I’ve had a client (early 60’s) in my cardio and small group weight training class for a little more than 7 years. Once a week cardio. Once a week in my small group training, which is mostly bodyweight / TRX (not heavy lifting). She is height weight proportionate, but on the slender side of that. Gets almost 20,000 steps a day as she walks her dog and trains it for sport. I would consider her very active and strong at bodyweight movement.
Recently diagonsed with osteoporosis. She didn’t tell me her number, but she was shocked. I’m a little shocked, too.
I just attended a class on working with aging clients. The course materials didn’t really fit didn’t really fit this client, they were more for the non-exerciser just getting started with very light load. She’s active, and she’s been weight training. The advice I did like, and will ensure that I’m implementing every class, is to ensure that I’m working all around her hip for stability and strength.
I see her again on Monday in small-group. My instinct is to get her bone density info so I know a basic idea of her extent, get a doctor’s clearance before changing anything we’re doing, but propose lifting external loads more frequently and bodyweight training less frequently.
I would be grateful for any additional ideas.
According to National Osteoporosis Foundation (https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movem…) there are weight bearing and muscle strengthening exercises that can enhance bone density in individuals with osteoporosis:
– stair climbing
– fast walking
Common complications of osteoporosis are hip and vertebral fractures after falls, so you may want to avoid recommending risk sports, such as cycling…
Osteoporosis is mainly a hormonal disorder (estrogen), which can be treated by prescribed drugs, and much less likely by vitamin D and calcium supplements — do not recommend them to anyone unless you are an endocrinologist, orthopedist or so.
I agree with you, Karin and Natalie. I don’t want to treat her with kid gloves. At the same time, I don’t want to suggest anything that might cause her harm.
She’s in a running club every Wednesday, so she’s tolerated impact for years.
You’re probably onto something, Natalie, regarding her rest. She’s super Type-A, and only rests when she sleeps. When we were talking about it in small group this morning, one of my other clients (a doctor) said that she needs more restorative, parasympathetic activity. She’s going to move her running group to a different day so she can come to my restorative yoga.
I’m still learning, and reading, and will keep doing so. It’s been a learning experience. My morning group that has been with me for years is mostly clients 55-73. Fit baby boomers. They dance hard, they lift hard. They’re how I want to live in my 60’s (I’m almost 50).
Hello Nancy Korf,
I have been alerted to the fact that eliminating all jumping and impact is detrimental, even for osteoporosis; just be more gentle. You may want to look into homeopathy and naturopathic doctoring. Keep the client strong, balanced and suggest an RD for the nutrition aspect. Don’t underestimate the power of proper rest; she may be extra busy and forget to sleep enough. Attitude also plays a huge part.
Natalie aka NAPS 2 B Fit.
this is such a tricky situation because once a client has the label ‘osteoporosis’, they are often all of a sudden treated with kid gloves, and that would be a complete disservice to the client.
I would communicate to the doctor all you have written here and get clearance to continue what she is doing. Keeping here strong is her best medicine against a potential break from a fall as you already noted. It would be ideal to get a note of clearance from the physician to that effect.
It is also possible that she will be put on medication, considering her genetic propensity and that fact that she is an exerciser. You may want to read up on the meds and the possible side effects.
Thank you, Sue and Janet, for your replies.
My thought (assuming doctor approves / agrees) was to ask her to start coming to me twice a week for small group rather than just once.
I’m not discounting bodyweight training. It’s fabulous! I was just thinking about more loaded linear training for greater strength. I went to a wonderful workshop with Michol Dalcourt last weekend at PTI – West (Seattle) and he was talking about how our clients should be working out a bit in each of the following four quadrants:
1) Loaded linear movement
2) Loaded 3-dimensional movement
3) Unloaded linear movement
4) Unloaded 3D movement
where loaded = external resistance and unloaded = bodyweight
where linear = one plane of motion and 3D = moving through multiple dimensions
It’s not “my fault” that she got osteoporosis, but I feel horrible that she has it. Frantically reading everything I can, so we can keep her safe and support her continued activity level. This is one very active woman!