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I have osteoporosis. Can I still do sit-ups and crunches?

The question

I read your advice regarding sit-ups and osteoporosis. I am 61 and have osteoporosis. I attend group classes in which we do a variety of crunch-type exercises (although never full sit-ups). Should I stop doing all of these exercises?

The answer

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I know how rewarding a good abdominal "burn" can feel, but I would advise you to stop doing any version of a sit-up or crunch. Bending and curling your spine forward is not advised if you have osteoporosis.

Basically, osteoporosis is when one or more of your bones has lower-than-optimal bone density. Osteoporosis affects a certain type of bone called trabecular bone. The vertebral bodies that comprise the anterior portion of the spine contain this spongy type of bone.

Think of the front of your spine as a pile of boxes stacked on top of each other. The trabecular bone is the interior of the boxes - the dense "packing tissue" that holds the exteriors of the boxes in place. A wall prevents the boxes from falling backward, but does not prevent them from collapsing forward.

This wall is the posterior portion of the spine, which is not composed of trabecular bone.

If you have osteoporosis in your spine, the packing material within the boxes starts to lose its density. This means that under the wrong types of stress the boxes could start to collapse forward and begin to look more like wedges.

When you flex forward in any type of crunch, you are increasing the risk of a fracture by placing your body in a position that stresses the already weakened trabecular bone.

This is why I highly recommend that anyone who has osteoporosis always choose exercises that maintain a neutral spine.

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Trainer's Tip

The other motions you should avoid when possible are rotation of the spine, lateral flexion and movements where you pull your knees to your chest.

Send certified personal trainer Kathleen Trotter your questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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