This portion of our article will concentrate on the most important areas of the body to strengthen, what types of exercises to perform, and the proper progression to perform them in to enhance muscular and bone development.
Section #1 is the hip area. Comprised of the largest muscles in the body, the hip area is the foremost section of the body to train. The most important types of machines to condition this area are the leg press, and total hip machine, shown in photos 1 and 2. The leg press is a compound machine, working the muscles of the hip and thigh during each push. The hip machine is an isolation machine, concentrating on one muscle group at a time (in this case, the gluteus maximus). Working the upper body major muscles (chest, shoulders, back) comprises section #2, and provides resistance to the bones of the upper vertebrae, long bones of the arms, and ribs. Photo 3 illustrates a weight-assisted machine for working the chest area (dip exercises), and the back (pull up exercises).
The most important element of exercise for this group is training progression, as the goal is to strengthen weak and porous bone to its natural density. A beginning program would start with low intensity, and more repetitions. It would look something like this:
| PHASE I: | Intensity | Sets | Reps |
| Chest Dips | Low | 2-3 | 10-15 |
| Lat Pulls | Low | 2-3 | 10-15 |
| Hip Extensions | Low/medium | 3-4 | 10-15 |
| Leg Press | Low/medium | 3-4 | 10-15 |
After a period of adaptation (phase I), it is time to increase the intensity, and change the number of sets and reps.
| PHASE II: | Intensity | Sets | Reps |
| Chest Dips | Medium | 3 | 10-10-8 |
| Lat Pulls | Medium | 3 | 10-10-8 |
| Hip Extensions | Medium-high | 4-(5) | 10-8-6-4 |
| Leg Press | Medium-high | 4-(5) | 10-8-6-4 |
The goal is to progress to a level that is is perceived as difficult, strengthens the musculature, and over time (4-8 months), has a positive effect on the bone density (as seen by DEXA scan). Medically, the density should improve from -10% loss to normal (0% loss in bone).
Both of the phases of training can be manipulated by the therapist/trainer depending on the initial conditioning level of the participant. Training should proceed in phases, as staying with the same level of resistance will not improve bone density or muscle strength.
This beginning program should give some hope to those who have not thought of strength training as a method of therapy for their osteoporotic condition. It is "good medicine" that can be performed, and enjoyed for a lifetime.
References
1. Greenwald, S. Menopause, Naturally. Volcano Press, Volcano, CA, 1984.
2. Whitney, E.N., Hamilton, E.M.N. Understanding Nutrition, 3rd Edition. West Publishing Company, St. Paul, MN, 1984.
3. Bompa, T.O. Periodization of Strength: The New Wave in Strength Theory. Veritas Publishing, Toronto, Canada 1993.