Meet Laura. Shes a 68-year-old client of ours in California, who is successfully reversing her osteoporosis, and building up her bone mass. But it wasnt all hunky dory forever. She had a long family history of osteoporosis, fear of fractures and falling, as well a fear of losing her independence, and being a burden on someone should she break a bone. Not so anymore.
In this case study, well cover:
- How the osteoporosis was affecting Laura.
- What shes tried in the past to manage her osteoporosis.
- Highlights from the exercise and nutrition strategies that we used with her to increase her bone density.
- The results that she achieved.
- Challenges that she experienced along the way.
- How her life is different now that her bones and muscles are stronger.
If youd like to hear Laura tell her own story, you can check it out in this video:
Or, if youd like to get help with your own bone density, just fill out the application form on our home page.
How the Osteoporosis Was Affecting Laura
The osteoporosis was affecting Laura in a very big way. Unlike typical metabolic or heart conditions, like diabetes or high blood pressure, with osteoporosis, you literally need to watch your every move. Because even a little bit of impact can cause a fracture in someone with osteoporosis.
And sure enough, Laura has sustained 3 fractures to her ribs. Because of that, things that someone with osteoporosis would never even worry about, made Laura worried. She was afraid to do any abdominal exercises, since the abdominal muscles attach to the ribs. She was afraid to lift certain objects, and the big fear that people with osteoporosis have: falling.
Falling is a big one, because when you dont have osteoporosis, and you fall, you just get a bruise, it hurts for a few minutes, and it goes away in a few days. No biggie. With osteoporosis, falling has serious consequences. You might fracture or break a bone. If its a bone like your hip or thigh, there goes your independence, because you cant walk. With the loss of independence and mobility, any strength they had is lost, and they become even weaker than before, making them prone to even more fractures and falls. The vicious cycle continues, and the decline is extremely rapid. One study showed that 27% of people who fracture their hip die within 1 year, 49% die within 3 years, and 74% die in 7 years. And those 1-7 years arent usually happy years. With the loss of independence, they either need a family member (spouse or child usually) to take care of them constantly, or they may need to be under medical supervision. Laura did not want to go down that route.
In addition to those concerns, she wasnt happy with her posture. Her mother was hunched over, and she didnt want that to be her as well.
Lastly, there was the threat of needing to go on medications. Laura wanted to avoid medications, unless there was no other option. Fortunately, the option she chose was exercise and nutrition, which, as youll see later paid off.
What Shes Tried in the Past to Manage Her Osteoporosis
Usually, before someone hires a personal trainer, they take multiple cracks with the do-it-yourself approach. Once do-it-yourself attempts have failed, they turn to professional help.
Sure enough, Laura has tried a number of things in the past to help her improve her bone density:
- Special diets for osteoporosis
- Exercise, but not in a focused way (not specific to osteoporosis)
- Exercise, in a focused way which still didnt work.
The last option was a program called Biodensity, which was specifically aimed at improving bone density but after 8 months, the pandemic started, so Laura had to stop the program. Unfortunately, that means we wont really know whether or not it worked.
Lauras Initial Assessment
After lots of frustration with everything that didnt work, Laura started Googling around for professional help. She came across my articles about exercise for osteoporosis, and how Darlene improved her bone density after breast cancer treatment, and decided to apply for our program as well.
So I chatted with her, noticed that shes in Los Angeles, so I suggested we do the virtual program with her. From there, I set her up with one of my top coaches, Shaneh, and he performed her initial assessment.
Heres what he noticed:
- The most glaring thing to Shaneh about Laura was her weight: she was only 87 pounds at 51.
- To go along with her weight, she had upper body weakness, and a serious hesitation to perform any kind of upper body exercises (understandable due to her history of rib fractures).
- She had a mild kyphosis (hunchback), and she didnt want that getting worse, like her mothers was.
Highlights of Lauras Exercise and Nutrition Programs
Lauras program so far was really divided into 3 phases:
Phase 1: strength training only.
During this phase, Shaneh just introduced basic (but effective) strength training exercises into Lauras routine, like deadlifts, squats, rows, and others. These were organized in a full body routine.
But, as you know from my article on the most important factors in an exercise program, the actual exercises are the 4th most important factor. Two variables that are more important than the exercises themselves at the intensity (how much weight shes lifting) and volume (how many sets and reps shes doing).
So Shaneh started Laura off with 2 sets of 10-12 reps, and over time progressed her up to 3-4 sets of 10-12 reps. Of course, ideally, the reps would have lowered to 5-8 over time (therefore, the relative weight would have risen), but with limited weights, they stayed at the same reps (and wait til you see what results she was able to achieve despite that).
I go into additional details on strength training over 60 in this article.
Phase 2: jumping + strength training.
Jumping is the most beneficial exercise you can do for bone strength (yes, more than strength training). But (and its a big but), its also a high-risk exercise. So how do you get the benefits of jumping, while minimizing the risks? A couple of different ways:
- First do a strength training-only phase, to get the muscles and joints used to higher loads.
- Limit the number of jumps.
So thats what Shaneh did with Laura in phase 2. He had her doing 40 jumps per workout (divided across multiple sets). He had her doing a variety of different jumping exercises, from circular jumps, to single leg hops, to explosive Bulgarian split squats and others. The reason for doing a number of different jumps, as opposed to just one type of jump is to load different parts of the skeleton, instead of just one part.
As you can imagine, 40 jumps doesnt take very long, so this wasnt a standalone workout (that would have been a very short workout 2-3 minutes), but it was integrated along with her strength training, which was continuing to progress from the previous phase.
Phase 3: more jumps + strength training.
The strength training from the previous phase was continued, but now, the jumps were ramped up to 36-50 reps per workout, and more advanced jumps were used: broad jumps, lateral hops and depth drops.
Nutrition and Supplements
You can bet that a person who weighs 87 pounds at 51 is not eating enough, so one of her goals was to gain weight. To gain weight, she needed to eat more. But we didnt want exclusively fat gain, so not only did Shaneh have her increase her calories by 10-15% per day, he had asked her to get at least 50% of her bodyweight in grams of protein.
Ultimately, we would have liked to have her get even more protein, but considering that her starting amount was so minimal, this was a good intermediary step.
As for the supplements that we recommended:
- Protein powder: because she wasnt getting enough through her diet, and in addition to calcium, bones are made of protein.
- Collagen: because some mechanistic evidence suggests that collagen may be beneficial to women with osteoporosis.
If youre wondering what about calcium, vitamin D, and vitamin K, she was already on those before she started working with us.
The Results
Laura came to us for a specific result. Not just for our charming company That result was greater bone density, and a lower chance of fractures. So how were the results? Fantastic!
After 1 year with us, she did a follow-up bone density scan, and heres what it showed:
- Her bone density at the lower spine increased by 4.1%.
- Her bone density at the area where the thigh bone meets the pelvis (a different part of the hip) increased by 7%.
- Her bone density at the hip increased by 8.4%.
Of course, if you dont have osteoporosis, and youve never had a bone density scan, these numbers have no context. So to put things into context, lets compare that to the leading medication for osteoporosis: Fosamax (generic name: alendronate).
According to Dr. Michael Holick, in 3 years, Fosamax improves bone density by 6-8% in the spine, and 4-6% at the hip. We got basically the same improvements with exercise and nutrition but only in 1 year.
To see the bigger picture, bone density is really a proxy marker for fracture risk. But fracture risk is disproportionate to bone density. Bone density may only improve by 4-8%, but fracture risk drops a lot more than that (like 20-60%, depending on which study you read, and different factors).
Needless to say, Lauras doctor was completely flabbergasted. His goal for her was to just slow her rate of decline. He was not expecting either stabilization or improvement. Imagine his surprise when she surpassed his best-case scenario.
Essentially Lauras bone density was now the same as it was 8 years ago! Dont get me wrong she still has severe osteoporosis, but less severe than just 1 year ago.
Besides the original reason that she came to us for (improved bone density), she got a lot of other bonuses:
- She gained 5 pounds, up to 92. For someone whose starting weight was 87 pounds, 5 pounds is quite a bit.
- Her deadlift when she started was only 30 pounds. Most recently, it was 58 pounds.
- Floor press (a chest and triceps exercise) improved from 24 pounds, up to 36 pounds.
- Bent over rows (an exercise for the back) improved from 20 pounds, up to 38 pounds.
How Her Life is Different Now
You can imagine just how life-changing it is to turn back the clock 8 years.
- The constant fear of falling and breaking a bone is greatly diminished.
- She has more confidence in her balance.
- Shes not afraid to lift challenging weights anymore, whether thats groceries or furniture, etc. In fact, when her son-in-law was moving furniture, he actually asked her for help, instead of his dad.
- Shes jumping!!! How many 68-year-olds jump? She hasnt done that in over 50 years.
- Her posture is better.
Its life-changing stories that my team and I got into this line of work to begin with. If youd like help either with your own osteoporosis, or a loved ones, feel free to see if you qualify to work with us by filling out the application form on our home page.
