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.
Osteoporosis can be genetic, no matter what she does she will have it!
However, I would get her report and talk to her doc about contraindications.
This can be a matter of calcium/vitamin D or a medication that she is on rather than exercise, eventually we will all have bone loss as this is a natural aging progression!
Osteoporosis has a genetic component, and the fact that she is slender adds to her risk.
Unfortunately exercise can do little to really help build bone mass back. What it can do is strengthen her muscles to help support her, and to reduce her risk of falls (and therefore fractures).
Of course you should get medical clearance first, but I would have her continue the program that she obviously is happy with. Certainly adding weights is a good choice, but do not underestimate body weight training. Balance training would be a great addition.
Be aware of the high risk exercises for those with osteoporosis including forward and lateral spinal flexion (crunches are out), also avoid twisting and high impact. (I have found many medical doctors are unaware of these restrictions.) Emphasize core stabilization exercises instead of crunches.
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!
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.