The Exercise for Osteoporosis with Sarah Purcell webinar had a fantastic turnout.

Sarah discussed:

1. Alignment
2. Loading
3. Weightlifting
4. Muscle tone
5. Balance

After the webinar, Sarah viewed the unanswered questions in the Zoom chat. She generously spent hours writing answers to questions about weight vests, best shoes for working out, comparing Pilates to yoga, guidance for endurance training and much more.

These answers can be found below.

I feel I/we have an exercise advocate on our side. One who isn't sitting and teaching old science.

Watch the webinar replay here.

Want to work with Sarah?

1. Short & Sweet with Sarah

• Monthly Membership - $27

Short & Sweet with Sarah was created for women with osteoporosis & osteopenia, to help you:

• • Begins with optimal breathing for exercise
  • Slowly, step-by-step recognizing your own movement  patterns that no longer work.
  • Gaining knowledge to repattern incrementally
  • Build core strength and stability needed to increase mobility and activity. 

Although this program is ideal for women who have been inactive, it is very helpful for active individuals with pain to unravel those patterns that may be overworking some areas and underworking other areas.

This is important so you can:

• • • Play with your grandkids
    • Get up and down from the floor like you used to
    • Have fewer aches and pains

2. Healthy Bones Healthy Body

• Monthly membership $27

Exercise library membership. This is ideal if you are ready to exercise. 

Discover how to make simple changes to your exercise routine that will benefit your bone health.

• • Alignment for loading your bones
  • Site specific exercises to load your bones
  • Safe ways to increase your heart rate
  • Move with confidence
  • Best is you have a core strength

Even if you have never done low impact aerobic activity or added weights to a movement class, Sarah provides the details and progressions that will make working out easy, safe and fun.

3. Bone Boot Camp

• One payment of $89

BONE BOOT CAMP is designed based on the latest research which tells us that bone strengthening is site specific and requires external load, or weights.

• • An at home weight lifting for osteoporosis or osteopenia course.
  • It contains a foundational section with the essential movement ingredients for weightlifting
  • A warm up and the 9 essential weightlifting exercises for site specific loading.
  • There are also Bonus exercises. 

About Sarah Purcell

Sarah Purcell is licensed and certified in Pilates and Yoga. Her extended certifications include the Buff Bones™ Bone Health and Movement program and the  Restore Your Core™ Pro Teacher Certification.

With her strong interest in anatomy, research, and managing her own osteoporosis naturally  is what she brings into her work.  Sarah created the successful online course Bone Boot Camp, an at home strength training program for women with low bone density.

As youthful as Sarah appears she is a mother, grandmother and lifetime learner.  What I appreciate about Sarah, in addition to her knowledge, is she's a delight to learn from.

Follow up answers from webinar.

Vests

A weighted vest is not appropriate for everyone.  In the end it is your personal decision, and I am not a medical professional.  Here is what I say to my clients.  It would be an informed decision if you know your bone quality as well as your bone density.  Additionally, you want to take spinal conditions into account.  If you have severe scoliosis or spondylolisthesis or any number of other disc or spine deformities or degenerations, you must take these into account.  It may be that you will choose to walk with a weighted belt and only add load to your hips and not your spine in the interest of safety.

Should you decide to use a vest the protocol is to progressively load slowly. One would start with a half pound, and if the first walk with a half pound was successful, then one would load another half pound each time they took a walk. As you get to a heavier load( the point that something is "heavy" is very individual) you would be wise to take more time to adjust to the load before increasing your weight. It may well be that you would walk for a week, with five pounds for instance, and the following week, see if five and a half pounds is okay. So, your progression would slow down.  The suggested maximum in the medical community is 10% of your body weight.

Vest that places the weight near the center of gravity

I'm going to make the assumption that the question is directed towards a person having a center of gravity somewhere in front of the sacrum when standing. So, if you were looking to carry most of your weight in that spot, you would want to be able to wear a weighted belt that sits a little lower than your natural waist. But, I do think another good option is the hyper vest elite.  It is made so that you can put two weights in any one pocket so you could redistribute the weight to try to get more of the weight near that theoretical center of gravity.

From that perspective, I think the Ironwear Fitness Vest is not as good because it's a much shorter vest. I've had clients who are taller than five seven tell me that the Ironwear Fitness Vest is too short , so be cautious if you are tall.  I think when you look at a lot of inexpensive vests, they tend to be centered all near up near the rib cage. I like the Hyper Vest Elite because it is longer and its pockets are more flexible, allowing them to take more than one weight in a pocket. 

Hyper Vest Elite link.

Website for Iron Wear fitness.

Pilates or weight machines?

I'd like to address this by asking a few questions:

How often should you strength train?

We should all strength train. 

I acknowledge up front that this does not mean heavy lifting and may be 1 pound weights for some individuals. We know that 2 to 3 days a week is optimal for hypertrophy or building muscle. 

Endurance based exercises

This type of work can be aerobic for heart health or it can be longer, slower core work such as pilates or yoga.  Many people suggest 2 or 3 times a week for this kind of exercise.

I recently read scientific literature that suggests:

Strength train 3 times a week,

Endurance train 2 times a week
Rest two days a week.  

Do that for 10 weeks. 

Next you start a new cycle where you:

Endurance train for 3 days a week,

Strength train for 2 and

Rest for 2 days during that cycle. 

Of course you may choose one day of rest because your 6th day is something very restorative.

The most important thing is to listen to your own body.

You should be able to determine your own level of fatigue. If you try strength training three days a week, do you still feel energetic on the 6th day? I have clients who start out strength training with such light weights for safety reasons, that they really need three days a week. But other clients really push themselves and 2 days a week is optimal.  These people may choose to not alter their training schedule every 10 weeks because they know what works for them.

As we age, we know our repair functions work more slowly than when we were younger, so we must be vigilant about listening to our own body and its signals.

Rep Protocol Question

If there's anything against a protocol where one:

Five Reps at 10 pounds

Then 10 reps at eight pounds

Finally 20 reps at five pounds?

Or is it better to do the same weight to your comfort level?

In order to get hypertrophy, one would be less likely to strength train in that format.  But I can see the use of a format like that because you are essentially pushing hypertrophy in the beginning and endurance in the end. I haven't seen any studies on this format, but I will look further into it.

When I Deadlift knees crack, is that okay?

Consistent cracking is an indication of either hydrogen pop or a tendon moving over a bone or two things rubbing together. 

I am not fond of letting that happen consistently over time as there will likely be a wear and tear event at some point.   I would experiment with a lower weight and see if the knees still crack. I would also take a slow motion video of yourself while performing the deadlift.   You may discover that you are either hyperextending your knees or maybe they are drifting inwards or outwards. I do think it needs another look.

Shoulder blades together and down your back

This is a very common question. And I would like to dispel the myth that pulling your shoulder blades down and back will actually improve your posture. What it may in fact do is just add more tension to an already sub optimal spinal alignment. The easiest way I can show this is with photographs.

As you can see, in the first photograph, I have a kyphotic posture or an upper spine that rounds forward.  I can alter what you, the viewer, see by merely pulling my shoulder blades back and looking more upright.

This is the second photo!  But in fact, I haven't changed that forward posture. 

Pulling the shoulder blades back via the rhomboid muscles when I'm standing doesn't actually make my spine more elongated period. 

Yet, I will suggest that you use your rhomboids in exercises.

The third photograph is standing more erect without so much forward shoulder and head. 

My shoulders are NOT pulled back, they are sitting easily.  I have externally rotated my arms to find a bit more openness in my chest.

1. Work on your shoulder blade mobility by doing rhomboid push ups.  The goal is to decrease the kyphotic curve and getting more active movement in protraction and retraction will be a big help.
2. Elongate your spine. Sometimes we talk about reaching the crown of your head more towards the ceiling. But we want to do that without extreme extension in the neck.
3. The bottom line is that I suggest people work on getting their hips back first, before worrying about their shoulder blades.  We want to have a more stacked alignment from their heels to their hips. And then to work on the stacked alignment in the upper body.
4. We are really looking at doing more thoracic extension. So it's a slow process. You look for small small changes, maybe 1% at a time. Here are some good exercises for encouraging more thoracic extension. 

Baby Cobra. Cactus arms at the wall facing away from the wall.( you will work on getting your arms on the wall completely while also keeping the back of your ribs on the wall.  Gentle rotations side to side. 

Best Shoes for Workout

Why wear minimalist shoes.

Best shoes

Hinge

The principle behind the hip hinge is to keep your spine in neutral. 

This means that the natural curves of your spine are kept intact.  A hinge is where we keep that neutral arrangement and move your torso including your pelvis over your legs. I used to teach taking a fig leaf at your pubic bone and imagine drawing the fig leaf down in between your legs moving it to almost face the ground. I have also suggested moving your sitting bones to the wall behind you. 

In either visual suggestion, the individual will sometimes move the spine at various points above the pelvis and that is when I began using a broomstick or a dowel. The 3 important points on the dowel are the head, the rib cage and the sacrum or the back of the pelvis. For some people a forward head posture makes it difficult to get their head on the stick. There's still a lot of good work to be done. Try to keep the relationship of your head exactly the same vis a vis the stick.  Keep your ribs and your sacrum on the stick.

By doing so, you are protecting your lumbar spine and your thoracic spine.  The biggest issue is unhinging or  raising back up.  Every individual really needs to have a good core strategy. So even if your hamstrings are very flexible, you should only hinge over as far as you have the strength to bring yourself back up without changing your spine. For people who don't have a good core connection yet, we start very small and progress to bigger hinges over time. A hip hinge is a great exercise to strengthen your back when done properly. It basically strengthens the entire back chain of your body.

Best Yoga poses

Tree, Chair, triangle if done with a neutral spine, Warrior I, II, II with a neutral spine. 

Thanks for being part of my community.

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