Several patients in the last few months have asked about weight lifting and its effect on osteoporosis or osteopenia. Osteoporosis is the slow demineralization of bone that occurs with age and with other factors such as poor diet. One of the main dietary issues is the lack of vitamin D, which is needed for the uptake of calcium from food. Calcium is the main substance of our bones. Most physicians and dietitians agree that in Maine we don’t get enough vitamin D from the sun even in the “dog days of summer.” Most of us would need to take a supplement or to eat a bale of spinach a week.

It has been well documented in news and scientific reports that one of the effective ways to combat osteoporosis is with exercise. Like many 60-second sound bites the specifics are left out and people with good intentions join a gym or start a workout that may or may not be effective. And many times, they end up in my office with an injury like a sprained back or sore hips.
Generally, the focus of the reports is on women above the age of 50 who are either pre- or post-menopausal. This demographic tends to be the most vulnerable to large bone injuries at the hip and pelvic region as well as the thoracic spine. However, one in four men will also have osteoporotic changes above the age of 60.

Most people will not know they have osteoporosis until after a fall and a fracture has occurred. Testing can be done, but it is usually done after the injury has occurred and the person falls into a specific demographic. Insurance companies are reluctant to pay for a test. There is some strong evidence that osteoporosis has genetic undertones and is hereditary. So, if you have family members who have had issues with osteoporosis getting tested is not a bad idea once you get into your fifties.

Fosamax is a well-known medication that has been on the market for 40-plus years and has been the gold standard to take if you have osteopenia (the early signs of osteoporosis). Although effective, research recently has suggested Fosamax as well as some of the monthly injectables alone are not as effective as these medications AND weight-bearing exercises.
Our skeletal system requires the effects of gravity to keep it strong and less prone to fracture. That is why even after a fracture, patients are encouraged to start weight-bearing exercise after initial healing has occurred.

Weight-bearing exercises do not necessarily require weights. Simple squats, lunges and step-ups for lower body strengthening may be adequate enough to make bones stronger. For the upper body, wall push-ups may be helpful, or 3-to-4-pound dumbbell curls. Going to the gym and starting 100-pound dead lifts may not be the best choice if you have never done them before, or even if you did 10 years ago. Heavier lifting does not reduce your chances of osteoporosis necessarily, but it could increase your chance of injury. As I explain to my patients, one set of exercises or a specific protocol does not fit everyone’s needs. Many individuals have unknown underlying musculoskeletal issues and going too heavy with weights can cause an injury. So even with good intentions it is best to start with basic light weight exercises. Being active, eating well and keeping moving, and working on your balance may be the best ways to combat the effect of osteoporosis and reduce the risk of falls that can cause a fracture.