DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Most people know the key to preventing osteoporosis is getting enough calcium in your diet, but you may not know that certain kinds of exercise are also an essential part of keeping your bones healthy and also of decreasing your risk of fractures.
Here to tell us all about exercise for your bones is Dr. Paula Rackoff. She's Assistant Chief of Rheumatology at Beth Israel Medical Center in New York. Welcome.
PAULA RACKOFF, MD: Thank you.
DAVID R. MARKS, MD: How important is exercise?
PAULA RACKOFF, MD: Increasing bone density is related to exercise, and there are certain kinds of exercises that really can increase your bone density, and we call those exercises "weight-bearing exercises" -- that's walking, power walking, jogging, tennis, field hockey, not that that many women play field hockey anymore.
DAVID R. MARKS, MD: And we're not recommending that 70-year-old women play field hockey.
PAULA RACKOFF, MD: Right.
DAVID R. MARKS, MD: These exercises, can they actually increase the amount of bone mass that a person has?
PAULA RACKOFF, MD: Yes, they can to a small percentage increase bone density. What they do even more than that, actually, is increase an individual's balance and agility, and what we really worry about with osteoporosis is fracture. In terms of hip bone density, it doesn't really matter how bad your bone density is in your hip as long as you don't fall and break your hip.
DAVID R. MARKS, MD: Now, there are a lot of exercises that people do that they think may be helpful, but they may be actually harmful because they may put them at risk for fractures and other problems.
PAULA RACKOFF, MD: Right.
DAVID R. MARKS, MD: Go through some of the typical exercises that you recommend for patients.
PAULA RACKOFF, MD: I recommend power walking.
DAVID R. MARKS, MD: What does that mean?
PAULA RACKOFF, MD: That means walking where you're increasing your heart rate enough so that you're perspiring. When someone's able to do that relatively easily, I'll actually ask them to put light weights on their wrists, around their lower spine, on their ankles. If someone's young and active, I would recommend that they start jogging -- not on a daily basis, but what we call "cross training" -- doing different exercises. And I would recommend light weightlifting with free weights. Then for my older patients I recommend balance training.
DAVID R. MARKS, MD: What does that mean?
PAULA RACKOFF, MD: There are certain exercises that a physical therapist can show an individual to increase your balance.
DAVID R. MARKS, MD: Can you give some examples?
PAULA RACKOFF, MD: There are deep knee bends. There's walking heel to toe, which some people have a difficult time doing.
DAVID R. MARKS, MD: Are these what we call resistance exercises?
PAULA RACKOFF, MD: The balance training ones are not, but the free weightlifting would be resistance training exercises.
DAVID R. MARKS, MD: How is this exercise actually preventing the bone loss? What is it actually doing?
PAULA RACKOFF, MD: The more you use an individual bone and joint, the greater the bone density. The perfect examples are tennis players. If you measure a tennis player's bone density in his or her right arm and they use their right arm to play tennis, that arm will have a greater bone density than the left arm, which is really just used for the toss.
DAVID R. MARKS, MD: Now, does this only work for people who are a little bit older and maybe they're losing their bone mass at a higher rate, or does this actually help when people are younger?
PAULA RACKOFF, MD: Actually, it's a really important question, because the greater your bone density when you're younger, the greater the bone density you'll have when you're getting older, so it's really important that children and teenagers exercise regularly, and they're really the ones who should be playing field hockey, soccer and jogging and really maximizing their bone density.
DAVID R. MARKS, MD: Does it make a difference in people who have a genetic predisposition to this disease?
PAULA RACKOFF, MD: It's just that much more important. If you had a mother or a grandmother who had a hip fracture and you're aware of that as a kid, you should be out there jogging and being as active as you can.
DAVID R. MARKS, MD: Are there any exercises a person shouldn't do?
PAULA RACKOFF, MD: For patients or people who already know that they have osteoporosis, the exercise you really don't want to do is flexion and extension of the back, because that can actually put so much stress on the spine that you could cause a vertebral fracture.
DAVID R. MARKS, MD: What does that mean, "flexion and extension?"
PAULA RACKOFF, MD: Bending backwards and forwards.
DAVID R. MARKS, MD: So people should not do that?
PAULA RACKOFF, MD: Not excessively.
DAVID R. MARKS, MD: Any final comments about exercise and osteoporosis?
PAULA RACKOFF, MD: The only other thing to be aware of is that there are different parts of the country where kids exercise too much, and certainly for a young, growing girl there's a risk of becoming so addicted to exercise that a girl can lose her menstrual cycle, and then it becomes a serious problem.
DAVID R. MARKS, MD: Does that set her up for osteoporosis?
PAULA RACKOFF, MD: Yes, actually. That increases her chance for not being able to attain her best peak bone density.
DAVID R. MARKS, MD: So moderation?
PAULA RACKOFF, MD: Moderation, but active.
DAVID R. MARKS, MD: Thanks for being here.
PAULA RACKOFF, MD: Thank you.
DAVID R. MARKS, MD: Thank you for joining our webcast. I'm Dr. David Marks. Goodbye.
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