It is very important for women to lift weights and continue to perform weight bearing exercises throughout their lifespan. Women are much more likely to be diagnosed with osteoporosis than men since they start with a lower bone density. Osteoporosis is a musculoskeletal diagnosis marked by low bone density which can lead to serious injuries such as hip, thoracic or lumbar compression fractures causing permanent disabilities.

When a women enters her 30s she has reached her maximum bone mass density. As she enters menopause there is a decline in estrogen which can lead to deterioration in her bone density. Osteoporosis is usually diagnosed with a bone densitometry or bone density scanning test, often performed on the lower spine and hips. This test can be ordered by your doctor if he or she suspects that you are at risk for osteoporosis.

Scans of the hip and spine and provide a T-Score, used to describe a person as having ‘normal’, ‘osteopenic’ or ‘osteoporotic’ bone. Osteopenia is a precursor to osteoporosis and can advance to osteoporosis with age if there is no modification to a her current physical activity.

OSTEOPOROSIS

T-score of- 2.5 or less

OSTEOPENIA

T-score of -1.0 and -2.5

NORMAL

T score greater than -1

Multiple studies have indicated that exercise training, particularly weight bearing as well as high impact exercises can contribute to an increase in bone mass and promote osteogenesis, or bone tissue formation. If a woman has been diagnosed with osteopenia or osteoporosis it is important that her physical therapist combine appropriate weight bearing exercises to her exercise routine. To prevent osteoporosis, those with normal or slightly low bone mass should always engage in moderate to high impact activities throughout their lifespan. Those with low bone mass should perform moderate to lower impact exercises: Tai Chi, stair climbing, low-moderate impact aerobics, as well as weight bearing exercises. The following are some recommended weight bearing exercises for the lower and upper body. Before you start any new exercise regimen be sure to consult with your physical therapist or physician to ensure that they are appropriate for your condition.

How to squat:

Stand with your feet shoulder width apart, keep your spine in a neutral position which means avoid hyperextending or arching your back
Engage your core by tightening your abdominal muscle, imagine that you're trying to put on a pair or tight jeans
Start bending at the hips and knees and lower your body down, try keeping most your weight on your heel so that so that you can engage your gluteal muscles as well as your quadriceps
Continue to squat down until your thighs are about parallel to the ground, you should be able to see your toes at this point, if not, you have shifted your forward onto the balls of your foot, which can cause increase stress your knees, adjust yourself at this point if needed.
Your knees should also line up with your big toe, if not try putting a resistance band around your knee to keep it from turning inward
Push through the heels to bring your body to an upright position
Make sure you also breathe, inhale on the way down and exhale up your way up if using your body weight as well as light to moderate weights, keep your abdominal muscle engage throughout exercise, also squeeze your gluteal musculature on the way up; if using heavy weights with a barbell (>80 percent of 1 rep max) also recommended to inhale and hold your breath through the entire repetition to maximize CORE stability especially when you get to the bottom, this breath holding should only last for a few seconds.

How to lunge:

Forward lunge:

Stand with your feet shoulder width apart and your hands at your sides.
Take a big step forward forward while keep you body upright, your torso should be directly above your hips
Bend at the knees and slowly lower your body straight down.
The front leg that will be the pushing leg, should be at a 90 degree angle at the knee, which will activate your gluteal as well as your quadriceps. Make sure you can still see your toes when you lower down, also make sure your knee is in straight line in relation to your big toe and the front of your hip, make sure the knee does not fall inward.
Your back knee should hover above the ground and can be at 90 degree angle as well, if you have adequate hip flexor flexibility you can place your back leg even further back, this will also engage the front leg’s hamstring and gluteal musculature
Keep your weight in your heel as you push back up to starting position.
You can perform a static lunge, and alternate each leg; if you feel stable you can try a dynamic lunge, which means you have to lunge and walk forward.
Use weights for more of a challenge if you are stable in a static and dynamic lunge.

Side lunge:

Take a large step with either left or right foot and lunge toward the same side.
Shift your weight to that leg and bend the knee to about a 90 degree angle
Make sure that your knee that’s performing the lunge does not extend past your toes, keep the opposing leg relatively straight.
Return to center and switch sides. This is a good exercise to also help you engage multiple muscle groups in the lower body: quadriceps, hamstrings, and adductors or inner thigh.

How to plank:

Keep your elbows bent 90 degrees and both forearms resting on the floor.
Place your elbows directly underneath your shoulders
Your body should form a perfectly straight line from the top your head to your heels.
Your feet are together with only the toes touching the floor.
Keep your abdominal tight, try to not arch your back or stick your butt in the air
Hold for at least 30 seconds progressing to 60 seconds
Make sure you breath during this exercise

Modified plank:

Assume the same position as a regular plank but place your forearm on an elevated and stable surface, the more parallel you are to the ground, the harder the exercise, so work yourself slowly towards that goal

Screen Shot 2016-11-25 at 4.47.36 PM.png

Some recommended upper body strengthening

Biceps curl

Keep your elbows tuck in and closed to your body
Make sure you keep tension on the biceps throughout the movement, especially as you lower the dumb-bell
Start with low weights 3-5lbs, try 10-15 repetitions for 2 sets, as the exercise gets easier try increasing up to 5 repetitions or add an additional set

Overhead press

Stand or sit, standing will force you to engage your CORE more than sitting so you can use lighter weights, sitting with a back support will allow you to focus more on your shoulders allowing you to use more weights, try both ways
Hold both dumb-bell in each hand at shoulder height, keep your elbows and shoulders are 90 degrees, your palms are facing away from you
In this position, inhale and exhale as you drive both dumbbells overhead
Keep your head upright and in a neutral position, try not to lock your elbows out, keep a slight bent in the elbow.
You can also try alternating unilateral dumbbell shoulder press as a variation.

References

Shanb, Alsayed A., and Enas F. Youssef. “The Impact of Adding Weight-Bearing Exercise versus Nonweight Bearing Programs to the Medical Treatment of Elderly Patients with Osteoporosis.” Journal of Family & Community Medicine 21.3 (2014): 176–181. PMC. Web. 17 Nov. 2016
Kelley, G.A., K.S. Kelley, and W.M. Kohrt, Exercise and bone mineral density in premenopausal women: a meta-analysis of randomized controlled trials. Int J Endocrinol, 2013. 2013: p. 741639.
Zhao, R., Zhao, M., Xu, Z. The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Osteoporos Int. 2015;26:1605–1618

Osteoporosis: Why Women Should Always Exercise!

Scans of the hip and spine and provide a T-Score, used to describe a person as having ‘normal’, ‘osteopenic’ or ‘osteoporotic’ bone. Osteopenia is a precursor to osteoporosis and can advance to osteoporosis with age if there is no modification to a her current physical activity.

OSTEOPOROSIS

T-score of- 2.5 or less

OSTEOPENIA

T-score of -1.0 and -2.5

NORMAL

T score greater than -1

How to squat:

Stand with your feet shoulder width apart, keep your spine in a neutral position which means avoid hyperextending or arching your back

Engage your core by tightening your abdominal muscle, imagine that you're trying to put on a pair or tight jeans

Start bending at the hips and knees and lower your body down, try keeping most your weight on your heel so that so that you can engage your gluteal muscles as well as your quadriceps

Continue to squat down until your thighs are about parallel to the ground, you should be able to see your toes at this point, if not, you have shifted your forward onto the balls of your foot, which can cause increase stress your knees, adjust yourself at this point if needed.

Your knees should also line up with your big toe, if not try putting a resistance band around your knee to keep it from turning inward

Push through the heels to bring your body to an upright position

How to lunge:

Forward lunge:

Stand with your feet shoulder width apart and your hands at your sides.

Take a big step forward forward while keep you body upright, your torso should be directly above your hips

Bend at the knees and slowly lower your body straight down.

Your back knee should hover above the ground and can be at 90 degree angle as well, if you have adequate hip flexor flexibility you can place your back leg even further back, this will also engage the front leg’s hamstring and gluteal musculature

Keep your weight in your heel as you push back up to starting position.

You can perform a static lunge, and alternate each leg; if you feel stable you can try a dynamic lunge, which means you have to lunge and walk forward.

Use weights for more of a challenge if you are stable in a static and dynamic lunge.

Side lunge:

Take a large step with either left or right foot and lunge toward the same side.

Shift your weight to that leg and bend the knee to about a 90 degree angle

Make sure that your knee that’s performing the lunge does not extend past your toes, keep the opposing leg relatively straight.

Return to center and switch sides. This is a good exercise to also help you engage multiple muscle groups in the lower body: quadriceps, hamstrings, and adductors or inner thigh.

How to plank:

Keep your elbows bent 90 degrees and both forearms resting on the floor.

Place your elbows directly underneath your shoulders

Your body should form a perfectly straight line from the top your head to your heels.

Your feet are together with only the toes touching the floor.

Keep your abdominal tight, try to not arch your back or stick your butt in the air

Hold for at least 30 seconds progressing to 60 seconds

Make sure you breath during this exercise

Modified plank:

Assume the same position as a regular plank but place your forearm on an elevated and stable surface, the more parallel you are to the ground, the harder the exercise, so work yourself slowly towards that goal

Some recommended upper body strengthening

Biceps curl

Keep your elbows tuck in and closed to your body

Make sure you keep tension on the biceps throughout the movement, especially as you lower the dumb-bell

Start with low weights 3-5lbs, try 10-15 repetitions for 2 sets, as the exercise gets easier try increasing up to 5 repetitions or add an additional set

Overhead press

Stand or sit, standing will force you to engage your CORE more than sitting so you can use lighter weights, sitting with a back support will allow you to focus more on your shoulders allowing you to use more weights, try both ways

Hold both dumb-bell in each hand at shoulder height, keep your elbows and shoulders are 90 degrees, your palms are facing away from you

In this position, inhale and exhale as you drive both dumbbells overhead

Keep your head upright and in a neutral position, try not to lock your elbows out, keep a slight bent in the elbow.

You can also try alternating unilateral dumbbell shoulder press as a variation.

References

Shanb, Alsayed A., and Enas F. Youssef. “The Impact of Adding Weight-Bearing Exercise versus Nonweight Bearing Programs to the Medical Treatment of Elderly Patients with Osteoporosis.” Journal of Family & Community Medicine 21.3 (2014): 176–181. PMC. Web. 17 Nov. 2016

Kelley, G.A., K.S. Kelley, and W.M. Kohrt, Exercise and bone mineral density in premenopausal women: a meta-analysis of randomized controlled trials. Int J Endocrinol, 2013. 2013: p. 741639.

Zhao, R., Zhao, M., Xu, Z. The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Osteoporos Int. 2015;26:1605–1618