How to train a client w/ Osteoporosis | Become a Trainer in Santa Monica / Atlanta

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Your bones are constantly changing. Beneath the surface, specialized cells called osteoblasts build up bone tissue while osteoclasts break it down. This delicate balance shifts as we age, with breakdown eventually outpacing construction—especially in women after menopause when estrogen production decreases. The result? Weakened bones vulnerable to fractures that can dramatically reduce quality and length of life.

The good news? Osteoporosis is 100% reversible. But not through the gentle exercise most people associate with bone health. True bone remodeling requires significant resistance—at least 75% of your maximum capacity. That means working in the challenging 6-12 repetition range where those last few reps feel difficult. Light workouts might feel tough, but they won't trigger the microscopic bone stress needed to stimulate rebuilding.

The type of loading matters too. Vertical loading—where gravity forces travel through the length of your bones—provides optimal stimulus. Back squats, bench press, and overhead presses create this vertical pressure, while even beneficial exercises like hip thrusts don't provide the same bone-building stimulus. This explains why activities like swimming and yoga offer minimal bone density benefits despite their many other advantages.

Proper progression is essential, especially for beginners or those with existing bone concerns. Start with bodyweight or assisted movements to develop competence before adding load. A thoughtful progression might move from TRX-assisted squats to goblet squats and eventually to barbell back squats, gradually increasing weight over time. With consistent training and proper nutrition (adequate protein and calcium), meaningful improvements in bone density typically emerge after about six months.

Personal trainers have a unique opportunity to address this critical health issue. By understanding bone physiology and designing progressive resistance programs, you can literally save lives. The stakes are high—approximately 50% of people who break a hip don't survive beyond one year. Through proper strength training that includes both bilateral and unilateral movements, you can help clients build bone density while improving stability and reducing fall risk.

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