. Extensive studies and individual testing would probably be required to give any patient definitive answers on how hard they can push themselves with weightlifting. With the health system already under huge overload there is no chance extensive testing would become standardised so we have to deal with a certain amount of mystery.

Its disappointing your wife went backwards between scans. I understand (particularly around menopause) it can be a losing battle for some no matter what they do. I myself am wary of drugs - the old standard Fosamax slows down the rate of bone loss but this means in time you have weaker bones because they are composed of old, inferior tissue. That's why there is a time limit on how long anyone can use it. I was put straight onto strontium ranelate which is supposed to both slow down bone loss and promote new bone growth - the problem - its too new and there's not enough feedback on it. I experienced extreme tiredness - sleeping 20 hours a day, unable to think for the 4 that I was awake. I'd just like to think/hope there are better options for us.

My initial blood tests tested a small handful of things. I'm now (having independently pursued it) being tested much more extensively. As there are so many factors that can affect bone health - not just minerals consumed but also how they are processed, the state of the collagen structure they are supposed to adhere to, hormones including those relating to stress and how they affect your ability to digest foods etc, etc. I think we all really need to sort these things out and nail the underlying cause so we can create the building blocks for bone growth then workout with weights to force bone growth. That's my own take on the situation - its not how I've been advised just what I've come to believe.

I do intend to log my progress with weightlifting and would be happy to share the results with anyone else who find themselves in my position. (I am surprised that for all my searching I haven't found places where others have already asked these questions). I hope your wife gets back into it and sees some good results for her next scan. Maybe if a few of us workout and keep logs we can start to build some unofficial data that will help others.

[Kate]

what are the key differences when a 50-60 year old picks up the sport as opposed to say a 30 year old?

I would guess that the main difference is in recovery capacity, but I don't really know.

I got a DEXA scan a little over 2 years ago, at age 47. My worst T-score was -2.7, which qualifies as osteoporosis; that was for the right hip. My other (lower) scores got labeled as osteopenia; that includes my spine.

My doc and I talked about starting me on Fosamax or something like it, but decided to try just increasing calcium and vitamin D intake first (blood test showed a D deficiency). I suppose I'm due for a follow-up scan.

I don't know if this will help, but I started weightlifting about a year ago, and haven't had any bone troubles or fractures that I know of. My progress has been slow, partly because I keep going off and doing other things -- for instance, a ton of yard work the last two weeks, including sawing limbs off a downed tree in my back yard and carrying loads of tree detritus to the curb -- and there is only so much I can recover from. (And there are only so many hours in a day.)

I have wondered about whether I should be doing power cleans. Have tried them, but am very bad at them, and might let them go. I'm not sure how much "explosive power" I need, given that my only other sport is cross-country skiing.

If you get any more concrete recommendations from your docs and care to share, I'd be interested to hear.

-Kate

[StrongIslander,NY]

i had a bone density test which showed that im at the level before osteoperosis
-1.9 where -2.6 or higher is boniva time. for me my bone loss is due to having had a bad liver. calcium is processed 3 ways -liver kidney and ingested.

my test was 6-7 mos ago and i am due to get a new density test. my pcp put me on 600 milligrams calcium w vitamin d plus im lifting religiously and milk too.

i'll be disappointed if it did not reverse. for me i did program as is and even over did it in some cases trying to stimulate neuromuscular growth.

[ColoWayno]

i had a bone density test which showed that im at the level before osteoperosis
-1.9 where -2.6 or higher is boniva time. for me my bone loss is due to having had a bad liver. calcium is processed 3 ways -liver kidney and ingested.

my test was 6-7 mos ago and i am due to get a new density test. my pcp put me on 600 milligrams calcium w vitamin d plus im lifting religiously and milk too.

i'll be disappointed if it did not reverse. for me i did program as is and even over did it in some cases trying to stimulate neuromuscular growth.

Your log has been inspirational. Please keep us informed.

[StrongIslander,NY]

i hear that alot Colowayno-trust me i dont mean to be. hell i might not use 100% correct form, i might even have to compensate alot for strength differentials between right and left side but i do what i set my mind to. thats it. i hate whiners i cant do something because.... theres no excuse unless your dead of course. i had something like 18 ops since birth til 2yrs old on intestinal issues- died twice-a stress stroke from ops as infant which impaired my left motor skills and then 20 yrs later find out i have hep c from all the blood transfusions and by 35 needed a new liver. nothing phases me . i think its sort of funny i'm either bullet proof or i'm starring in my own movie final destination where death keeps trying to take me out. when i was really down n out sick i'd think what did i do ?

getting that sick like i did really fucks with your head. it took me like 2 yrs to get back to me. by that time i felt victimized.

so if im inspirational to you---good.its just another day for me.

[red hot moon]

Thanks Kate and StrongIslander for posting up your experiences. Its really good to read that you are both lifting without fractures - this is the sort of experience I'd been hoping to hear of. I am very interested to hear how you both get on with your next scan.

I have had chronic muscle pain and headaches for years and think it might all be connected - once I get the results of my tests, advice from a nutritionist and start lifting I'm aiming to have a scan 1 year after that. Seeing as I've been advised to take medication but have decided against it I'll be keen to check my progress at the 1 year mark even though it seems like 2 years is the standard.

If I find any more info or articles of interest to this topic I'll post here.