My clinician told me not to take up skiing or ice-skating now that I have bone loss. Why is that, and are there other activities I should avoid?

High-impact winter sports are discouraged for people who have any degree of bone loss unless you have always been a skier or skater. The learning curve for these types of sports involves many falls, which is the reason to avoid them. The impact from the falls further increases your risk for a fracture. Even professional skiers and skaters fall sometimes. It has nothing to do with stamina or willingness to learn. It has to do with the likelihood of falling. Any sport that involves a high possibility for falls should be avoided.

And it's not just winter sports. For example, if you've never run the 100-meter high hurdles or done horseback riding, now is not the time to start! Similarly, you should avoid sports that are high impact, where there is a strong possibility that you will have rough contact or be knocked over by another player. So, sports such as football, soccer, field hockey, softball, and kick-boxing are best avoided if you have osteoporosis.

Midlife and beyond, particularly if you are retired, present many opportunities to try new things and explore your interests. It's great to take up the challenge of learning and trying new things! Remaining physically active is very important, but stick to new activities that have low impact and low risk for falls.

If you have been told that you have osteoporosis or if you have a history of spinal fractures, it is particularly important to avoid forward bending or twisting of your spine. You should be careful to avoid toe touches, sit-ups, and some movements in yoga and Tai chi (see Questions 43 and 44). If you have been told that you have osteopenia (T-score of —1.0 to -2.5), you can still do exercises that involve forward bending or twisting of the spine as long as the bone loss is not in your spine (see Figure 10 in Question 44).

Should I stop exercising if I break a bone?

Exercise and physical activity are so important to your overall health and well-being that the simple answer is "no." However, if you break your hip, then your legs will be immobilized before surgery and immediately afterward (see Question 78). Probably you will be encouraged to move your upper body, and you may need to shift in bed using a "trapeze" over your head. Even though you may not be using a walker immediately, you need to retain your upper body strength so that when you do get moving, you will be strong enough to support yourself. One of the reasons that it's so important to keep a well-conditioned upper body is that you never know when you may need to rely on your arms to help you move around.

A broken wrist will prevent you from doing many activities, but regular exercise doesn't need to be one of them. Obviously, you can't swim or lift weights with the affected arm. However, walking, stationary biking, and other activities that don't require the use of your arm can keep you in good physical shape. A cast can cause poor balance, making it more likely that you will fall. So, running and any sport that requires running would be best to avoid until your wrist is completely healed.

If you break a bone in your spine, you will probably not be able to continue your regular exercise routine, particularly if you need to wear a back brace. If you are accustomed to walking or other weight-bearing exercise, you should continue to walk, but instead of 30 minutes at a time, try a few minutes per hour. Sitting for long periods without movement can actually cause more

Breaking a hip may be the first sign that someone has osteoporosis.

pain and stiffness. Be very aware of your posture as you sit and walk, and keep your head up and your spine straight. Keeping your shoulders back and your abdominal muscles pulled in will also increase your back muscle strength to support your spine. You can do some gentle arm and shoulder exercises when you are sitting, but use pain as your guide. If just lifting a teacup causes pain, then activities using the arms and shoulders may need to be avoided for a while. Some experts suggest partial squat exercises, which help to increase the strength of your thigh muscles, without causing additional stress on the spine.

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