Jane Brody on Backs and Bones. Preventing the Vertebral Fractures of Aging with Weight-Training & Some Inspiration from Sandy Palais

 

Sandy Palais, 73, of Arizona started lifting weights about 10 years ago after she was diagnosed with osteoporosis.  She started weight training to build bone mass.  But she built muscle mass as well.

 

I was planning on posting some fantastic new recipes today, but you'll have to wait a bit longer.  Sorry.  I got side-tracked!

 

I've Got Bones, Backs, & Strength-Training on My Brain Today!   Here's Why:

• Vertebral Fractures.  Jane Brody, the long-time New York Times health writer, published a much-needed piece about spinal (aka vertebral) fractures yesterday.  This is a subject that's close to my heart--both my mother & aunt experienced them--setting them off on that slow downward disability spiral.  Unfortunately, these too-common fractures are often the first sign of osteoporosis and they often go undiagnosed.   Read, Along the Spine, Women Buckle at Breaking Points, July 27, 2011. 
• Forget the Crunch, but Follow This Back-Saving Advice.  Brody also provided some excellent tips on how to protect & strengthen our backs as we go about our day-to-day activities.  I found out I'm doing a lot of things wrong!  Like the way I carry groceries, & standing on my tip-toes, reaching with one hand to get things off my kitchen's top shelves.  Brody's easy-to-follow advice also appeared in yesterday's New York Times.  Check out,  "Forget About Crunches.  Here's How to Protect Your Back",  which is based on guidelines that appeared in, "The Health Professional's Guide to Rehabilitation of the Patient with Osteoporosis,"  Osteoporosis International  14(Suppl 2):S1-22, 2003.
• Meet Sandy Palais, My Inspiration.  Two weeks ago, while I was stair-climbing on a Mediterranean cruise ship, I heard the inspiring story of 73-year old Sandy Palais via an NPR podcast, "Seniors Can Still Bulk Up on Muscle By Pressing Iron".  If Sandy's experience doesn't inspire you--I don't know what will!   After listening to her story, I promised myself I'd figure out a way to make sure I fit in 2-3 serious weight-training sessions every week.   Sandy Palais story highlights the recent research of Dr. Mark Peterson of the University of Michigan.  He recently published a review & commentary on the importance of weight-training for the over-50 year old set.  According to Peterson, If you want to remain active, strong, & mobile as you age--weight-training is a must.  Peterson, M.  "Resistance Training for the Aging Adult:  Clinical Implications & Prescriptive Guidelines"   American Journal of Medicine  2011 Mar;124(3):194-8.
• My Brand-New Weight-Training Program Begins Mid-July.  This morning I finalized my plan to take my weight-training to the next level.  No more of my 1 or 2 times a week at the gym--doing that same-old-same-old machine & a few free weights routine--if I can fit it in.  I'm getting serious, baby.

I'm ditching the gym weight work-out, for a time-saving one at home.  Next week, Beth, an accredited weight-trainer who I really trust, is stopping by my house to see the modest assortment of free weights, barbells, & equipment that my husband has collected in our basement.  Then she's going to design an hour-long program that I can do 2-3 times a week at home--focusing on compound moves, core strength, and that biggie, back strength.  Here's a motivator:  Beth works with a 76 year-old woman who now astounds her doctor with her strength & vitality.   I'll be working out on my own--in my own home. Beth knows that I don't need a trainer at my side to motivate me--I just need someone to design a program.   Then in 6-8 weeks, when I start to plateau, and my muscles need a new challenge, she'll switch it up for me.   The cost?  $75 for the two visits, to get me started out on a program.  I think it's worth it.

• About a year ago, I asked Dr. Angelo Licata, an expert in osteoporosis, what he'd advise to maintain & strengthen the spine.  Don't quote this--I'm going from memory here, but, as I recall he said estrogen will only help maintain spinal bone density--it won't increase it.  And only exercises that specifically target the back will help strengthen the spine and increase bone density--and most people don't bother with these.  BTW, Licata is the doc behind the study that discovered vitamin D, when taken with your largest meal, increases absorption significantly.  That's how I take it.
  

 

I've Got Some Good Reasons to Be Concerned About My Bones

I've got plenty of risk factors:  small-boned, caucasian, 117 pounds, age 61, with a family history of severe osteoporosis. I don't take, nor want to take bisphosphonates.  I do take a low dose of bio-identical estrogen.  From my very first bone density scan, I fell right into that "questionable & controversial osteopenic" category.  The good news is that somehow I've been managed to "pretty much" maintain the density I've had over the past 10 years--lost a titch--but nothing that's considered "statistically significant".

My osteoporosis bone genes look bad.  Lots of vertebral fractures in our family--my mom & her sisters.  But is it more about lifestyle than genetics?  What do you think?

• My mom was tiny & small-boned--4 foot, 11 1/2 inches at her tallest. 
• She never exercised--and certainly never weight-trained.
• Little vitamin D or calcium.  With her very fair skin she always avoided the sun, missing out on vitamin D--and foods rich in calcium rarely passed my mom's lips.
• A diet high in animal protein & grains that upsets acid balance.   Mom's diet was high in white bread, high-fat meats like brisket, pastrami & hot dogs--M & M's, Hershey's milk chocolate, & pastries.
• Little vitamin K or plant-based calcium.  Mom's vegetable of choice was iceberg lettuce. 
• And now the latest research hints at a connection between skin & bones. Seems that what's good for the skin, is good for the bones.  It's looking like early wrinkles are associated with low bone density.  It's all very preliminary  (don't run to the mirror), but it's interesting to me, because my sun-avoiding non-smoking mom was definitely an "early wrinkler".  Learn more about that story here!
• In her seventies she suffered falls, painful vertebral fractures--and a devastating wrist fracture.   Her doctor said her bones were like dust--and I better pay attention to my bone health.

She had that Bad Bone-Breaking-Trifecta:  Loss of muscle, loss of strength, and loss of balance.  Unfortunately, she came "of age" before the medical community paid much attention to preventing this Trifecta.

 

Jane Brody & the Story Behind "The Achey Breaky Back" - The Vertebral Fractures of Aging

 

This is a story that's worth reading.  Vertebral fractures.  They're common, they're painful, they're hard-to-diagnose, and as we get older they can set us up for some serious slow sliding into disability.  Click here to read the full article.

An Excerpt:  

"An 80-year-old friend was lifting a corner of the mattress while making her bed when, as she put it, “I broke my back.”

In fact, she suffered a vertebral fracture — a compression, or crushing, of the front of a vertebra, one of the 33 bones that form the spinal column. This injury is very common, affecting a quarter of postmenopausal women and accounting for half of the 1.5 million fractures due to bone loss that occur each year in the United States.

By age 80, two in every five women have had one or more vertebral compression fractures. They often result in chronic back pain and impair the ability to function and enjoy life. They are one reason so many people shrink in height as they age.

But while vertebral fractures are a telltale sign of bone loss among women over age 50 and men over age 60, most who suffer them are unaware of the problem and receive no treatment to prevent future fractures in vertebrae, hips or wrists, the bones most likely to break under minor stress when weakened.

Yet, if a vertebral fracture is diagnosed and properly treated, the risk of future fractures, including hip fractures, is reduced by half or more, studies have shown.

“Most vertebral fractures do not come to medical attention at the time of their occurrence,” Dr. Kristine E. Ensrud and Dr. John T. Schousboe wrote recently in The New England Journal of Medicine. One reason is that the pain may be minimal at first or, if more severe, attributed to a strain that subsides over a few weeks.

Indeed, patients or their physicians are made aware of these fractures in just one-fourth to one-third of the instances in which they are discovered on X-rays, according to the doctors.  Read more here.

 

Jane Brody - Ditch the Crunch - Protect Your Back - Advice from the National Osteoporosis Foundation

 

Read the complete story here.

"If you have not suffered a vertebral fracture, adopting an exercise routine that improves posture and strengthens back muscles can go a long way toward preventing one. And if you are already plagued by back pain due to vertebral fractures, the exercises and protective movements described below may bring relief and prevent the problem from getting worse.

These guidelines and exercises have been adapted primarily from recommendations published in the medical journal Osteoporosis International.

First, it is critically important to know what not to do. Avoid those infamous stomach “crunches” and toe touches and any exercise or activity that involves twisting the spine or bending forward from the waist with straight legs.

Next, recall a mantra you may have heard often as a child: Stand up straight. Good posture — proper alignment of body parts when you stand, sit or walk — reduces stress on the spine. Lift your breastbone, and keep your head erect and shoulders back, all the while gently tightening abdominal muscles and maintaining a small hollow in your lower back.

More advice from the experts:

1. When sitting for long periods, place a rolled towel or small pillow at the small of your back. Walk with your chin in and head upright.

2.  Learn to bend over safely from the hips and knees, not the waist. Start with your feet shoulder-width apart and keep your back straight. Do not twist; turn to face the object you wish to reach before you bend.

3. To reach your feet (for example, to tie your shoes), sit on a chair and cross one foot at a time over the opposite knee, or stand with one foot on a stool.

4.  Lifting an object can be problematic. If possible, first get down on one knee and lift the object to your waist; then stand up, holding it close to your body.

5.  When carrying packages, use two bags with handles packed as evenly as possible, and carry one bag in each hand. If you have recently had a vertebral fracture, limit the weight you carry to 10 pounds.

Another option: Use a backpack, preferably one with straps that snap in front at the chest and waist. In fact, according to Dr. Kristine Ensrud of the University of Minnesota, one of the recommended back-strengthening exercises involves wearing a small backpacklike device containing a two-kilogram weight.  My Comment: Here's another bone-building option to consider:  the weighted vest.

6.  Avoid overreaching. Don’t reach for objects on a shelf higher than one you can touch with both hands together.

7. Protect your back when you cough or sneeze. Tighten your abdominal muscles, and place one hand on your back or press your back into a chair or wall for support. Alternatively, gently bend your knees and place one hand on them.

JANE E. BRODY

Want to learn more about safe ways to strengthen your core & your back?  Read:  "Is Your Ab Workout Hurting Your Back?   Dr. Stuart McGill Advises to Trade in the Crunch for the Bird Dog, Side Bridge, & Stir the Pot" 

If you don't see the video, click here.

   

 

If Sandy Palais Can Do It, So Can We!

 

I feel strong," says Palais, who was able to compete in the local senior Olympics

 

Do yourself a favor & read or listen to Sandy's story on the NPR website.  At age 63, after receiving a diagnosis of  osteoporosis, she took to the weight room, and ten years later, at 73, she's a Senior Olympic Weight Lifting champion with strong muscles, and bones to match!  Sandy can squat with 135 pounds, bench press with 80 pounds, & deadlift 165 pounds.  She's my inspiration to kick my weight-training up a notch!

Here's an excerpt:

 

NPR's PATTI NEIGHMOND: Sandy Palais is 73 years old. She works out five days a week, two hours each day. Today she's lifting weights at the gym at Arizona State University in Tempe.

Ms. PALAIS: I use the leg extension. I use the leg curls. I'll do back extensions, triceps extensions.

NPR's PATTI NEIGHMOND: Palais starting lifting weights about 10 years ago, shortly after she was diagnosed with osteoporosis. She was losing bone mass. What she didn't realize - she was losing muscle mass as well. And weight training builds both. So Palais went to the gym three days a week. It didn't cost much and student trainers were there to help. Within a year she was able to compete in the local Senior Olympics.

Dr. MARK PETERSON (Physical Medicine and Rehabilitation, University of Michigan): Sandy is like a hero to me. I think she is an outstanding role model.

NPR's PATTI NEIGHMOND: Mark Peterson first met Sandy Palais when he was a student. Now Peterson's a researcher at the University of Michigan and he's just completed a study looking at this very question: Can older people reverse the process of muscle loss?

Dr. PETERSON: What we found was, boy, people beyond the age of 50 make dramatic increases, much more dramatic increases than I think was historically thought.

NPR's PATTI NEIGHMOND: After five months of lifting weights two to three times a week, both men and women increased their muscle mass on average by nearly two and a half pounds. Not only did that reverse age-related muscle loss, it actually built lots of new muscle.

Muscle strength and balance prevent falls, which is one of the most common reasons seniors end up in hospitals. But if you're like most people over 50, you don't get much exercise, so Peterson says start slowly with weightlifting. For example, just get in and out of a chair.

 

So there you have it!

Any weight-training advice you can share? 

Has anyone personally seen bone density gains from weight-training, rather than drugs?

 

Comments

[Ken Leebow]

Debby,

For what it's worth, at age 47, my orthopedic doc told me that I had the back of an 85-year-old - Degenerative Disk Disease. It's actually not a disease. As we age, everyone's disk degenerates.

Since I'm very active, I decided to take action.

1. Bought a new bed (Tempurpedic) ... Amazing bed
2. At Relax the Back (store), I bought a new desk chair ... made a huge difference
3. Started weight training ... of all my exercise routines, it's my favorite

I recommend to all to view this video by Christina Economos (she's with Tufts University)- titled Nutrition and Physical Activity for a Lifetime. It's at my website: http://bit.ly/b8A87R

If that video does not convince you to weight train, nothing will.

Now at age 56, I'm in better shape than I was in my 20s. No drugs, no surgery ... just lifestyle changes!

As Dr. James O. Hill states: "Exercise is better than any drug or anything else we have for aging. There's no downside. If this were a drug, it would be the safest, most effective drug in the universe."

For a great laugh about Big Pharma, watch Bill Maher's rant ... http://bit.ly/ise9ev

Good health to all,

Ken Leebow
http://www.LifewithoutLipitor.com

P.S. Since many females are diagnosed with "osteopenia", this is an excellent report from NPR about this non-disease - http://www.npr.org/templates/story/story.php?storyId=121609815

[Donna Cash]

Here's my bone-strengthening advice: when you walk, wear a weighted vest. I have a 25 lb. and a 10. lb. This makes walking a real workout and puts weight evenly on the shoulders, spine, hips, and legs. Ditch the gym equipment workouts and use free weights - you get much better muscle involvement to mimic real-life movement. Buy and learn how to use kettlebells ! Kettlebell movements are very dynamic and focus more on the hips, spine and core and you'll see stamina and strength increases in no time....plus its way fun !

[Viv]

Thank you for an excellent article.

I have watched the video before and think the exercises are fantastic. One thing people need to know is that they should firm up their abdominal muscles before they do each exercise. An easy way to do this is to cough. When you cough, you can feel your abdominal muscles tighen up. This move makes the exercises much more productive. Of course, you should keep the abdominal muscles firm for the whole exercise.

Thanks again for sending me this.

[Wendy]

I'm working on this now myself - I have all the same risk factors you have in addition to some tricep problems that are beyond belief.

Anyway, I started taking a "pump" class at a local gym - I think it's a good strength building workout although we do crunches at the end and maybe I'll avoid those now according to this woman.

The problem is I'm only going once a week and I need to workout at home between classes. I think what I need is a video because I need to concentrate on a visual of good form all the time or I'll stray.

If you hear of any good weight-training videos where you just need some hand weights or the bar bell (we use the long bar bells - love those), please pass it along.

You go, girl!

[Julie Kennedy]

After being diagnosed as osteopenic at the age of 42 and being offered biophosphonates (Which I refused), I read The Myth of Osteoporosis by Gillian Sanson. Ms. Sanson refutes the theory that bone density alone equals fracture risk. The book is very well researched and referenced. I would recommend it to anyone as a counterbalance to all the bone density propaganda.

[Carol]

Wow. You just go from strength to strength. What a wonderful post. No time right now, but I'm going to go back and go through all the links later - I've been developing a home program in the last few weeks, and I'm sure there will be some new exercises to add or swap with what I have. My 90 year old mum has suffered with many of these things - stress fractures, spinal fractures, a cataclysmic femur break....so I've seen first hand the misery it causes. She played tennis till she was 78, but now refuses to work at exercise, believing that there's no point, because she's "too old". So thank you for the extra ammunition!

[Carla]

YAY!!! Great info --I don't have to do crunches anymore!! YAY!.. And thanks for the post about alternatives. I missed that post somehow in the past.

Have you met Ernestine Shepherd? She's a great role model too!

http://ernestineshepherd.net/?page_id=2

Carla

[Louisa]

I started using kettlebells about two years ago. I'm turning 60 in a month, and have been active all my life, but kettlebells have made me even stronger. They're assymetrical weights that look like bowling balls with a handle. It takes a lot for me to sweat, but kettlebells will do it. By using them I get a strength workout along with cardio. Recommended!

[Linda P.]

A couple of decades ago, my then-teen daughter, a competitive gymnast, was diagnosed with Scheuermann's disease. It causes true hunchback, not a curving like scoliosis. Hers was far progressed at diagnosis since doctors had thought her pain was due to injuries, pleurisy and a variety of disorders. She was put in a full Milwaukee brace from her chin to the tops of her thighs. We were counseled that, because her curvature was progressing, she would probably need surgery. One orthopedic doctor said she would never do gymnastics again, and a second said she might be able to compete again after she was out of the brace. The third said that gymnastics was the best bone-building exercise that existed, since the full body's weight was absorbed when she landed after a tumbling run or when she lifted herself over a bar or flung herself into the air. He wanted her to continue because it was a high-impact sport. She wore that full Milwaukee brace to sleep, eat, go to school, and go on her first date, but it came off for her gymnastics classes, six days a week, and for her quick showers. She avoided surgery, but at meets we certainly got a few worried moms and dads coming over to us after they'd seen her show up in that scary-looking full Milwaukee brace, wanting to know if she'd been injured in gymnastics. Since both my grandmothers broke their hips, I've remembered that orthopedic doctor's advice. I'm certainly not going to be performing gymnastics! However, I include some level of impact--jogging, for example--in my exercise repertoire. Recently, I've been struck by an autoimmune disorder that has robbed me of the strength to jog, but I still walk as much as I'm able, too, along with the other forms of exercise such as weight training.

[Steven Rice Fitness]

Bravo for your commitment to weight training and consulting with a professional. There's a big first step for most people to get some equipment and start doing some lifts, but there is an almost equally important need to learn to do the exercises correctly. The next challenge, I have to inform you, is the need to continue to physically challenge yourself with heavier weights and a variety of exercises. Unfortunately 2 visits from a trainer may not suffice for this. Some people will go for years with the same routine and after the first month or two never see any improvement. Fitness is a life long process.

I have an 83 year old client, and I just keep making things harder, and he just keeps on meeting the challenge.

[The Healthy Librarian]

Steve,

No worries! I've been listening to your advice. It was just 2 visits to get started--then regular follow-ups to switch the routines & up the weights so I continually improve & don't plateau--every 6 weeks or so. You are 100% right--I'm ready to stop doing my same-old-same-old stuff!

To everyone: I really appreciate the time you all took to share your experiences & wealth of knowledge re weight-training & bone/muscle strength! Very helpful!!! I've learned a lot from all of your comments--and from those who wrote off-the-blog.

Busy, busy week--so no time to respond individually! Apologies.

Did you all follow that link from Carla--to Ernestine Shepherd? OMG--do it & get inspired! Here it is: http://ernestineshepherd.net/?page_id=2

Off for the 4th of July weekend--and pretty booked through the following week--have lots of recipes & health updates to share--so stay tuned.

Happy 4th of July everyone.

I'm packing my suitcase with Match Meat to grill burgers, plus Alvarado Street Sprouted Burger buns, some Italian Field Roast Sausage, just in case--& 2 cook books to experiment with!

[raye]

I just love this post! I stumbled on an article about Sandy about a month ago, just after my latest bad DEXA, and it did all kinds of things to boost my moral. I know this on all kinds of levels with every fiber of my being: unless there's some secondary cause for your bone loss, there's no reason why a fitness program shouldn't be able to reverse it. I had great results with the Yoga vs. Osteoporosis program in my first year, but the second year it wasn't enough. More than likely because I am in the throes of menopause right now. I have a "tree" full of weights ranging from 5 lbs to 30 lbs, I just have to use them. But I second the recommendation for a weight vest. I have one that goes up to 30 lb. I do my squats and lunges with that. When I peaked and it was time to up the load, I added two 2 lb dumbbells. If/when I peak on that, I'll move to the vest + two 5 lb dumbbells. The key really is to keep switching up your routine.

My other weight vest is 10 pounds and a little less obvious. I wear that on hikes and walks and even do yoga in it. It has really changed my workout. It has the added benefit of not feeling or really looking like a weight vest.

Bravo for being smart and getting someone to help you design a program. Good luck with it!

[KK]

Wendy, check out http://www.collagevideo.com/ . They have a huge assortment of fitness videos, include descriptions and fitness level (beginner, intermediate, advanced), and have clips of each.

Kathy

[Anna]

As grains are acidic and we are supposed to be keeping our blood as alkaline as possible - I am wondering whether I should I cut back (or even cut out) grains?