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From: Art S on 15 Apr 2005 00:23 "Kate" <katebooks(a)juno.com> wrote in message news:1113481525.824877.116370(a)f14g2000cwb.googlegroups.com... > Lee, > > After reading some of your other posts... > Since you go to a gym, you can use the bike. Recumbent bike supports > your spine and bike is a good weight bearing exercise for your hips. Not really. Since the body is supported from the waist up, the only load will be based on how hard the pedals are pushed. Unless the bicyclist is pushing hard enough to support their entire weight (which very few do unless they are standing on the pedals), there will be less stress than simply walking. It can be good as an aerobic/cardiovascular exercise, but it is poor for increasing bone density. > Most recumbent bikes at gyms allow you to increase resistance > progressively. > > Then stair climbers are also good for hips. Just be sure not to 'hunch > over' the front bars; stand tall. They aren't as good as real stairs for building bone density. This is because - due to the "stair" going down, there is minimal impact, which means minimal stress on the bone, which probably means no increase in bone density. It can be a good aerobic/cardiovascular exercise, though, if done properly (stand upright and don't use the hands/arms to support any of the weight). As an aside, going down stairs is better for increasing bone density than going up stairs because there is more "impact" when the foot "hits" the stair. > > You can get more benefit if you do one of these for a month ...and then > change off to the other. This gives a sense of 'new stresses' when you > go back to the other machine and osteoblasts respond better [at least > that is what some of the research says.] All of the research I have seen says "different" stress (different angle or different peak load). I haven't seen anything that just says "new" stress. Could you provide your references, please? Also, note that both stair climbing and bicycling stress the bones in the same way: along the axis of the bone. Keep in mind that bone doesn't have eyes - it doesn't know what exercise is being done. All it "knows" is that it is receiving a certain level of stress (stretch or compression) in a certain direction. > > As for your back, there are lat pulls .... > I am not sure why you want the abs so much but one alternative would be > to try some isometric exercises for your abs. They do not require > bending, twisting etc. > > YOur health care provider ought to be helping you design an exercise > program to fit your condition!!! If s/he is not able or willing to do > that, why not ask for copies of your dexa scans [it is your right to > have these] and then take these to physical therapist or such who > should be able to help you devise a program that fits your > circumstances. Medicare would probably pay for the consult if your > health care provider writes a script for it. Lee should get copies of the DEXA scans regardless. Seeing a Physical Therapist is also a good idea. The PT can do two things: first, help with balance exercises, if required (at 71, it may be premature). Second, help with proper exercise technique (my personal estimate is that 95% of the personal trainers don't know their head from a hole in the ground, but this is gym dependent. The PTs I have seen have all known more about how to do exercises than the personal trainers I have seen. Note that Cyli may disagree - it appears that the people in her gym are doing more technically complicated lifts (Olympic Lifting) than the people in my gym and that may be reflected in the trainers there.) Many states limit what a Physical Therapist can do (no diagnosis, etc), so Lee may need a doctor's prescription to see the Physical Therapist. Art
From: Cyli on 15 Apr 2005 03:50 On Fri, 15 Apr 2005 04:23:44 GMT, "Art S" <thedabbler02(a)earthlink.net> wrote: > The PTs I have seen have all known more about >how to do exercises than the personal trainers I have seen. Note that Cyli >may disagree - it appears that the people in her gym are doing more >technically complicated lifts (Olympic Lifting) than the people in my >gym and that may be reflected in the trainers there.) No disagreement here. My trainer was good and careful. I shouldn't have spoken of trainers in general. The lifters I've watched were all serious about it. I'm not talking about the average guy who wanders in and does a few reps. I tended not to pay attention to them. They had the gym set up so that some of the machines I worked out on faced the weights area, so I almost had to watch the lifters or shut my eyes. It was the major downtown gym of a local chain and had the most equipment of any of the chain, so they may have had a better group of trainers? I know that in my very little bit of visiting the suburban ones I couldn't see anyone I'd bet was a trainer and the equipment was a bit spotty as to numbers (but clean beyond belief), with the 'burbs having emphasis being on the handball and tennis sorts of stuff. Cyli r.bc: vixen. Minnow goddess. Speaker to squirrels. Often taunted by trout. Almost entirely harmless. http://www.visi.com/~cyli email: cylise(a)gmail.com.invalid (strip the .invalid to email)
From: Kate on 15 Apr 2005 19:30 Art said about recumbent biking: >Not really. Since the body is supported from the waist up, the only >load will be based on how hard the pedals are pushed. Unless the bicyclist is pushing hard enough to support their entire weight (which very few do unless they are standing on the pedals), there will be less stress than simply walking. It can be good as an aerobic/cardiovascular exercise, but it is poor for increasing bone density.<< Art, this goes agaist the recommedations of Leon Root, Md and also Nancy Lane MD both of whom have books out about osteoporosis. Even my orthopedist has said that recumbent bikes are good exercises for increasing hip BMD - especially since most of them allow you to increase the resistance at will - thus providing the same 'increase' as one has when increasing weights in weight lifting. The research studies about weight lifting - [most of which show postive results on bone density,] NO one was ever asked to raise her 'full weight' - in fact, depending on the level of conditioning of the participants, many showed improvement with very low poundage. So too with gym cycles--- the resistance can be changed to fit the fitness level of the rider. Stairs - I agree with your comment that 'real stairs' are best. But I would never recommend that to anyone whose balance and co-ordination I do not know well. One of the real problems with 'real' stairs, as well as 'step programs' is that participants can fall - and this is dangerous for those with ostoporosis. Stairmasters do provide 'weight bearing' - much as lower free weights do AND those using Stairmasters have double handles to ensure that they do not fall. Again, Root, the doctor-author mentioned above suggests Stairmasters. As for changing from one type of exercise to another - so that there are 'new stresses', that is mentioned in so many books about Osteoporosis I am not sure what to reference. As I read the literature it says that although all weight bearing exercise puts stress on bones, different exercises put more and less stress on different parts of the skeleton. Osteoblasts only respond to 'increased stress' - which is the reason that any exercise loses its ability to stimulate new bone growth unless there is increase weight added. But if you stop the exercised generated increased stress on a bone for a period of time, the osteoblasts in those bones get used to the less stress. {There is not a loss of the bone that was created during the first exercise period since the osteoclasts are not being stimulated] But when you increase the stress again by taking up the activity again, the osteoblasts are again stimulated since this is now a 'new level of stress compared to what they are used to' and they pick up activitiy. The key is to wait long enough between switching off and switching back. If we do not change exercises, then it becomes necessary to keep adding weight/stress since the osteoblasts are no longer stimulated once they have gotten used to a given amount of bone stress. [In lifting weights, this is why we need to keep adding heavier weight for the weight lifting to increase bone mass]. When doing things like walking, racewalking, dancing, jogging people can not keep 'adding weight'...so the advice has been to change off to a different exercise and then come back to what you were doing. Most orthopedists can tell you exactly what bones are stressed by what exercise. Cyclists develop different problems from joggers and the latter do not get hurt in the same place as race walkers and those doing weighted walking develop other problems etc. Of course, gymnastics is the 'best' exercise for buidling bone - even with the commonality of annorexia [a risk factor for osteoporosis] among women gymnasts, for example, they were found to have greater BMD than most others. This is, of course, because of the 'weight bearing' and the bounding etc. These gymnast studies are one of the reason why they began to test 'jumping jacks' and jump rope - which proved great for buidling BMD BUT THESE EXERCISES could be dangerous for anyone with osteoporosis since they could cause fractures if bones are porous. Kate
From: Art S on 16 Apr 2005 02:39 "Kate" <katebooks(a)juno.com> wrote in message news:1113607828.707599.121090(a)o13g2000cwo.googlegroups.com... > Art said about recumbent biking: > > >Not really. Since the body is supported from the waist up, the only > >load will be based on how hard the pedals are pushed. Unless the > bicyclist is pushing hard enough to support their entire weight (which > very few do unless they are standing on the pedals), there will be less > stress than simply walking. It can be good as an > aerobic/cardiovascular > exercise, but it is poor for increasing bone density.<< > > Art, this goes agaist the recommedations of Leon Root, Md and also > Nancy Lane MD both of whom have books out about osteoporosis. Never heard of them. My library has some books by each of them, so I've put in a request. > Even my > orthopedist has said that recumbent bikes are good exercises for > increasing hip BMD - especially since most of them allow you to > increase the resistance at will - thus providing the same 'increase' as > one has when increasing weights in weight lifting. > Any peer-reviewed studies? When I looked in pub med (www.pubmed.com), I didn't find any studies on recumbent bikes and bone density. I found several talking about bicycling and bone density, but "mixed" results: 1. (article in German. everything is based on a translation) Modification of bone quality by extreme physical stress. Bone density measurements in high-performance atheletes using DEXA Sabo D, Reiter A, Pfeil J, Gussbacher A, Niethard FU. Z Orthop Ihre Grenzgeb. 1996 Jan-Feb; 134(1):1-6 Bone density was measured in 40 internationally top ranked high performance atheletes and compared to 21 age-match controls: weight lifters (28): bone density was 23% higher in Ward's triangle sport-boxers (6): up to 17% higher in spine, 9% in hip, and 7% in ward's triangle bicycle racers (6): 10% LOWER in the spine; 14% LOWER in the hip, and 17% LOWER in Ward's triangle. 2. Low bone mineral density in highly trained male master cyclists Nicols JF, Palmer JE, Levy SS Osteoporosis Int. 2003 Aug;14(8):644-9 Basically, controls, master cyclists (51.2 +/- 5.3 years of age with 10+ years training and racing [with the mean being 20 years]) and junior cyclists (31.7 +/- 3/5 years of age 10+ years training and racing). The group of master cyclists had significantly lower BMD, with 4 having clinical Osteoporosis. Nobody else in the study had clinical Osteoporosis. 3. Bone mineral density after bicycle ergometry training Leeds EM, Klose KJ, Ganz W, Serafini A, Green BA Arch Phys Med Rehabil 1990 Mar; 71(3):207-9 A group of quadriplegics measured before and after six months of bicycling. Post exercise measurements were lower, but no statistically significant difference was found. Three additional men with spinal chord injuries who had been bicycling for three years were measured. Their mean BMDs were not significantly different from the group that had only bicycled six months. 4. Non-weightbearing exercise may increase lumbar spine bone mineral density in healthy postmenopausal women Bloomfield SA, Williams NI, Lamb DR, Jackson RD. Am J Phys Med Rehabil 1993 Aug; 72(4):204-9 Seven postmenopausal women exercised on bicycle ergometers for eight months at a moderate intensity (60-80% of maximum heart rate, however that was determined. Bone density in the spine went up 3.55 +/- 1.43% in the spine, as opposed to a non-exercising group whose bone density went down 2.44 +/- 0.81%. No change in the femoral neck was noticed. 5. (article in chinese; all info from a translation) Preventive effects of exercise training on bone loss during 21 day -6 degrees head down bed-rest Liu YS, Huang WF, Li LP, Zhong CF, Dong RD, Sun HY Space Med Med Eng (Beijing). 2003 Apr; 16(2):96-9 Ten healthy men were seperated into two groups of five. Both had 21 days of -6 degrees head down bed rest, with one group doing bicycling while in a supine position. The non-exercise group's BMD went down by 5.8% in the femur, while the exercise group's BMD went down by 0.9%. Not a ringing endorsement. Note that the ability to increase resistance in and of itself is not meaningful unless the minimum amount of stress required to increase BMD can be reached. To phrase it another way, if you can do a bicep curl for 15lbs, then buying a weight set that lets you do from 0.5 to 5 lbs in .5 increments won't do you any good - the maximum weight is below the threshhold required for growth. > The research studies about weight lifting - [most of which show postive > results on bone density,] NO one was ever asked to raise her 'full > weight' - in fact, depending on the level of conditioning of the > participants, many showed improvement with very low poundage. So too > with gym cycles--- the resistance can be changed to fit the fitness > level of the rider. > My point is that when you walk, your leg (and hip) is supporting your full body weight. When most people bicycle, it isn't. That suggests that bicycling will put less strain on the bones than walking, further suggesting that bicycling will do less to maintain BMD than walking. When lifting weights while standing, by the way, the proper things to compare are total weight (body weight + additional weight) and speed (so, if done safely, a fast movement - such as is done in olympic lifting - is better than a slow movement - such as is done in almost all other weight lifting). In addition, the expected benefit is based on how much the bone is accustomed to supporting vs how much it is being asked to support. Most people are able to support their weight on one leg easily but don't do the same with one arm. As such, I would expect exercises to increase BMD in the leg (and hip) to require more weight than exercises to increase BMD in the arm. Finally, the studies that I have seen regarding weight lifting don't say how much weight is being lifted (which, as an aside, I find extremely irritating. I saw one study indicating that women doing one kind of weight lifting lost BMD while other women doing a different kind of weight lifting increased their BMD. The weight lifted was recorded, but isn't provided, reducing the value of the study. As a further complication, the group of women who lost BMD all "coincidentally" started with higher BMDs than the other group and ended with higher BMDs than the other group, making me suspect that the two groups were not comparable.). > Stairs - I agree with your comment that 'real stairs' are best. But I > would never recommend that to anyone whose balance and co-ordination I > do not know well. One of the real problems with 'real' stairs, as well > as 'step programs' is that participants can fall - and this is > dangerous for those with ostoporosis. While true, you might want to consider the possibility that you are being over protective and hiding information. Wouldn't it be more valuable to the person you are talking to to note both the positives and negatives and let them make their own decision (such as "I think it would be better to go up and down stairs, but I'm not ready for it yet so I should see a PT and work on my balance first" instead of "walking on a stair master will increase my bone density so there isn't any need to worry about anything else"?) > Stairmasters do provide 'weight > bearing' - much as lower free weights do AND those using Stairmasters > have double handles to ensure that they do not fall. Again, Root, the > doctor-author mentioned above suggests Stairmasters. 1. Ignoring the cardiovascular element ('cause this is an Osteoporosis news group), there is less impact from walking on a stair master than there is from walking on the side walk. This is because 1) when you are walking, you place all the weight on the foot relatively quickly, increasing the stress on the bone; on the stair master, weight is placed gradually, minimizing the stress and 2) since the platform that the foot is being placed on is going down, it reduces the impact from pushing the foot against it when "climbing" the stair. 2. This suggests that the impact from using a stair master will be lower than what most mobile people are already adapted to. 3) This suggests that using a stair master for increasing bone density will, for most people, be a waste of time and effort. If you can find a peer-reviewed study, I would be delighted to read it. > > As for changing from one type of exercise to another - so that there > are 'new stresses', that is mentioned in so many books about > Osteoporosis I am not sure what to reference. As I read the literature > it says that although all weight bearing exercise puts stress on bones, > different exercises put more and less stress on different parts of the > skeleton. Then (please) point out the specific benefit of each of the exercises you recommend, rather than saying they are good simply because they are "different" and "new". And while there is a diffence between doing a standing military press and a seated military press (basically lifting a weight overhead while standing or sitting), the difference is from the hips down, so if you are looking for a change in the spine, shoulders, or arms, the differences will be minimal. And I suspect that the writers are talking more about the differences between something like a biceps curl and a squat than they are between two variations of the same exercise. Keep in mind that, as I said in another post, your bones don't have eyes. They don't know what exercise is being done. All they "know" is that there is a certain level of stress (dynamic or static) in a certain vector. If someone changes from one exercise to another and both appear the same as far as stress on the bone goes then, as far as bone growth is concerned, they are the same exercise. > > Osteoblasts only respond to 'increased stress' - which is the reason > that any exercise loses its ability to stimulate new bone growth unless > there is increase weight added. Provided you are talking about increasing the weight to stay reasonably close to what the bone can support and not talking about someone who can do an unweighted squat (almost everyone) and having them do the squat with 1 lb (less than a 1% change for the average woman), I completely agree. > > But if you stop the exercised generated increased stress on a bone for > a period of time, the osteoblasts in those bones get used to the less > stress. {There is not a loss of the bone that was created during the > first exercise period since the osteoclasts are not being stimulated] Bone is constantly being remodelled. If you stop the stress on the bone, the osteoclasts WILL tear down the bone and, since it isn't being stressed, the osteoblasts will NOT build it back down. That is why people who are bedridden for a long enough period of time lose BMD (see reference 5 above, or look up weightlessness and osteoporosis). > > But when you increase the stress again by taking up the activity again, > the osteoblasts are again stimulated since this is now a 'new level of > stress compared to what they are used to' and they pick up activitiy. > The key is to wait long enough between switching off and switching > back. If it is the same level of stress as before AND the bones are already adapted to it, I would only expect the BMD to remain the same. If you have a peer-reviewed study on this, I would love to read it. > > If we do not change exercises, then it becomes necessary to keep > adding weight/stress since the osteoblasts are no longer stimulated > once they have gotten used to a given amount of bone stress. [In > lifting weights, this is why we need to keep adding heavier weight for > the weight lifting to increase bone mass]. When doing things like > walking, racewalking, dancing, jogging people can not keep 'adding > weight'...so the advice has been to change off to a different exercise > and then come back to what you were doing. As I've said, I wouldn't expect change in and of itself to be of benefit. A change from walking to jogging? yes. From jogging to running? yes. From up hill to down hill? yes. The reverse of any of those? No. I suspect that some of your sources have either been misinformed or misread something. Again, if you have a peer-reviewed study supporting your claims, I would like to read it. > > Most orthopedists can tell you exactly what bones are stressed by what > exercise. Relatively simple logic can do that: trace the skeleton from where the weight is being held to the first place the body is supported. > Cyclists develop different problems from joggers and the > latter do not get hurt in the same place as race walkers and those > doing weighted walking develop other problems etc. Of course, > gymnastics is the 'best' exercise for buidling bone I have vague recollections of having seen a study showing that serious (competitive) weightlifters had a higher BMD than gymnists. Gymnastics will provide more impact than walking, jogging, running, or jumping, though. > - even with the > commonality of annorexia [a risk factor for osteoporosis] among women > gymnasts, for example, they were found to have greater BMD than most > others. This is, of course, because of the 'weight bearing' and the > bounding etc. No, it is because of the impact when they do things like land on the floor from being over 6' above the ground or "hit" the pomel horse with their hands while running at full speed. Note that they only do body-weight exercises and that weight changes gradually as they age. > These gymnast studies are one of the reason why they > began to test 'jumping jacks' and jump rope - which proved great for > buidling BMD BUT THESE EXERCISES could be dangerous for anyone with > osteoporosis since they could cause fractures if bones are porous. I have seen studies showing JUMPING can increase BMD. I haven't seen any showing that JUMPING ROPE can increase BMD. Keep in mind that an adult jumping rope to increase BMD is going to be jumping rope by themselves, and (probably) not playing the games that girls do when jumping rope. Because of this, unless they've been told that they need to keep their jumps high, there will be a tendency to increase their effiency by keeping their feet as close to the ground as possible so, as they get more proficient, the value - as far as increasing BMD goes - will be reduced. > > Kate > Art
From: Kate on 16 Apr 2005 09:03
Art, Thank you for a long, informational post. 1.On the cycling, I was not addressing general biking but recumbent bikes in a gym which allow you to add resistance. Most road cyclers use gears to reduce resistance so I would not expect them to show increase BMD. 2. Perhaps I am misreading your posts, but I sense they seeem to hold that a person's full weight must be involed to improve bone density. We disagree on this. Studies of women using weights - even light weights of 2 - 7 pounds in a sitting or recumbent postion, for example, have shown increase bone mass. Much depends on 'what was the level of habitual bone stress before starting exercise.' 3. I am glad you are getting Leon Roots books... he offers a chapter exercises in Beautiful Bones without Hormones [2004]...and some of his recommendations were a bit surprising to me. It seems that more and more books are being published. The studies. One of the things that is interesting to me is that the scientific studies in relation to osteopenia and osteoporosis treatments do show 'mixed results'. It is one reason why I am publishing both 'pro' and 'con' studies on the web site for each osteopenia treatment I discuss. Example...most of the studies on walking [which is weight bearing] show it is not very useful for building BMD. Other show it is useful. 4.I agree with you that bones do not see/perceive what exercise we are doing. What I was trying to communicate was: 1. repeated stress at the same level loses its ability to increase BMD. so doing the same exercise, eg. jogging, race walking eventually loses its bone builidng effect. There are 2 ways to overcome that..increase the weight involved eg. race walk with weighted vest [something that most do NOT recommend since it can lead to injury], OR stop the exercise for a long enough period and when you take it up again, the osteoblasts will again respond since they now exerience it as 'new stress again'. 2. different exercises stress different bones. eg. race walking offers signficantly different stesses from hiking....even though both do have some stresses in common. If a person is going to use the info in #1, and she switches from one form of exercise to another that offers significantly different stresses, this can be an advantage. 5. Most research into Osteoporosis and Osteopenia treatments has only been well funded for about 20 years, studies are still in 'their infancy' . The areas in which there are repeated studies of the same treatment[s] are fewer than in many other health areas ....and where such repetitions occur, they are finding varied results [eg. the variety of results about walking as a bone density exerices]. I suppose that is why some health care providers emphasize, the 'art of healing' as well as the 'science'. Though like yourself, I do like to read the studies and search out a whole history of studies which repeat variables. Thank you for listing the studies on cycling. You included one that I have not yet read and so I shall get it via college interlibrary loan. Do you know of any studies using hypnotism or guided imagery? That's been so successful in other fields like cancer. If so, I would be glad for references so I can order copies. Finally, I think that our conversation has moved past Lee's original request. Kate http://www.osteopeni3.com |