I recently discovered that my mother, who has osteoporosis, has been instructed by her physical therapist to avoid any exercises (loaded or unloaded) that train spinal flexion. She was told that these types of exercises would put her at higher risk of spinal injury, due to her condition. Is there any evidence that supports this?
it’s my understanding that repeated spinal flexion is not inherently more injurious than any other type of movement. Is osteoporosis any different?
I told her that I didn’t think it was the case. She asked me to send her a relevant article.
Do you think I’m correct?
If so, is there anything I can send her (maybe specific to osteoporosis)?
There is no evidence to support this recommendation.
There are plenty of studies of high intensity resistance exercise for osteoporosis (most recently the 2018 LIFTMOR trial), but there are no studies specifically examining spinal flexion in the context of exercise for osteoporosis. However, this physical therapist should be providing evidence to support her recommendation, rather than asking for evidence to refute it.
Additional question:
Does the research on resistance and bone mineral density point to increased benefits to training with higher relative 1RM percentages? I remember teacher making a claim about this years ago, but I don’t know if the research demonstrates it.
There’s no specific cut-point used in the literature, but typically anything close to 70% 1RM or above would work for this. RPE’s track well with intensity, but different rep ranges use different intensities.