A reader question from Marilyn:

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Dear Chad,

Those have been interesting videos the last couple of days. I’m more cautious about exercise because of my low bone density. I know it’s good to build bone density through exercise, but if my bones are still low in density, I don’t want to risk injury or a fracture. I’m also protective of my knees, as we have lots of friends and relatives who have had knee replacement surgery. That does not sound as though it has an easy recovery.

I went to a yoga class on Wednesday night. …I find that my wrists or fingers hurt when I’m doing “downward dog” for longer periods of time (holding yourself up on your hands and toes). I alternate between holding myself up with my palms or my fingertips. Occasionally I put my knees on the mat instead of just my toes in order to take some weight off my wrists. Maybe I’ll see what it feels like to put my forearms on the mat sometimes.

I hadn’t taken a yoga class for several years, so I’m really out of practice. …Are you familiar with yoga? What do you think of it?

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My Reply:

Yes, knee surgery can have a tough recovery. I’d want to avoid that if possible!

As for your safety concerns about minimizing the risk of an injury or fracture in exercise, you’ll want to avoid sudden, excessive forces on the bones and joints. This is the most likely cause of such injuries.

Also, you’ll want to make sure that your body is always in a position that is appropriate for your joints (no joint pain), and that you are stable in this position, with little chance of getting out of alignment while you are exercising.

While you engaged in exercising, your body is progressively becoming weaker (by definition–that’s what exercise does). It is very important that your stability will not be eroded as your strength diminishes, as is often the case in many types of exercise, especially those that use body-weight movements, free weights, elastic bands, and the like.

In the early 1980s, the Nautilus exercise corporation was conducting new research to attempt to measure the effect of exercise on bone mineral density in elderly women with osteoporosis. A challenge they faced was to how to *safely* get these elderly women to exercise given that they were older and not trained athletes (i.e., they did not have much skill or motor control), and also they had low bone density.

Here was their solution:

1. Use Machines

They had the women do women do weight training with machines that forced stability.

When holding body poses or using free weights, it is very easy to get out of proper alignment, or generally out of balance, which could lead to falling or other injuries.

Proper machines restricted the movement range and type of movement, severely limiting any such possibilities throughout the whole exercise. This allowed high probability that that every joint stayed positioned correctly through each exercise. They wouldn’t have started with misplaced pressure on wrists from being flat on a floor, and they wouldn’t end up with it.

Machines can be designed to virtually force proper joint alignment and function. But maintaining proper joint position in an unstructured, “free” pose can take a lot of skill and strength. If you have neither skill nor strength, I’d be wary of exercises that are unstable and require active stabilization.

2. Slower Movement

They had the women move at a creeping slow snail’s pace.

We’re talking about a plodding 10 seconds to move in each direction. This is virtually still. This eliminated impact forces such as what you’d get from walking/running, or falling out of balance and onto your hip, dropping a weight, etc.

This extremely slow movement further allowed the instructors to better make sure that the elderly subjects were doing every portion of the exercise correctly and in alignment. It made the exercises simpler–more like simply holding one stable position than demanding the coordinated effort of moving more quickly while maintaining precision to keep the joints properly aligned and protected.

3. Precisely Adjustable Resistance

The choice of using weight machines allowed the instructors to adjust the amount of weight to be exactly right and manageable for the participants.

For many people, *especially* weakened, elderly women with less motor control, their body weight is going to be far too much resistance to be safe and appropriate.

For the this issue, I can imagine two other solutions instead of weight machines: working out on the moon or training completely submerged underwater. Both of these could immediately lower one’s body weight.

However, both of these “solutions” would lower the exercise resistance one experiences in an uncontrolled, one-size-fits-all manner. That is still not optimal.

Plus, both of those solutions require an expensive, cumbersome, difficult-to-use breathing apparatus.

Well, in under-water exercise, you could restrict activities to those that allow you to keep your head above water–but that severely limits what muscles you can work.

Both solutions may also require extensive travel (depending on the season and how close you live to a pool or to the moon).

A weight machine not only allows for selecting an exactly appropriate weight for each exercise, but it also allows for progressively, slowly increasing that resistance as a person becomes stronger, and would benefit from a little more resistance.

4. Ability to Get More Benefit with Less Resistance

Another benefit of moving so slowly was that this lowered the total amount of resistance the subjects needed. This is because the slow movements exhaust muscles more efficiently and faster.

This lowered weight further lowered forces on the joints (such as knees). So these forces have now been lowered both from the elimination of pounding and accelerating, and from now being able to use even less resistance to start.

In an extreme case of joint issues (such as knee pain), I’ve seen it helpful to reduce the speed of movement from *almost* zero movement, to zero movement–i.e., doing isometrics.

I’ve seen isometrics work very effectively.

And I’ve seen reports that bone density responds very well to isometrics done properly. How exactly do you really do isometrics properly and most effectively? Well, that’s probably a subject for another time.

Yoga Question

As for the question about yoga, I’ve done some yoga, not a lot, and there are many varieties of yoga, and many types of instructors.

Done exactly right, it can place loads on the muscles that can cause strengthening for some people. However, I don’t believe that you can ever have the precision, the control, or the safety as with the approach mentioned above.

Much of the focus in yoga is on learning skills and holding positions that are often difficult for anyone to do correctly, much less people who are in a weakened condition.

Yoga also suffers from the major limitation that people doing yoga are stuck with always using a minimum of their own full body weight for every position. This limitation can severely restrict the positions a person with strength issues, and it can make things dangerous for reasons I’ve already mentioned.

I believe that any person concerned about safety in exercise should be incorporating the principles outlined above.

Also, I’ve had many older clients who have commented on how aches and pains they had observed from doing activities like yoga and pilates went away after they started training with these principles. And, at the same time, they’ve commented on how their functional strength went up higher than ever before. Note that this further reduces the risk of injury in all life activities outside the gym.

Plus, their bone density tests sometimes shock their doctors in how much their bone density actually *increased*.

Now, not everyone is elderly, weak, or worried about their bone density. BUT, I consider safety to be a fundamentally important consideration in any exercise whose purpose is improved health (as opposed to just fun).

When I exercise, I incorporate all of these principles for myself, and at my LA gym, we do personal training for all of our Los Angeles clients, even the strongest, with these considerations in mind.

Even if you don’t consider yourself in the category of people I’ve been talking about, I encourage you to apply these principles to your workout.
I hope this has been helpful, and I’ll talk to you again soon.

Cheers,
Chad

P.S. If you want a personal trainer in Los Angeles to hold you accountable to working out, and to apply everything I’ve discussed here, we do have a few spots open. You can click on the introductory workout link above to learn more.