First I would work with her physician to see if she is cleared for exercise and then if there are any restrictions. I would then, since she is currently diagnosed as having osteopenia and not osteoporosis, I would let her continue with her current exercise routine, but add in exercises to enhance bone density.
Good luck. Take it slow and stay in contact with her physician.
since she knows that she already has lost some BMD, I assume that the test was done by her physician and that she is cleared for exercise. According to the ACE AHFS manual, the diagnosis of osteopenia alone does not mandate the cessation or even alteration of all activity. In addition, the bone scans are site specific and have probably been performed at the hip.
While I would refer the question about the rowing to her physician, I would suggest to her to include weight-bearing exercises to replace the rowing. Since you describe her as very fit, she may be able to start exercising at intensities that can actually improve BMD.
Wish you good luck with your client.
Osteopenia/osteoporosis is a clinical condition as you know and I would be sure that the insurance you carry covers training individuals who have clinical conditions in the event that she injures herself while you are training her.
I am curious to know why do you think that her osteopenia is heading “quickly to porosis?” Do you know her BMD? You haven’t given us any numbers.
Is she being treated for osteopenia? What did her physician say?
If I were in your shoes I would really have her get a release from her physician because she has a clinical condition and I would also purchase ACSM’s textbook
“Exercise Management for Persons with Chronic Disease and Disabilities.”
If you arm yourself with the science, you never have to ask the forum.
Best to you.
Hi Sarah. I’ve worked with several women with osteoporosis or osteopenia. I totally agree with Steve that the first step should be to discuss this with your client’s treating physician (with her permission of course). Working with and through her physician is essential when working with this condition. My client presented with osteopenia and after several months of our working together, had a completely ‘normal’ bone scan on her next doctor’s visit. It can be done as long as it’s done safely!
Rowing is a fairly low-impact exercise, but again, I’d check with her physician to make sure that this is not contraindicated for her. You don’t mention what part of your client’s body is affected by the osteopenia, so that also will have an impact on what exercise is appropriate for her.
i hope that this helps.