Forum / Let's Discuss! / Osteoperosis

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On: October 27, 2015 11:17 AM
Hello! Hope all is well in Asheville :) I am working with a regular client who is dedicated to the practice, and desires a tough workout. She is in her early 40s and is fit. She swims regularly and does weight traning. Her core recruitment is lacking, but improving, and she has great body awareness. However, she has osteopenia, bordering on osteoperosis. She suffered from an eating disorder early in life and was told this is the result of her nutritional deficiency. She takes private sessions with me twice a week and is doing wonderful. The struggle I am having is layered. My client really likes to work hard. She is used to strength training. I do remind her that this is not weight training and we are doing different work here, but she desires to be challenged and I want to provide that for her. I have found some very challenging and safe options for her, but the problem lies in the lack of variety and the frequency of her sessions. I would love to hear any exercise and modifications you use with your clients. And I am also curious if you have anything to talk about in terms of a scale of what may/may not be safe for a client with osteopenia/osteoperosis. Like I said Shelley is very strong and active and I do feel comfortable challenging her in ways that I would not with a senior client or an extremely weak client with the same condition. And I also feel that providing a challenge is beneficial to her as well. I would love to hear your thoughts. Thanks so much!!!!!!!! Jackie
On: October 28, 2015 05:25 AM
Hi there Jackie! What a great question that we all struggle with.... First and foremost lets address the osteo question. You want to make sure that you shy away from spinal flexion. So neutral pelvis and spine are the name of the game. And as you said above her core awareness is lacking so this is where much of your focus should be placed. There are some interesting clues in your question as to the personality of your client which sounds to me like a larger question mark than dealing with osteo! Clients who are used to gym workouts and who have had eating disorders typically have a more difficult time actually connecting to the FEELINGS in their bodies, and their natural impulses. They over rely on the set of rules inside of their heads, and judge all choices up against that set of perceptions. So if I were you I would throw a monkey wrench or two at her. Use the lightest springs she can manage. This is much harder work as we all know to be the "spring" holding the movement together instead of the "pusher". I would work on a ton of balance challenges also so she needs to innately focus on postural organization. The Bosu can be great for this! I would also do tons of release work with her. There are some pretty mind blowing studies out right now talking about how weight training isn't hitting those nooks and crannies to build bone. I believe that it is because most weight lifting form isn't bio mechanically sound, and most gym goers are actually too tight to be in their core bodies while lifting. This should be a major impulse for her to ACTUALLY change the manner in which she chooses to work with and move in her body. It's time to take that old "no pain, no gain" mentality and push it to the way side (at least when she is in the studio with you!). The release work that Jen and I endlessly talk about (for good reason!) works for the intense work out client... well... because it hurts! And that is the one signal that they unfortunately recognize as "good" in their brain body psyche. Our culture reinforces this backwards mentality at every turn. So let's use it to our advantage and bring some actual good in with it. I would also really really focus on detailed cueing. Let no stone go unturned. Make her juggle lots of body cues at once... talk about a challenging workout! Slow her down, ask her questions about what she is feeling instead of focusing in on the completion of the exercise. Use overballs, balance mats, light springs, and wobble boards to challenge her perceptions inside and out. Also for the osteo side of things, look up what Rebekah Rotstein is doing with her Buff Bones protocol. And check out some upcoming Pilates Show where I will go over some challenging feet in straps for Osteo clients that I learned while working in Tucson with Rebekah! Thanks for writing in... Hope that helped! Love, Casey
On: October 30, 2015 02:42 AM
Hi Casey, As someone who has osteoporosis, I would be interested in reading the studies you refer to in your reply above. Would you be willing to share your resources regarding "weight training not hitting those nooks and crannies to build bone" ? Thank you, Amy
On: October 30, 2015 12:12 PM
Hi there! I bet you will find this article as interesting as I did! There is SO much to osteoporosis that we are still learning about. I believe that weight lifting and weight bearing exercises are vital to our osteo clientele, it is just not the whole picture. It is important that posture comes first and joint range of motion is preserved. That unfortunately doesn't always happen at the gym. Also, what we are learning about now with all of the emerging information on the fascia and how it connects to the bone is fascinating too! Clearly this investigation on how we can preserve our bone health and remain vital and pliable structurally is an ever evolving process. This article sparked all types of ideas for me when I read it.... Time to experiment with the jump board! Hope you enjoy! Love, Casey
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