Does Low Bone Mass Mean Osteoporosis?

mbai-skeleton-hipNearly 30 years ago when I was in school, I wrote an exercise physiology paper on exercise and osteoporosis.

At that time there wasn’t much research available. But even then, the studies I found on tennis players, astronauts, and bed rest pointed in the direction that weight-bearing exercise could help maintain the bone density you have and even promote bone growth. I was intrigued. I’ve followed the research over the years and even created an osteoporosis exercise program.

In working with my clients, I often hear the question “what’s the difference between osteoporosis and low bone mass? (osteopenia) And what can I do about it?

Well to answer these questions, I have to start at the beginning.

Osteoporosis is a disease, which, over time, causes bones to become thinner, more porous and less able to support the body. Bones can become so thin that they break during normal, every day activity. Osteoporosis is a major health threat. 54 Million are at risk, nearly 80% are women.

Postmenopausal women are particularly at risk because they stop producing estrogen, a major protector of bone mass.

As we age some bone loss is inevitable. Women age 65 or men age 70 should get a bone mineral density test. If you have a family history of osteoporosis or other risk factors you may need a BMD much earlier.

The test is completely painless, non-invasive and takes only a few minutes.
It compares your bone mineral density to that of an average healthy young person. Your results are called your T score. The difference between your score and the average young person’s T-score is called a standard deviation. (SD)

Here is how to interpret your T score:

  • Between +1 and –1: normal bone density.
  • Between -1 and -2.5: low bone density (osteopenia).
  • T-score of -2.5 or lower: osteoporosis.

Until recently it was thought that if you had low bone mass (osteopenia) you were well on your way to getting osteoporosis. But it’s now known even at this stage bone loss can be slowed down, stopped and even reversed. You and your doctor will have a number of options depending upon your particular condition.

Many MDs like to start with a calcium and vitamin D rich diet coupled with weight bearing exercise. For many of us, that’s all we need. Others will require medication and there are many bone-building medications available.

Remember it’s never too early to start taking care of your bones. The more bone density you have as a young person the less likely to end up with osteoporosis later in life.


May is Osteoporosis Prevention Month! It’s Never Too Late To Take Care Of Your Bones!

by Mirabai Holland MFA Certified Health Coach, Certified Exercise Physiologist.





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Working Out Your Bones By Mirabai Holland, MFA ©2012

Weight Bearing Exercise

By now we all know that Osteoporosis makes bones so thin and porous that they can break during everyday activities like stepping off a curb or picking up a grocery bag.

We’ve all heard that estrogen protects women from bone loss and that we can loose up to 30% of our bone mass in the first 10 years after menopause. And we’ve heard that we should do weight bearing and resistance exercise to help prevent bone loss and promote bone growth.

But what IS weight bearing exercise? What’s the difference between weight bearing and resistance exercise? And what kind of exercise routine should I do to protect my bones?

I hear this all year long. So, here are the answers.

Weight bearing means literally making your bones carry weight. Standing makes your bones carry your body weight. Standing with your grandchild on your shoulders makes your bones carry your weight plus your grandchild’s.

Studies show that weight bearing exercises like walking and jogging that also apply impact to your bones are even more effective

Resistance exercise uses your muscles to apply mechanical forces to your bones like pushing (compression) pulling (tension), twisting (torsion), and bending.

So, the more weight, impact and resistance the better, right? No. Even if your body were a machine made of steel there would be a weight, impact and resistance that would break it.

And we know our bodies are much more fragile than that. Common sense must rule.

Walk, jog, jump rope, dance, pull on a rope, push on a wall, wring out a towel, and bend bones with weight lifting exercises. But do it safely. Do it in moderation. Stay in your comfort zone. Start with a comfortable amount and build up slowly over time. Take breaks between shorter intervals of training. Studies show that those break times may be when bones get stimulated to grow.

Studies also show that site-specific exercises are very effective. So, do exercises that involve the 3 areas most at risk for Osteoporotic fracture, the spine the hip and the wrist?

Walking loads your spine and your legs including the hip joints. Wrist curls and wringing a towel work your wrists and forearms.

Do any weight-training resistance exercises every other day because your muscles need time to recover. A starter routine might be 20 minutes or more of brisk walking every other day and weight resistance training on the days in between.

But make sure you talk to your doctor about your particular exercise needs and limitations.

They vary greatly from person to person.

So why not use Osteoporosis month to set an example for the women in your family of any age because it’s never too early or too late to start working out your bones.

To Read More On Osteoporosis:

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Best Exercises For Combating Osteoporosis by Mirabai Holland, MFA ©2012

Skeletal Fitness by Mirabai Holland: A Workout For Your Bones

Osteoporosis is one of those silent diseases that can creep up on you before you know you have it. To combat Osteoporosis and help keep your bones healthy for a lifetime, it’s important to increase your Skeletal Fitness!

Osteoporosis is a disease, which, over time, causes bones to become thinner, more porous and less able to support the body. Usually there’s no pain in the early stages.

44 million of us are at risk for Osteoporosis. The vast majority are women.

Women often develop Osteopenia (low bone mass that can lead to Osteoporosis) in the first few years after menopause because they lose bone-protecting estrogen.

But, we can prevent and help reverse the effects of Osteoporosis by working out our bones. On the outside, bones look solid and rock-like, but they’re not.

They’re living tissue. There is a smooth, hard, outside layer

made of cortical bone, and the inside, is a strong, light weight,

honeycomb-like structure, called trabecular bone, which contains blood vessels, and bone marrow. The combination of cortical and trabecular bone enables the skeleton to be light, strong, flexible and efficient.

By young adulthood, our bones have grown to their full size and density. But activity in our bones is far from over. In a cycle called remodeling, old and weakened areas of our skeletons are broken down and replaced with new well-formed tissue. Adults have about 10 to 15% of their bone replaced each year.

In bones with Osteoporosis, the remodeling cycle is out of balance. Bone is broken down but little or nothing takes its place. The outside hard cortical layer

gets thinner, and the honeycombed, trabecular inside becomes more porous.

Most people don’t discover they have Osteoporosis until a fracture occurs.

Fractures occur most often at the spine, at the hip, and at the wrist.

The good news is since bones are living tissue they can become denser with weight bearing exercise.

For example, astronauts lose bone mass in the weightlessness of space. To combat this, NASA is training astronauts for a mission to Mars, to do weight bearing exercise that simulates the exercises they will need to do in space to maintain their bone mass. Weight bearing exercise for Skeletal Fitness is called bone loading. When working out your bones it’s important to load the areas most at risk for fracture: the spine, the hip, and the wrist.

So for instance try these Do’s to help load the three areas most at risk:

· Carrying a backpack instead of a purse to help load your spine.

· Take stairs instead of the elevator whenever you can to load your hips.

· Grab some soup cans and do 8-16 reps of wrist curls and when that gets too light invest in some hand weights. Remember; always exhale on exertion when you’re lifting a weight. Start with a comfortable weight and add one pound every couple of weeks, or, when it feels too easy.

· As you get stronger you can add a full body weight-training program with special emphasis on the areas at risk for Osteoporosis.

Weight train every other day, because your body needs time to recover and grow stronger.

If you are at risk for or have Osteoporosis, here are some Don’ts

· As a general rule, don’t do anything that requires you to bend forward from the waist with the back rounded; this is called spinal flexion and increases the risk of collapsed vertebra so no toe touches.

· Avoid sit-ups, and crunches. Instead, you can strengthen your abdominals by keeping them pulled in, navel back to your spine during daily activity.

Also, always consult with your doctor, get all the information you can, together you can decide what’s best for you. And remember, it’s never too early or too late to start working out your bones!

For more information on bone-loading workouts please visit

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