Jumping Improves Hip Bone Mineral Density

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Here’s a great reason to jump for joy — new research shows that with only 20 jumps a day, premenopausal women can significantly build hip bone mineral density.  I always encourage women to remember that a small change to your daily routine lead to a big impact in your bone health, and this is a perfect example!

The study followed 60 women ages 25 to 50 who took part in the jumping program. One group of women jumped twice a day, six days a week, and as high as possible for 10 times.  Another group jumped 20 times, with the two groups each resting 30 seconds between jumps.  After 16 weeks, both groups had positive hip bone mineral density changes, while a group of women that did no jumping had a negative change in their hip bone mineral density.

What’s more, this study is important because it highlights that changes can be made in the hip, one of the most common and dangerous fracture areas. It’s estimated that the number of hip fractures could triple in the United States by the year 2040, according to the study authors.

I do want to note that the jumping in the study was jumping with a lot of force.  I call this power jumping, which is jumping as high as you can, swinging your arms up above your head.  You can land with your feet apart or together.

While jumping is simple, you may want to avoid it if you have severe osteoporosis, a history of fracture, balance problems or other health issues.  Also, keep in mind that this study looked at pre-menopausal women.  Other studies with postmenopausal women have not been so successful, even though they included more jumping.  I suspect that one hundred hops a day or jumps would benefit postmenopausal women, along with better nutrient intake and the alkaline diet, such as found in my Better Bones program.

 

Reference:

Tucker, L.A., Strong, J.E., Lechemianant, J.D., Bailey, B.W. (2014) Effect of Two Jumping Programs on Hip Bone Mineral Density in Premenopausal Women: A Randomized Controlled Trial. Am J Health Promot.

The best exercise for 2014? You decide…

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As 2014 gets closer, are you thinking about any fitness resolutions? One colleague told me recently “I’m hating my gym membership already” – and this is before she’s taken her first class!

Dr_BrownIn fact, many of us start off the New Year with grueling plans about what kind of exercise we’re going to do — for strength, for flexibility, or for weight loss. But if you do so, you may forget the most important consideration of all – what’s right for you?

Doing what’s best for you as an individual has always been an important part of my Better Bones approach, so I was extremely pleased that the concepts of personalized medicine and fitness were “hot” topics at a conference I recently attended.

If you would like to make an exercise resolution for 2014, here are a few ideas for helping you choose:

The best exercise for you is something that makes you feel good. Pay attention to what invigorates you and feels good for your body without causing any distress. For some of us, that may be a walk around the neighborhood, while for others it may be swimming, lifting weights or vigorous stretching. By doing what you love, you’ll do it more often and stick with it – and enjoy doing it!

Exercising outside can be lifting to the spirit. For me, there is something truly inspiring about getting out in nature as much as possible. One of my favorite activities in the winter is to snowshoe along with my dog. Short walks outside, cross-country skiing (with poles for balance) and even shoveling and building snow forts build fitness while helping us connect with nature.

With just about any exercise, you can increase bone-building action. As far as I’m concerned, any exercise is good exercise! For extra bone-building, the key is to “take your bones off guard” by varying your favorite routine. It seems that bone acclimates itself to the stresses we put on it, so unusual impact appears to stimulate bone-building factors. If you’re walking, add a few hops. If you swim, add some resistance paddles.

I’m hopeful that we’re all getting to the point where we no longer need to think that everything works for everybody!

 

120 minutes a week to healthy bones

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How often have you used the excuse “I don’t have time” for not exercising? Even if you start off with the best of intentions, exercise plans often seem to fall by the wayside when time gets crunched. Even for people like me who make exercise a priority, lack of time can get in the way of the best laid plans, as I found out recently when I over-scheduled trying to take advantage of a intriguing educational opportunity.

red_boots_iStock_000012038483XSmallBut there’s encouraging news even for those with limited time, according to a recent study focusing on the impact of exercise on bone health. As little as 120 minutes a week — or only a bit more than 17 minutes a day — of walking or other physical activity helps reduce the hormone sclerostin, an inhibitor of bone formation. What’s more, the bone-strengthening benefits were seen in women in the years leading up to their menopause transitions — a critical window of opportunity for bone health!

My favorite ideas for sneaking in two hours of physical activity in a week

• Take a long hike with your family and friends.

• Rake leaves, prepare the yard for winter, pick fall produce.

• Run (or walk) to do your errands – literally!

• Use the stairs whenever possible. Even going down the stairs helps build bone.

• Set an alarm on your computer or phone for “movement time.” When it goes off, take a walk around the block or do some stretching exercises.

• Decide it is okay to be “inefficient” with some household chores. I know one woman who walks her laundry out to the clothesline in small batches to add some extra movement to her day.

• Try doing an activity for five minutes – even when you don’t want to. Many of my patients tell me that once they commit to just five minutes, they end up continuing for much longer, as well as enjoying it!

What are some of your favorite options for adding more movement into your daily routine?

 

Reference:

Ardawi MSM, et al. 2012. “Physical activity in relation to serum sclerostin, insulin-like growth factor-1, and bone turnover markers in health premenopausal women: a cross-sectional and longitudinal study” J Clin Endocrinol Metab 2012; 97(10): DOI: 10.1210/jc.2011-3361. URL: http://www.ncbi.nlm.nih.gov/pubmed/22865898 (accessed 08.06.13)

 

Why your bones and heart will love t’ai chi

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iStock_000015999421XSmall_tai_chiAs spring rolls in and I’m seeing more and more people go by my window for a long run or walk, I can’t help but think about the connection between bone health and cardiovascular health.

After all, we know there’s a clear link between the two — so much so that people with osteoporosis may benefit from cardiovascular disease screening. An earlier study shows that people with osteoporosis are nearly six times more likely to have coronary heart disease than those without.

But if hitting the pavement doesn’t appeal to you, you’ll be interested in two new studies that emphasize how many options you have to keep your heart and bones safe and healthy. One of the best is by practicing t’ai chi, which gives you the following benefits:

T’ai chi reduces fall risk

While spring brings warm weather in other parts of the country, where I live there can still be snowy and icy, so I’m still taking special care. That said we need to be thinking about preventing dangerous falls year-round. A recent study focused on the use of t’ai chi-based exercising to keep dementia patients and their caregivers safe from falls. After 16 weeks of practicing t’ai chi, participants scored better on functional tests designed to test fall risk. While this study focused on a specific population, I have no doubt that my practice of t’ai chi has helped me keep my balance and reduced my chance of fracturing in some tricky situations.

T’ai chi training improves cardiovascular health and muscle strength

In another study, older women built muscle strength and heart health by performing t’ai chi as little as three times a week for 16 weeks. This news is very important as many people still think cardiovascular health can only be achieved by pounding away on a treadmill or practicing high-intensity yoga — which many of us prefer not to do! This study emphasizes that t’ai chi provides a great exercise alternative, especially since we know it also calms our minds, another important benefits for bone health.

Personally I practice Qi Gong exercises, a close cousin to t’ai chi, on a daily basis. I use the Qi Gong system known as the “Dragon’s Way” developed by Dr. Nan Lu and consistently find improvement in balance, muscle conditioning, digestion and ideal weight maintenance. For information on Dr. Lu’s program see his book, “Traditional Chinese Medicine: Lose 12 Pounds in Six Weeks with Dragon’s Way®” and his Qi Gong exercise DVD.

Incorporating t’ai chi or its cousin Qi Gong into an exercise routine is one of my favorite examples of the Better Bones Revolution principle that everything you do for your bone health will also be good for the rest of your body.

 

References:

Yao, L., Giordani, B, Algase, D.L., You, M., Alexander, N.B (2012). Fall Risk-relevant Functional Mobility Outcomes in Dementia Following Dyadic Tai Chi Exercise. Western Journal of Nursing Research. Published online 2012 April 19. doi: 10.1177/0193945912443319. PMCID: PMC3468653

Lu X, Hui-Chan CW, Tsang WW. (2013) Effects of Tai Chi training on arterial compliance and muscle strength in female seniors: a randomized clinical trial. Eur J Prev Cardiol. April;20(2):238-45. doi: 10.1177/2047487311434233. Epub 2012 Jan 4.

 

Everyday activities can make a positive impact on your bones

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From weeding to dusting to extra minutes waiting for the next task at work, you can make bone-building part of many of your daily routines.

The key here is mindfulness. That is, put your attention on what you are doing, even if it’s just an everyday chore, and choose to do it consciously in a way that stimulates bone. For example, adding both more impact to your step and more stretch to your upper body movements stimulate new bone growth. A third focus might be put on balance to reduce your risk of falls and fractures.

I think you’ll be surprised at how many opportunities to build bone you can find in a day. Here are a few of my favorite ideas:

Gardening_iStock_000006037150XSmallIn the yard

• I love to work in my yard and garden, and if you drive by my house, you can see me taking breaks to hop 20 times or stomping down with vigor on mole hills and uneven patches.

• Squatting is a great exercise, so once in a while I do a full squat when picking up sticks and debris.

• Taking a moment to notice your balance is very revealing. How does it feel to slowly shift all of your weight to one leg and then to the other? Bearing the full body’s weight in one leg is a strength training exercise in itself.

At home

• As you dust each room, focus on stretching as far as it feels comfortable — and then try extending a bit more. Again, you’ll be moving the connective tissues in your body, making tendons tug on bone and sending the message to build bone.

• If you stand on one leg as you vacuum, you’ll be doubling the weight on your leg — creating twice the impact on your bone and twice the workout on the muscles.

• Wear a weighted vest to take best bone-building advantage of the time you spend housekeeping…do less and accomplish more!

At work

• I know women who schedule “walking meetings” with their coworkers. This works especially well for brainstorming meetings, when getting away from a desk sparks extra creativity. A good brisk walk or short stomping march at lunchtime thrills bone.

• One chair exercise is to tuck your tummy in and push your spine against the back of the chair, stretching your arms out to your side at the same time.

• While waiting for a phone call to go through or a meeting to start, I often stand and do “power” heel drops. Lift up on your toes and then drop your heels down as hard as you can.

What are your ideas for adding bone-supporting physical activities to your day? Even three 35-minute sessions a week can substantially reduce your risk of osteoporosis and needless fracture.

 

You can’t exercise if you don’t do this!

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As I mentioned in an earlier blog post, I spent a weekend in Maine recently. I was there to shoot an exercise video that I hope will encourage the people who follow my program to get more of what’s best for bone. And by that, I don’t just mean movement — I also mean gaining an awareness of how to move in a way that’s both relaxing and healthful.

I was working with Meredith Sabella, a wonderful instructor from Springboard Pilates, which is a local studio in Portland. The studio is an adorable Victorian-style brownstone in a somewhat quiet neighborhood (I say “somewhat” because it’s close to a hospital and we had to do several retakes because of ambulance sirens!). A group of volunteers who performed the exercises with her as Meredith explained what to do. Meredith has a great way of explaining how to do the movements of Pilates, tai chi, yoga, and isometric exercises that I wish I could capture in words — but you’ll have to wait to see her in the video instead.

Breathe Deeply

But one of the most important instructions Meredith gave as she took our volunteers through the exercises was such a simple thing, you’d think no one could overlook it — even though many people do. The instruction was simply to breathe deeply. It’s amazing that we need to be told this, but when we’re focused on performing exercises (and especially if they’re not very familiar moves) sometimes we forget to breathe deeply — or even at all. Holding your breath while exercising is a common mistake that people make, and they usually don’t realize they’re doing it.

It’s important to know that how you breathe while exercising affects your ability to exercise effectively.

Holding your breath (or breathing with shallow or short breaths) means too little oxygen gets to the muscles, and that means you tire sooner, so you don’t get the benefit of sustained activity.

In contrast, deep breathing not only provides your muscles with more oxygen, it also signals to your muscles to relax. And relaxing your muscles helps in a number of ways: it makes the muscle’s performance more efficient, it makes their motion smoother and less erratic (try swinging a golf club with tense arms and legs and see where it gets you!), and most importantly, it reduces both the stress factor involved with exercise and the potential for injury.

So the next time you go to exercise, try to keep in mind your breathing. Focus on keeping it slow, deep, and rhythmic. If you find yourself holding your breath or hyperventilating, make a conscious effort to draw in breath all the way to your belly, and then slowly release it (through your nose if you can). You may find your exercise regimen is both more relaxing and more energizing as a result. And that’s good for bones, too!

Choose your groove: finding your right way to exercise

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I have so many clients who wrinkle their noses at the idea of weight training, even though they know it’s good for them. Ditto yoga, ditto t’ai chi. It only makes sense — what one person finds invigorating and fun is a boring chore to someone else.

That’s why figuring out what to put in the Better Bones exercise video I’ve told you about was a bit of a dilemma for me. Plus, there are so many good exercises out there that help with bone strength and flexibility that I didn’t want to just pick one and say “This is IT for bones.”

In the end, I decided to demonstrate a variety of exercises and explain how to do them

That way, people watching the video could try out different exercise methods and say, hey, this seems like something I could do (or, Not on your life! as the case may be). This video, when it’s finished, will be a collection of segments that feature moves from Pilates, yoga, t’ai chi, isometric exercises using a Theraband (but you can use an ordinary towel, too), assisted activities for those who cannot stand for long periods of time, and exercises using an Osteo Ball.

And really, there is no “right” or “wrong” way to exercise for bone health. Certainly, there are some exercise methods that provide greater effectiveness in building and strengthening bone than others, but every form of exercise offers benefits to bone health. I’ll just show you some good choices!

I also decided to choose exercise that everyone can do

After working with clients for over 25 years, I understand that even exercising to a video can be a little intimidating at first for someone who hasn’t exercised in a while. So I made a point of including real people, not models, in the video segments. The instructor who explains the moves in the video is a professional Pilates trainer, but the women who perform with her are ordinary women who volunteered — in other words, none of them is a professional dancer who can twist herself into a pretzel at the drop of a yoga mat. Because starting an exercise program is not about how well you can perform the moves or how perfectly you do a particular set, but rather it’s about getting to a place where you find an exercise method that you really enjoy and feel comfortable doing.

My hope is that if you feel hesitant to join a class or seek out instruction in various styles of exercise, this video will help you to take the plunge. It was designed to be used as both a sampler of methods you can try, or as a full half-hour workout composed of moves that specifically benefit bone without being too difficult or high-level for a beginner. I couldn’t resist adding an educational component about why exercise benefits bone, but the beauty of video is you can skip over the parts you don’t want to watch (though obviously I hope viewers don’t do that on the first time through!).

Although it will be a little while before all the editing is done, I’m excited to see how it comes out — and I hope you will be, too.

 

Keeping exercise in mind

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You may have seen recently in The New York Times a discussion of yoga’s benefits for joint and bone health. At the very end of the article was a mention of a 2009 pilot study by Dr. Loren Fishman that showed the benefits of yoga for osteoporosis. I found that study on-line and the initial results are impressive: among patients who regularly performed 10 minutes of yoga daily, spine and hip density generally increased during the 2-year study period. The study didn’t have a lot of compliant participants, so it’s not a strong finding, but it’s still eye-opening. But what’s interesting to me about this study is that while Dr. Fishman was focused upon the physiological benefits of yoga, there’s another way in which yoga and other exercise methods like it can be helpful to bones: stress reduction.

Worry, anxiety, and stress in general are detrimental to bone health

At the Center for Better Bones, many of the people I talk to have one factor in common: they are worried. Yoga, tai chi, and qi gong are all forms of exercise that have an additional component: in various ways, they not only support physical strength and flexibility, but also mental and emotional relaxation. All of these forms emphasize the importance of deep breathing, of slow, controlled, focused movements, and of working the body and mind together — being present and mindful throughout the practice.

I like to quote the aphorism that there is no greater influence on the body than thoughts held in the mind. When thoughts are racing, anxious, negative in nature, it increases stress hormones — and long term, high levels of stress hormones deplete bone mineral reserves. By taking direct steps to calm an anxious, worried, depressed, or angry mind-set through these types of exercise, we can lessen the impact of stress hormones on the bones.

Now of course, taking up tai chi, qi gong, or yoga isn’t going to solve serious long-term mental health issues by themselves — and I often suggest to clients who suffer from such issues to work with a qualified therapist — but they can be one method of retraining your psyche toward more positive and uplifting emotions, with benefits for both mind and body. So when I offer yoga or tai chi as alternatives for clients who are exploring new methods of exercise, I do it in the hope of helping them not just to start getting more exercise, but also to make use of the power of their minds to help their bones.

 

References

Brody, J.E. 2011. Ancient moves for orthopedic problems. The New York Times, August 1, 2011. URL:http://www.nytimes.com/2011/08/02/health/02brody.html

Fishman, L.M. 2009. Yoga for osteoporosis: A pilot study. Topics in Geriatric Rehabilitation, 25(3), 244–250. URL:http://journals.lww.com/topicsingeriatricrehabilitation/Fulltext/2009/07000/Yoga_for_Osteoporosis__A_Pilot_Study.9.aspx

 

Simple exercises to prevent a new fracture

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I think it’s time we all put a little more muscle into our fracture prevention efforts.  Exercise, specifically strengthening tendons and muscles, can enhance bone and reduce risk of recurrent fractures.

This is most important for those of you who have already experienced a fracture and are therefore much more likely to experience another — especially if you had a fracture with only minimum trauma, like falling from a standing position.

Below, I share some exercises to strengthen the wrist and the spine — as well as a balance enhancement exercise that will help reduce hip fractures.

To strengthen the wrist

WristWrist fractures are the second most common of all osteoporotic fractures with some 400,000 occurring each year in the U.S. Wrist breaks most often happen if you fall forward and land on your hand.

Get started: Use hand weights, or even soup cans. With the weight in hand, flex the wrist up, then down, and then in a circle for full range of motion. Do 20 repetitions of each movement, gradually using heavier weights.

 

To strengthen the spine

SpineVertebral body fractures are the most common of all low trauma fractures in both women and men. Several studies have shown that back strengthening exercises reduce the risk of a first or recurrent spinal fracture. Any movement that strengthens your back extensor muscles (those muscles which go up and down the sides of the spine) will enhance spinal bone density and significantly reduce fracture risk.

Get started: Practice the back extensor chest lift daily, as shown below, to reduce the incidence of new spinal fracture. Start with one rep a day and work up to 20 reps a day for five days a week. For extra strength, you can add a weighted backpack as illustrated below or wear a weighted vest. Learn more.

 

To reduce hip fractures

Hip

Nearly all hip fractures occur as a result of a fall, so balance enhancement ranks right along with leg strengthening for hip fracture prevention. The exercise below strengthens the lower body, improves balance, and is said also to enhance digestion.

Get started:  “A simple kicking the heel forward exercise builds both balance and leg strength. Stand firmly on both feet placing your hands on your hips, then lift up one leg by bending the knee, then push that foot out in front of you with foot flexed, thrusting the heel out. Hold on to a chair or table if you are unsteady. Begin with 10 reps on each leg and work up to 20.

 

If you have already fractured, it is wise to take a serious look at every step of my Better Bones Health Package 

Learning how to play: Exercising for bone health

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It’s not news that exercise is good for bones. But many people hear the word “exercise” as being synonymous with “chore” — well, I’ve got another synonym instead:

Play!

Have you ever seen a little boy jump in a puddle? It’s not a quick hop or a gentle tap with a toe — it’s a hard stomp or a two-legged, I’m-a-rocket-ship splashdown, ending with the child covered in muddy water, grinning ear-to-ear. But what you may not see is that the child has triggered a chain reaction in his bones simply by jumping in the puddle. He has just sent a signal to his bones that it’s time to build.

You see, bone responds to the forces applied to it, and those include both the force generated by muscles and tendons tugging on bone, as well as the impact that reverberates through the bones when we jump or run or hop or any action that causes our skeleton to smack into something. Bone and muscle work as a single unit, so any time you use a muscle, you’re stimulating your bones. Just as with muscles, the most effective bone-building exercise programs are progressive, increasing in intensity over time. Better still, the effects of exercise on bone are site-specific, which means you can work particular muscles to strengthen particular bones — very useful if you’ve had a fracture, or if you’ve been told you have osteopenia in your hip or wrist.

This means that you don’t have to force yourself into a high-intensity workout regimen you don’t really enjoy, just because you want to strengthen your bones. Instead, you can start with something simple, even playful — hopscotch, jumping rope, tap dancing, or even playing tug-of-war with a dog. In short, you have permission to have fun!

And that’s what’s most interesting about our boy and his puddle — because the sheer joy and pleasure of physical play also support bone health. Having fun translates into a multitude of positive responses throughout the body — chemicals in the brain, relaxation in the muscles, lower stress, and yes, better bones. I think many of us forget what it feels like to be a kid as we grow older, and to my mind, that’s one of the biggest barriers we have to doing all the things that make our bones stronger, including (especially!) exercising. I blame the fact that it’s called “working out” — most of us have all the “work” we want already, so who wants more?

So how about this: I’m not going to suggest you go work out if you want better bones. Instead, I have only two words for you:

Go play!