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Are there any exercises that I should avoid? Yoga and tai chi are great exercises, but are they helpful for preventing or treating osteoporosis?

If you have never skied, ice skated, or roller bladed, don't start now! In fact, any sport or exercise that involves the possibility of falling is not a good one for those trying to preserve their bones. Contact sports can be a problem. Golf and bowling can cause too much bending and twisting of the spine and could be more harmful than helpful.

If you have been diagnosed with either osteoporosis or a vertebral fracture, forward bending (flexion)[1] is also a bad idea whether you are exercising or not. Figure 10 shows the body positions and exercises that you should avoid. You will probably recognize that these positions are related to exercises such as toe-touches and sit-ups. When you bend forward, you are pressing the front, or anterior, parts of the vertebrae, causing them to "crunch," or compress. This kind of compression can cause fractures. Figure 6 (Question 18) shows how tiny

Positions and movements to avoid when exercising if you have osteoporosis. Source: Duke University Medical Center's Bone and Metabolic Disease Clinic. Reprinted with permission. Gold DT, Lee LS, Tresolini CP, eds. Working with Patients to Prevent, Treat, and Manage Osteoporosis: A Curriculum Guide for the Health Professions, 3rd ed. Durham, NC: Center for the Study of Aging and Human Development, Duke University Medical Center; 2001.

Figure 10 Positions and movements to avoid when exercising if you have osteoporosis. Source: Duke University Medical Center's Bone and Metabolic Disease Clinic. Reprinted with permission. Gold DT, Lee LS, Tresolini CP, eds. Working with Patients to Prevent, Treat, and Manage Osteoporosis: A Curriculum Guide for the Health Professions, 3rd ed. Durham, NC: Center for the Study of Aging and Human Development, Duke University Medical Center; 2001.

fractures eventually cause the spine to bend forward in a curve (kyphosis). In one study of women with osteoporosis, 89% of women who regularly did spinal flexion exercises also developed at least one new vertebral fracture.

You should also avoid rotation of the spine. For example, do not do alternating toe-touches where you touch your hand to the opposite foot. Some weight-lifting machines provide for exercising the muscles near the waist by holding the lower body steady and twisting the upper body with weights. Avoid this type of rotation exercise if you have osteoporosis of the spine.

If you regularly practice yoga or tai chi, you are also more likely to have good balance and therefore prevent falls.

Some of the positions of yoga and tai chi are not appropriate for people with osteoporosis unless they are performed exactly correctly. You should avoid forward bending or twisting of the spine. In yoga, the goal is to bend at the waist while keeping the back completely straight, but since most people do not bend at the waist without also bending their spine, forward bending in yoga is not advised. Yoga and tai chi are both excellent exercises for flexibility and stretching, and for gradually straightening limbs and spine to their full extension[2], however. They are also great for stress management because they both use a combination of breathing and smooth body movements. If you regularly practice yoga or tai chi, you are also more likely to have good balance and therefore prevent falls. And a recent study indicated that yoga might also help to prevent weight gain at midlife. This added benefit is most likely because those who regularly practice yoga seem to be more in tune with their bodies and experience less stress, depression, or boredom that can lead to poor eating habits.

Learning good body mechanics without bending or twisting the spine is important. Activities of daily living such as making your bed, putting clothes or food away on lower shelves, and even removing food from the oven can cause vertebral fractures if you have osteoporosis. Bending at the knees without forward flexion of your spine will keep the pressure off the front edges of your spine bones. It's also important to distribute your weight evenly over your knees when you bend them to avoid twisting or rotation of the spine. Bending forward with heavy groceries or anything heavy can be particularly dangerous to your spine.

Exercise is site-specific. This means that if you exercise your forearms and wrists, the bone density in your wrist and forearm will improve, but not in other bones. Your bones only get stronger in the areas where you are exercising. And if you stop exercising routinely, the improvement in your bones will be lost.

  • [1] A bending motion of any joint.
  • [2] Straightening a flexed limb.
 
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