A prospective client, 60 year old female has osteoporosis, have been diagnosed osteopenic in 2005 and osteoporosis last month. She also had a body composition done and she was told she very little visceral fat. She’s never taken hormone therapy and is now seeing a clinical nutritionist certified by the IAACN (International and American Associations of Clinical Nutritionists). She follows a paleo-style eating regimen and, as the result of this ‘diet’ she’s lost approximately 30 pounds. She’s very thin, weighing approximately 93 pounds and she’s 5′ 3 1/2″ tall. Her blood work looks great and she feels really good. She knows she needs to gain muscle mass which will help with her bone density. Besides the osteoporosis, another of her primary concerns is the fact that’s always had a tummy that juts out, even now being as small as she is it still protrudes. She’s talked with a variety of professionals and some people tell her she should do Pilates to help with her core (this has always been a weak area of her body); others tell her to do high intensity/low velocity training (think Arthur Jones’ method) which will help her gain strength and, resultingly, increase her metabolic rate. She also needs some work to improve her balance, posture and functional fitness level. She just wants to know which way to go and I’ve offered a variety of suggestions as well. She’s still looking for more information. Any hints or tips you may offer will be greatly appreciated!!
Hey there Cheryl,
I have held an advanced Pilates cert. for quite awhile. Please see below article for contraindications doing ALL exercises while bones are weak. The problem lies with imbalanced exercise programming. Sounds like a good cross training program is in order: Weight bearing as mentioned, perhaps walking. Pilates could be incorporated to increase core strength but there is also corrective fitness that may be appropriate too. Plenty of choices wrt core exercises!
There was no mention of ROM and/or flexibility in this post so I’d also take that into consideration. If there is diminished joint ROM (think ankles, hips) then this MUST be worked on as well as one legged balance and strength work. As far as the belly distention:If she’s ever been this weight I’d find out if she had a belly then…it could be how/where she stores fat.
If this were my client: I’d focus on band work (continuous tension) and light weight training (single arm/leg focus) in controlled positions rather than whole body moves. Add Pilates and whatever else the client might enjoy doing to promote program adherence.
Hello Cheryl Wiest,
Sherry makes two great points that I agree with: the belly jut could be due to posture, and, working with a nutritionist is great due to the low weight for height.
The best exercise regimen is to beware of the osteoporosis while incorporating balance and overall full body program (strength, cardio, flexibility) as can be tolerated. There are so many options which can be overwhelming; but, options add variety do quell boredom in the future.
Start with what she needs, then add what she wants.
Natalie aka NAPS 2 B Fit.
I’m glad she is seeing a clinical nutritionist since this could be a case of disordered eating. I would not recommend pilates unless it is with someone who is trained to work with people with low bone density. Many pilates postures are not recommended for those with low bone density. I would recommend a combination of weight training, balance work and weight bearing exercises like walking (so it sounds like you’ve got it covered). Unfortunately it is difficult to increase bone density at that age. The main focus of a program should be to maintain or improve function, improve balance to prevent falls and increase upper body strength to help soften the landing in the case of falls. I don’t think she needs to increase her metabolic rate. As for the belly jutting out, is this belly fat or poor posture (an anterior pelvic tilt can look like a belly jutting out)?