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Dr. Susan E. Brown

Why You Should Strengthen Your Wrists

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If you strengthen your wrists you may be helping yourself more than you think. Wrist fractures are “sentinels” of bone fracture risk; in fact, having a low-trauma wrist fracture may be more important than a diagnosis of osteoporosis in determining risk for subsequent hip fracture.

It makes perfect sense — when we fall, the reflex to throw out our hands and take the impact on the wrists protects our hips from being injured far more seriously. As we get older, that reflex isn’t as quick, and thus we have greater frequency of hip rather than wrist fractures.

So how do you know if your wrists are strong enough to stop your fall? And if they’re not — what do you do about it?

Get a grip on your grip strength

To start, figure out how strong your grip is. Grip strength is a marker of overall muscle strength. As studies have shown, muscle weakness as measured by grip strength is a predictor of unhealthy outcomes including cardiovascular and metabolic diseases, disability and even early mortality (Correia Martins et al., 2018).

One sign that your grip may be getting weaker is if you notice that opening jars is getting a bit harder. My favorite tool for measuring grip strength is a simple hand held-dynamometer. Simply squeeze the handle of this device as strongly as you can to measure your grip strength. Grip strength norms by age have been well established, so it is easy to see how yours compare (Massey-Westropp et al., 2011).

Exercise to strengthen your wrists

If your wrists aren’t as strong as you’d like, there’s certainly much you can do to change that. But first, understand that dominance has a profound effect on strength of the wrist and the bone mineral density of the wrist and forearm.

You might want to jot down the grip strength difference between your dominant and non-dominant arm and then exercise and non-dominant arm specifically to bring it up to the same strength level as a dominant arm. After all, we might have to stop a fall with either wrist, so we want to have both wrists as strong as possible.

Here are some basic exercise principles to strengthen your wrists:

  • The impact of exercise is “site-specific” — that is, if you strengthen the muscles around the wrist, you will strengthen the wrist. That means that you need to load, and thus strengthen, all the muscles around the wrist and arm.
  • Simply doing one type of exercise, such as a wrist curl, isn’t going to cut it. It only exercises one set of muscles, so you need to include wrist exercises that involve a full range of motion of the hand and wrist. See our exercise graphic below for ideas!
  • As with all exercises, start slow and build up. You do not want to overdo it.

Maintain a healthy skeleton

Of course, your wrists don’t exist by themselves, floating in midair — and anything you do to support your overall bone and body health will certainly help your wrists too. So in addition to wrist-strengthening exercises, you can also do full-body workouts to strengthen your muscles and bones as well as focus on getting the full suite of bone-building nutrients and alkaline diet that support better bones and a better body.

Your wrists are the first line of defense against a fall, so why not give them a helping hand?

References

Correia Martins A, Moreira J, Silva C, et al. Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study. JMIR Res Protoc. 2018 Aug; 7(8): e10304. Published online 2018 Aug 2. doi:  10.2196/10304

Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand Grip Strength: age and gender stratified normative data in a population-based study. BMC Res Notes. 2011; 4: 127. Published online 2011 Apr 14. doi:  10.1186/1756-0500-4-127

 

Dr. Susan E. Brown

Osteogenic loading — a key to reversing osteoporosis

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Bone responds to certain levels of physical strain in a really interesting way — it gets stronger.

Any type of strain on bone that applies enough impact or compressive pressure to stimulate new bone growth is called “osteogenic loading.” Our wise body constantly monitors strain, and in the brief moment of impact, when strain is enough to slightly stretch, bend or compress the bone matrix, this impact sends a warning message: high loads are coming, and the bones should grow stronger to carry them.  This signal tells the bone-building osteoblast cells to increase their minerals uptake and build bone —which is why we emphasize the importance of having those minerals in your diet or using a well-constructed multivitamin like our Better Bones Builder.

The basics

Even when just standing upright, the simple act of resisting gravity puts a load on bone, but this is a one that our body is well adapted to. To build stronger bones, a much higher load — that is, greater compression and bending — is needed to encourage our bodies to spend the necessary energy and resources.

The load put on bone can be measured in terms of multiples of body weight. The higher the load, the better able the activity is to stimulate bone growth. Calculations of multiples of body weight look like this for common physical activities:

Osteogenic loading

Learn which activities load your bones the most.

Swimming: 0 (Your load is actually lessened in water.)
Standing: 1
Brisk walking : 1–2
Running/jogging:  3–4
Power jumping: 4+
Resistance, strength training:  4 to 10 (Depending on impact.)

Safe impact training programs for osteogenic loading

Most physical activity loads bone to a degree, but for strong osteogenic stimulation, the load needs to reach around 4 times body weight.

At these higher multiples of body weight, however, safety becomes an issue.  Any bone will succumb to fracture under loads that exceed its capacity. When training with high multiples of body weight, professional guidance is mandatory.

Nonetheless, many safe impact training programs have been shown to build bone, including those used at the Australian Bone Clinic and in hopping programs.

Simple ways to increase your osteogenic load

  • If you have a desk job, stand frequently and walk, or stomp/skip around every hour.
  • Walk more, walk faster, jog if you can.
  • Practice stepping down stairs with a thud, or walk downhill.
  • Do 100 heel drops.
  • Turn up the music and kick up your heels in dance.
  • Practice jump rope or 1- or 2-legged hopping or jumping, if your knees permit.
  • Begin a strength training program, even in a moderate one. Many studies report a gain of both bone and muscle mass with regular resistance training done just twice a week.

I have seen uncounted clients gain significant bone density doing our full Better Bones, Better Program while amplifying our exercise component with serious strength training.  We are now documenting a variety of successful exercise programs and will be detailing them to you in this weekly blog and on our new Exercise Evolution Channel. Not everyone is suited to lifting heavy weights, but everyone can and should work to increase muscle mass and bone strength.

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References

Bone Health and Osteoporosis: A Report of the Surgeon General.  Rockville, MD: U.S. Department of Health and Human Services, 2004.

Jaquish J, Singh R, Hynote E, Conviser J. Osteogenic Loading: A New Modality to Facilitate Bone density Development. A: Jaquish Industrial Research, LLC, 2017.

Westcott W. Resistance training is medicine: effects of strength training on health. Current Sports Medicine Reports July/August 2012;11:4P209216.

woman weight training
Dr. Susan E. Brown

Getting more by doing less with high-intensity, slow-motion weight training

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A few months ago, I spoke with Rick Berman, a certified personal trainer and owner of Studio 2020 Fitness. Rick uses a weight training technique that was originally researched for building bone — a slow-motion, high-intensity training program. While this strength training program might not suit everyone, I like it because you can see benefits working out only once or twice a week for 15 to 20 minutes!

If that sounds too good to be true, for once, it’s not — because this workout is not light duty. The whole point, Rick tells me, is that you have to work the muscles to great intensity in order to stimulate the muscle cells to build more muscle (which, as you know if you’ve read my blog, goes hand-in-hand with building bone. That means working the muscles to the point of complete fatigue — that “just can’t do even one more rep” point. This is accomplished by slowing the workout down considerably so that you aren’t using momentum to provide energy for the next rep; it forces your muscles to provide all the force needed to raise the weight. Getting to complete fatigue doesn’t actually take long, when you’re doing that much more work with slow movements (and that’s why the workouts are fairly short).

This program takes advantage of the body’s ability to adapt to the stresses we place on it — the more work we do, the more the muscles and cardiovascular system adjust to meet those strains. And it doesn’t matter how young or old you are: Rick says that “a number of my clients are 60, 70 years old — I have some in their 80s — and I see people that come in the door that can barely lift, sometimes, 20, or 30, or 40 pounds. I’ve had clients that have started at 20 pounds, and within … maybe 8 weeks, they’re doing 40 or 60 pounds.  We see very rapid increases in muscular strength.”

It should be no surprise that this method is good for developing bone as well as muscle. As Rick pointed out, the original exercise protocol was developed for an osteoporosis study some 33 years ago at the University of Florida Hospital. The slow speed was initially used because of fears that the research subjects — women 60 and older with osteoporosis — might injure themselves, but the serendipitous finding was that this slower training safely created more muscle mass, even with less-frequent workouts!

For more, watch my full discussion with Rick Berman. You will learn a lot!

Important PS: Always check with your doctor before starting any new form of exercise. There is no “one size fits” all strength training program and this intense slow-motion workout is not for everyone. If you’re new to weight training, I encourage you to work with a professional trainer who can teach you correct technique to avoid injuries and help you get the most out of your workouts. Best would be to find a trainer like Rick who specializes on slow-motion, high intensity training if you chose to give this system a try.

 

Dr. Susan E. Brown

How much exercise is “enough” for bone health?

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When I talk to some of my clients about exercise, I know a lot of them aren’t enthusiastic, thinking I’m going to tell them they need to spend hours lifting heavy weights and sweating in a gym. After all, everyone knows it’s weight-bearing exercise — and lots of it — that builds bone and lowers the risk of fractures, right?

Surprise! Not necessarily. Two new studies show that even small amounts of low-impact exercise have a positive effect on fracture risk.

Twenty minutes of walking does the trick

The first study (Stattin et al. 2017) followed more than 65,000 Swedish men and women for 17 years and found that participants who walked or bicycled daily for even short periods of time had a lower fracture rate compared with those who did not. Regardless of sex or age, even relatively sedentary people could lower their fracture risk by exercising just a little bit every day. As long as they got at least an hour of exercise per week, these otherwise inactive people had a 13% lower rate of hip fractures and a 6% lower rate of any fracture compared to people who did none at all.

It’s worth emphasizing that the findings held true whether you looked at any fracture (including common, relatively mild fractures like vertebral or wrist fractures) or the more serious and life-changing hip fractures that everyone fears.

Of course, the more exercise they got, the better the results: those with 20 minutes of walking or cycling every day, which translates to about 2 hours per week — had a 23% lower rate of hip fracture and a 13% lower rate of any fracture. That’s a pretty good return for not a lot of effort — just imagine what you get when you do even more!

Light loads do more than you think

The second study (Hamaguchi et al. 2017) had a small group of 7 postmenopausal women undergo six weeks of training wearing a weighted vest with 380-760 g (roughly from 1.75 pounds) of added weight. With just two workout sessions per week, the participants saw improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%) — which is helpful in maintaining balance and preventing falls. Workouts consisted of squats, front lunges, side lunges, calf raises and toe raises (eight sets of three repetitions with a 15-second rest between each set).

A little bit goes a long way

I know that it can be hard to start exercising if you’re not accustomed to it, and especially if you’re recovering from a muscle strain or a fracture, the get-up-and-go impulse just isn’t there. But you don’t have to do a lot to get benefit from it! Both of these studies show that a little goes a long way. 

 

 

References

Hamaguchi, K.,  et al. 2017. The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: A pilot study. BMC Geriatrics 17:102.

Stattin, K., et al. 2017. Leisure-time physical activity and risk of fracture: A cohort study of 66,940 men and women. Journal of Bone and Mineral Research 32(8):1599-1606.