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File #: 10084652 Surgeon consulting pelvic x-rays for a hip replacement. A doctor examining a pelvic x-ray displaying signs of osteoporosis - hip degeneration. Credit: iStockphoto (Royalty-Free) Keywords: Osteoporosis, Arthritis, Orthopedic Surgeon, X-ray Image, X-ray, Human Groin, Osteoarthritis, DoctorGetty Images/iStockphoto

The question: I have been diagnosed with osteoporosis. My doctor says I have to exercise. What exercises should I do?

Osteoporosis is a condition where one or more of your bones has lower-than-optimal density. The good news is that bone is actually an active tissue, so an appropriate exercise regimen can positively affect your bone density.

To promote bone health, pick movements that require your muscles to work against gravity. Think strength training and moderate-impact activities such as walking.

My four-step recipe for healthy bones is as follows:

  • 1. Slowly progress until you can regularly accumulate a minimum of 10,000 steps per day. Don’t worry: You can spread the steps out over the entire day.
  • 2. Three times per week, do 20 to 30 minutes of more intense continuous walking.
  • 3. Try to lift weights two to three times per week. Pick exercises that don’t round or twist the spine – this means no crunches or oblique crunches. Try front and side planks instead.
  • 4. Include a few balance exercises. The likelihood of breaking something when you fall increases with osteoporosis, so be safe: Stand beside something you can grab if needed. No injuries allowed on my watch!

The main takeaway is that while exercise is always important, when you have osteoporosis it is even more essential to move on a consistent basis. Swimming or Aquafit, although a fantastic adjunct, shouldn't replace a strength or walking program, since being in water doesn't force your body to work against gravity.

Trainer's tip: Consider meeting with a nutritionist, as diet also affects bone density. Most of us know that the amount of calcium in our blood effects bone growth, but you might be surprised by the significant role played by other vitamins and minerals. For example, magnesium and vitamin D help to allow calcium to be absorbed, while some food and liquids actually leach calcium from your bones.

Kathleen Trotter has been a personal trainer and Pilates equipment specialist for 10 years. Her website is www.kathleentrotter.com.