The legendary band, The Delta Rhythm Boys, had it right when they wrote the lyrics for “dem dry bones.” As adults age, minerals begin to leech out of the bones, leaving them brittle, fragile and prone to breaking. This condition, known as osteoporosis, may seem inevitable, but with a little work, adults can protect their bones and keep them healthy throughout the years.

Normal, age-related bone mineral loss causes a net loss of five to 10 percent per decade and begins after the peak of full bone mass — starting approximately when men and women are in their 30s (Snow-Harter & Marcus,1991).

Risks for Osteoporosis and Fragility Fractures

Some may think of osteoporosis as a women’s disease, but this is not the case.

Wake Orthopaedics surgeon, Justin Kauk, MD, shares, “Osteoporosis is not just a women’s disease. Men are affected too. It is critical that we make them part of the conversation, so they can take steps to protect their bones as they age.

Statistics related to osteoporosis and fragility fractures in men provide clear evidence to this point:

Strength Training is Key

One key method to protect the bones of both men and women is strength training — which plays an essential role in the golden years. Strength training and weight-bearing exercises both prevent and treat bone-related issues. They can help increase bone mineral density (BMD) and help preserve and enhance muscle mass at any age.

According to American College of Sports Medicine, exercise is the only tool that helps:

• Increase low bone mass density
• Improve muscle mass
• Promote strength gain
• Sustain balance
• Sharpen thinking skills
• Manage chronic conditions

Bone and muscle mass, strength and balance are all independent risk factors for fractures. If strength training is properly planned and physiologically sound, exercise should be a direct stimulus to improve bone strength and structure (ACE 2015).

In honor of Men’s Health Month this June, let’s discuss the ins and outs of strength training for men.

Preparation for Strength Training

As a general rule, it is best to properly fuel before a workout by feeding the body wholesome nutrients as part of a healthy lifestyle. Bones require available nutrient energy. Calorie restriction can negatively impact bone strength by suppressing anabolic hormones.

Hydration is also key to overall health and wellness and successful workouts. Sweating during a workout depletes the body of fluid. Hydrating before and during a workout reduces the risk of heat stress, supports normal body function and maintains performance levels.

A proper warm-up is additionally essential. Below are examples for someone new to exercise:

• Circling the arms
• Squatting gently using body weight or sitting to standing
• Marching in place
• Modifying jumping jacks
• Standing hamstring curls
• Stepping side-to-side
• Walking forward and backwards

Guided Workouts

A good way to start strength training is to seek out professional guidance. Individuals are cleared as long as they can perform exercises safely and do not have any exercise contraindications.

A green light from a medical provider not only provides clearance but also helps men safely and effectively take the first step towards their fitness goals. Setting a Specific, Measurable, Achievable, Relevant, Time-bound (SMART) goal is also a good first step. Men should begin slowly and work on consistency. If they have a fitness membership, they should check to see if the facility has trainers available to teach proper use of equipment. This will ensure maximized results without setbacks since there is a specific loading pattern to improve and assist with bone health.

The Importance of Strength Training

As mentioned earlier, men are susceptible to osteoporosis as they age. And, for those with a diagnosis, strength training is still a very good idea. Specific training guidelines are available to fitness practitioners, and patients should work with a fitness professional who has the proper training and education.

Cardio and Strength Training

Cardiovascular exercise and strength training are two valuable components of exercise, and men need to engage in both. Circuit training can raise the heart rate while strengthening the muscles. Otherwise, when possible, cardio bursts can be added in between strength sets.

Strength Training Sessions and Repetitions

The length of a session and number of reps will vary depending on experience as well as goals. For most men, a good starting point is 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week. Emphasis should be on weight bearing activities. In addition, men should incorporate moderate to vigorous strength training two to three days a week. Exercise should include each major muscle group and emphasize bone-loading forces. Exercise progression should be individualized.

For men with osteoporosis, cardiorespiratory exercise should be three to five days per week of moderate intensity. Some men may be able to tolerate more intense exercise. Weight-bearing, large muscle group activities, such as walking or stair climbing, are advised when appropriate. These men should also perform two to three days a week of moderate strength training. Exercise should include each major muscle group and emphasize bone-loading forces and a focus on standing exercises that emphasize balance, gait and functional movements. Exercise progression should be individualized.

While engaging in any type of physical activity, remember to be kind to the joints!

Going It Alone

Appropriate bodyweight training along with resistance bands and dumbbells are a great option for men who are cleared to exercise alone at home. Several “adjustable” dumbbell sets that vary from light to heavy weight are available for purchase. A fitness or yoga mat could also be helpful. This type of equipment would allow for a variety of effective workouts.

Safety Equipment

Playing it safe is of utmost importance with strength training. A weight belt and knee/elbow wraps are available if needed. While these can help with specific heavy weight training, they are not typically necessary for the average health seeker population.

Gloves can be worn to prevent calluses, and several options are available at most local fitness stores.

Both free weights and machine weights can be used safely. Men should choose whatever is available to them. During strength training of any kind, it may be necessary to have a spotter. If one is not available, the safest option is to utilize a lifting rack or stand that has adjustable safety pins, spotter arms or safety bars. However, this type of strength trainings isn’t necessary to be successful.

Strength Training and Blood Pressure

Broad epidemiological studies have found there is a negative association between exercise and the development of high blood pressure. Men should check with their doctor and make sure they are safe to exercise if their blood pressure is not controlled. An exercise specialist can monitor blood pressure during a workout once cleared by a physician.

Recovery After Strength Training

Stretching and walking at an easy pace are great ways to reduce the risk of injury post workout. These activities reduce muscle soreness and can dissipate or reduce lactic acid buildup.

The Next Step

If you would like to get started with strength training, WakeMed Primary Care has appointments available for fitness evaluations.

Once you are cleared for exercise, you are welcome to learn more about programs available through WakeMed Healthworks fitness and wellness programs. We have locations in both Raleigh and Cary.

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About Joelle Sevio

About Wake Orthopaedics

For 20 years, Wake Orthopaedics has been serving the Triangle community with comprehensive orthopaedic care to help their patients regain their mobility and restore their quality of life. With specialties and expertise in conditions of the bones, muscles and joints, our team of board-certified and fellowship-trained specialists utilize progressive treatments and state-of-the-art technology to care for everything from hip fractures to ACL injuries to arthritis. In addition to traditional orthopaedic services, Wake Orthopaedics provides trauma services, rehabilitation services and care for pediatric injuries. Wake Orthopaedics is a WakeMed Physician Practice.

About WakeMed Primary Care

WakeMed Physician Practices features board-certified primary care, internal medicine and family medicine physicians conveniently located throughout the Triangle.

Our exceptional and compassionate providers and care teams pride themselves on developing long-term relationships with their patients and their families.

Source:

Downey C, Kelly M, Quinlan JF. 2019 Mar 18;10(3):166-175. Changing trends in the mortality rate at 1-year post hip fracture – a systematic review. World J Orthop. doi: 10.5312/wjo.v10.i3.166. PMID: 30918799; PMCID: PMC6428998