Starting with Starting Strength with severe osteoporosis at age 25

I recently got diagnosed with severe osteoporosis in my spine (T-score -4.1) and severe osteopenia in my femurs (T-score -2.3). The results don’t lie but I have had an lot of drunk accidents in my past and didn’t broke my bones. The score in my spine is really bad (-2.5 is the treshold for osteoporosis). My doctor advised me to make lifestyle changes so I quit drinking alcohol, using drugs and tabbacco 1.5 year ago. My nutrition is great and even take extra Calcium/Vitamin D suppluments. I also take medication to make my bones a little stronger. My doctor also advised my to exercise a lot, but didn’t give any exercise advise or restrictions because it is really uncommon for someone my age to have osteoporosis (the cause is hormonal and i take testosteron injections for that).

At first i did cardio 4 times an week and I started two months ago with resistance training. I am really at love with weightlifting because it gives me life lessons. It is amazing to see strength improvement every session and due 400 cal surplus I gained around 3 pounds of muscle mass already, but my primary goal is increase my strength.

I researched a lot about the optimal training program to build muscle and get stronger. I believe that that major big compound lifts are the greatest to implement in my training regime. Barbell exercises are natural movements and are therefore functional. I really want to do the big lifts and bought Starting Strength to read about them, however I am scared that deadlifts, OHP and Squats will cause compression fractures. I love the fact that you could increase the weight a little each lifting session and the fact that you will get stronger each time.

Right now I follow my modified version of a PPL-routine (6 days/week):

PUSH

5 x 5 or 3 x 8-12 Barbell Bench Press

5 x 5 or 3 x 8-12 Dumbell Shoulder Press

3 x 8-12 Incline Bench or Dumbell Press

3 x 8-15 Triceps Overhead Extensions and 3 x 8-15 Lateral Raises (Superset)

3 x 8-15 Triceps Pushdown and 3 x 8-15 Lateral Raises (Superset)

Pull

3 x 8-12 Seated Cable Row

3 x 8-12 Lat Pulldown (right now I have trouble with lat activation so I often do ‘warm-up sets’ with 15-20 reps)

3 x 8-12 Seated Machine Row (Chest Supported Dumbell Row gives me a lot of back pain so I do this instead)

4 x 8-15 Dumbell Biceps Curl

4 x 8-15 Hammer Curl

Legs

4 x 6-12 Seated Cable Leg Press

4 x 12-20 Leg Curl Machine

4 x 12-20 Leg Extension

3 x 12 Calf Raises

Altrough I made some progress, I don’t think my training schedule is best for me. My wish is to replace the program for Starting Strength so I don’t have isolation exercises but the functional big compound lifts. I know this are questions I should ask my doctor but she couldn’t give me advice, even physical therapists couldn’t give me answers.

  1. Do you think it is possible to do Starting Strength with severe osteoporosis?
  2. Should i do my linear progression in an slower tempo?
  3. Are there exercises that are unsafe for me?
  1. Sure.

  2. Unfortunately I don’t have any evidence to base such a recommendation on. This will ultimately be up to you.

  3. I will only comment on the basic barbell lifts here and say that we have evidence suggesting that performing them is safe in the setting of osteoporosis when loaded appropriately.