If you were asked to name the worst medical epidemic in the United States today, you might guess heart disease. It would be a noble guess, but it would be wrong. Today, currently half of all women over the age of 62 suffers from osteoporosis. It will afflict more than 40 million women by the year 2,000, and cost billions in health care dollars. How will rehabilitation fit in? Two ways Ð prevention, and prompt treatment. By promoting exercise and healthy diets to women during child bearing years (20-38 years), they can certainly reduce the risk of acquiring the disease in the first place. By having referrals for orthopedic assessments, and complete exercise programming immediately after diagnosis, we may save most of the health care dollars in medical treatments that would normally be spent on these patients.
A diet rich in leafy green vegetables, fiber, low in fat, and of course, high in calcium (among the other 72 trace minerals, according to Dr. Joel Wallach) is the first step in prevention. Exercise Ð especially strength training, is the second most important step. A properly prescribed program will increase density in the femoral neck and lumbar vertebrae, where it is needed most. This section 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 - hip area. Comprising the largest muscles in the body, the hip area is the foremost section to train. The most important types of machines to condition this area are the leg press, and total hip machine. The leg press is a compound exercise, working the muscles of the hip and thigh. The hip machine is an isolation exercise, concentrating the gluteus maximus. These machines are preferable to free weights to start out with because the learning curve is less, and improvements can be made with less chance of injury.
Section #2 - upper body. 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 #2 illustrates a weight-assisted machine for working the chest area (dip exercises), and the back (pull up exercises).
The most important element of program design 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: (Low intensity) | Sets | Reps* | Rest Period |
| Chest Dips | 2-3 | 10-15 | 2-3 minutes |
| Lat Pulls | 2-3 | 10-15 | 2-3 minutes |
| Hip Extensions | 3-4 | 10-15 | 2-3 minutes |
| Leg Press | 3-4 | 10-15 | 2-3 minutes |
After a period of adaptation (phase I), it is time to increase the intensity, and change the number of sets and reps. [* = where 30 repetitions are possible with a maximum effort].
| PHASE I: (Medium intensity) | Sets | Reps* | Rest Period |
| Chest Dips | 3 | 10-10-8 | 3-5 minutes |
| Lat Pulls | 3 | 10-10-8 | 3-5 minutes |
| Hip Extensions | 4-(5) | 10-8-6-4 | 3-5 minutes |
| Leg Press | 4-(5) | 108-6-45 | 3-5 minutes |
[Leave 4-6 reps to spare at the end of each set]