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Strengthening Bones with High Velocity Resistance Training (HVRT): A Guide for Those with Osteopenia and Osteoporosis
Strengthening Bones with High Velocity Resistance Training (HVRT): A Guide for Those with Osteopenia and Osteoporosis
For anyone managing osteopenia or osteoporosis, finding safe, effective ways to protect and strengthen bone health is critical. A recent systematic review, focused on high velocity resistance training (HVRT), provides valuable insights on how this type of training can benefit bone mineral density (BMD) in older adults—particularly at the lumbar spine, hip, and femoral neck, which are key areas prone to fractures.
What is HVRT?
High velocity resistance training (HVRT) is a form of exercise that combines speed with strength, emphasizing powerful, controlled movements that target muscle and bone. Unlike traditional resistance training, HVRT often involves quicker concentric (lifting) movements paired with slower eccentric (lowering) movements, which engage the muscles attached to bones in ways that promote bone health.
Key Findings from the Review
This review included 25 studies, totaling over 1,200 participants. Here’s what it found:
- Small but Significant Gains in Bone Density: The review found that HVRT programs, when performed twice or more weekly, had a significant positive impact on BMD in older adults. Increases ranged from 0.9% to 5.4%, primarily in the lumbar spine, femoral neck, and total hip.
- Consistency is Crucial: Importantly, studies showed that BMD improvements were lost if exercise was stopped for six months or longer. Thus, consistency is essential to maintaining gains.
- Multimodal Programs Enhance Outcomes: Programs that combined HVRT with other exercises, such as balance and flexibility work, tended to show even better results. This blend of exercises seems to create a synergistic effect that further supports bone density.
- Longer Duration Leads to Better Results: Programs lasting six months or more tended to yield the most notable BMD improvements. Bone remodeling is a slow process, so longer-term commitments to HVRT are recommended.
Practical Takeaways for Improving Bone Health
1. Consider HVRT as Part of Your Routine
- Minimum Frequency: Aim for at least two HVRT sessions per week.
- Duration: Commit to at least six months of consistent training to see meaningful changes in bone density.
- Controlled Environment: HVRT is best done in a safe, supervised setting, such as with a trainer experienced in osteoporosis-friendly exercise regimens, especially for those new to resistance training.
2. Blend HVRT with Other Exercises
- Including balance exercises, flexibility work, and moderate-impact activities (like walking or light jogging) can amplify the osteogenic effects of HVRT, helping to strengthen not only bones but also the muscles and ligaments supporting them.
3. Avoid Long Breaks
- If you stop training for six months or more, you risk losing any gains in BMD. Schedule your workouts as part of your weekly routine, and avoid long gaps to maintain bone strength.
Making It Work for You: Safety First
For many, the idea of high velocity training can sound intimidating, especially if you’re managing a condition like osteoporosis. However, HVRT can be modified with machines or lighter weights to accommodate different ability levels safely. Additionally, explosive movements can be adjusted to fit your fitness level—there’s no need to engage in highly intense or Olympic-style lifting to benefit from HVRT.
Beyond Bone Health: Preventing Sarcopenia and Powerpenia
Alongside improving BMD, HVRT may also help prevent sarcopenia (age-related muscle loss) and powerpenia (decline in muscle power). Sarcopenia and powerpenia are serious issues for older adults, leading to reduced mobility, higher fall risk, and overall decreased quality of life. HVRT, with its focus on explosive movements, can help retain both muscle mass and power, essential for everyday tasks and fall prevention.
For more on powerpenia read our full article here.
Take Control of Your Bone Health
For those diagnosed with osteopenia or osteoporosis, HVRT offers a promising, science-backed way to take control of bone health. Start by consulting with your healthcare provider and a qualified trainer who can help design a safe, effective HVRT program tailored to your needs. With commitment and the right guidance, you can build a sustainable exercise routine that strengthens your bones and supports long-term health.
Let’s build stronger bones—starting today!
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REFERENCE: Haque, I., Schlacht, T. Z., & Skelton, D. A. (2024). The effects of high velocity resistance training on bone mineral density in older adults: A systematic review. Bone, 179, 116986. https://doi.org/10.1016/j.bone.2023.116986
How to Perform an Effective Hip Flexor Stretch
A Safe and Effective Hip Flexor Stretch
The main muscles that make up the “hip flexors” are the rectus femoris, iliacus, and psoas major. This muscle group can become overactive and tight resulting in a variety of musculoskeletal issues. Many people perform a hip flexor stretch as a routine, or to help with a specific condition: knee pain, hip pain, back pain. Unfortunately, we see many patients who are performing a hip flexor stretch incorrectly and are exacerbating their condition. Take back pain as an example. Tight hip flexors can cause abnormal posture through the low back resulting in joint compression and irritation. Many patients will then stretch the hip flexors aggressively to help alleviate the symptoms. However, in an effort to loosen up the hip flexors, patients are compromising their low back by compressing a twisting the joints. To stretch the hip flexors properly, there are a few cues that you want to pay close attention to. Take a look at the following video; we go through the proper set up and execution of a safe hip flexor stretch.
Now, if you search “Best hip flexor stretch” you will get thousands of results and some are going to look really cool, and effective. At our chiropractic office in Mission Valley, San Diego we strive for keeping the exercises simple, accessible, and effective. Many of the “cool” or “aggressive” hip flexor stretches often put patients into compromised positions for their condition. Try this version of the hip flexor stretch. If you are suffering from low back, knee, or hip pain, please schedule with us to get a full evaluation. We specialize in treating sports injuries and tight hip flexors are a common presentation we see in our athletes as well as our workforce patients. Our office, Peak Form Health Center, is conveniently located off Texas Street, in Mission Valley, San Diego.
Get Ready for the San Diego Rock ‘n’ Roll Marathon
The San Diego Rock ‘n’ Roll marathon is coming up! You are likely finishing your build phases of training and are headed into a much needed taper to help rebuild your body before the big day. Now that training volume has decreased, you have more time to address your body to get it into tip top shape before race day. Beyond foam rolling, stretching, and mobility work, the following are services that can help decrease tightness, soreness, aches, and pains before your big day. Our office accepts most major insurances and offers affordable cash rates. Our San Diego Chiropractors treat runners and running injuries on a daily basis using the following techniques:
Active Release Technique– Our staff is trained in Active Release Technique which is a state of the art soft tissue injury management system. Our chiropractors utilize ART to help reduce tightness and soreness at isolated parts of the body. For example, many runners feel tight in their hips and quadriceps following long runs. One or two ART sessions before the Rock ‘n’ Roll Marathon can help rid the muscles of that tightness.
Graston Technique– While training for the Rock ‘n’ Roll Marathon, if any injury is long standing, particularly in a tendon, Graston is excellent to get ample blood supply to that area. Our San Diego Chiropractor will sometimes have runners perform movements while using the Graston tools to help facilitate movement between the fascia and muscles. Bascially, your muscles move better so you do not feel tight and sore before your race!
Spinal Manipulation– If your back is stiff and lacks proper range of motion, spinal adjustments may be the right treatment for you. Spinal manipulation is an excellent treatment to help restore proper joint mobility. Spine stiffness is a common complaint in runners especially when training for a marathon due to the long hours of training and consistent bouncing motion into the spine.
Massage Therapy– Our massage therapist is an avid runner and endurance athlete. If you have numerous areas of tightness and soreness, schedule a massage to have a nice once over to all of those complaints.
Head into your race feeling as healthy as you can and you will see great results. After the San Diego Rock ‘n’ Roll Marathon, we recommend our runners to receive treatment about once every 4 weeks to help reduce tightness in the common running muscles and joints. Our office is conveniently located in Mission Valley, San Diego near the Rock ‘n’ Roll Marathon course!
Good luck in the San Diego Rock ‘n’ Roll Marathon!
New Methods in Treating IT Band Syndrome
IT band syndrome remains a stubborn condition that our chiropractors treat at our office in Mission Valley, San Diego. Runners, triathletes, and cyclists are the main groups of people who we treat for this condition. We previously posted treatment recommendations for IT band syndrome (found Iliotibial Band Syndrome) but wanted to update the information regarding treatment. The previous post still highlights relevant treatment advice in terms of research based treatment. Continue below to see the most recent types of treatment our San Diego chiropractors utilizes to best treat IT band syndrome.
Do you truly have IT band syndrome?
Many patients self diagnose their knee pain as IT band syndrome. They may be correct but true IT band syndrome is characterized by outside (lateral) knee pain right at the bony attachment of the IT band. It is often worse with repetitive movements such as running, walking, hiking, and cycling.
There are many cases that we have seen where the patient is experiencing general knee pain and were diagnosed with IT band syndrome. After our chiropractor evaluates the knee pain, it is often found that the person is experiencing knee pain due to muscle imbalances between the front of the thigh and back of the thigh. The pain and discomfort is often due to very tight and sore quadricep muscles. IT band syndrome is diagnosed because the IT band itself is found superficial to the outside quadricep muscle.
These patients are categorized as “quad dominant” and our San Diego Chiropractor works on the tight/sore quadricep muscles while strengthening the back thigh muscles, namely the gluteus maximus and hamstrings. Along with general strengthening and stretching, the patient must be taught how to use the glute muscles and hamstrings more during their activity.
New Treatment Approaches
We have had a lot of success using various types of myofascial release. Our San Diego Chiropractors have been trained in Active Release Technique and Graston Technique. Cupping is another therapy that has been used to help increase mobility between muscle fibers. Using motion with different types of myofascial techniques is especially helpful for treating IT band syndrome in runners, cyclists, and triathletes. The movement with myofascial work helps create mobility between layers of muscle/fascial tissue that often gets “bound up” with the constant repetitive stress from the sports mentioned previously. Take a look at the videos demonstrating IT band syndrome treatment:
Cupping used during athletic movements to decrease tissue compression and increase blood flow
Active Release Techique applied to the quadricep and IT Band
Strengthening the Hips for IT Band Syndrome
The previous article (found Here Iliotibial Band Syndrome) we wrote discussed several exercises that are still beneficial for IT band syndrome. We are finding even more success with more aggressive glute and hamstring exercises to help stabilize the hip and knee. Below is one of our favorite hip extension exercises. You can perform it one side at a time to make sure you are getting the most out of each hip. Our San Diego chiropractor treats many running injuries and will also assess different muscles groups to help establish proper running form.
If you are experiencing IT band syndrome, it is important to get evaluated by a sports chiropractor. Our San Diego Chiropractors work with all types of athletes. Each treatment is unique to the individual but likely includes some form of myofascial release, stretching, and strength training. Our office is conveniently located in Mission Valley, San Diego.
Cycling Knee Pain Treatment
Most cyclists at one point or another experience knee pain when riding their bike. There are many types of cycling knee pain and many different causes. In majority of cases, knee pain from cycling is due to overuse of the muscles/tendons around the knee joint. The complicating factor is the bike itself and how you are fit on that bike. A dialed in bike fit will allow your body to absorb the forces that hard cycling produces. If your knee joint, is working in a strained position, the muscles and tendons will eventually fail once a certain volume and/or intensity is reached during training. Forced time off will occur, the cyclist will train pain free until that tissue threshold is hit, and then knee pain occurs again. Frustrating! Below you will find the most common causes of knee pain in cycling.
Anterior knee pain
- Patellar tendonitis most common
- See our post here on patellar tendonitis
- Chondromalacia
- Fat pad impingement
- Bike fit suggestion: increase saddle height
- Advanced with evaluation of foot: shoe insert, cleat wedges
Medial knee pain
- Pes anserine bursitis
- MCL/knee capsule irritation
- Bike fit suggestion: move cleats outward
- Advanced with evaluation of foot: shoe insert, cleat wedges
Lateral knee pain
- Iliotibial band syndrome it band syndrome
- Hamstring strain (biceps femoris)
- Bike fit suggestion: lower saddle height, move clears inward (toward bike)
Posterior knee pain
- Hamstring tendonitis
- Hamstring train
- Calf strain
- Bike fit suggestion: Lower saddle height
Evaluation of Cycling Knee Pain
Evaluation begins with a thorough history, including details on your personal history of cycling, and bike fit. Our sports chiropractor will take you through various range of motion, orthopedic, functional movement, and strength/endurance testing. After the evaluation, a working diagnosis is developed and treatment begins.
Treatment for Cycling Knee Pain
Most cases of knee pain from cycling improve with a combination of manual therapies including Active Release Technique, Graston Technique, and joint mobilization. A individual exercise routine will be prescribed as well to strengthen/stretch the affected tissues to reduce pain and dysfunction quickly. Our cycling doctor will help construct a cycling training plan to get back to riding pain free; some bike fit suggestions may be necessary.
Schedule today to get your knee pain properly diagnosed at our Mission Valley, San Diego office. Both Dr. Travis Rose, DC CCSP and Dr. Kevin Rose, DC DACBSP are trained to treat cycling injuries and are both avid cyclists and triathletes themselves. Dr. Travis Rose, DC CCSP has additional training in Bike Fit analysis for health care providers.
Outer Hip Pain in Runners
Outer hip pain is a very common complaint we see with out runners at our Mission Valley office. The outer hip musculature is designed to provide hip, and lower back stabilization during running. When there is pain or tightness at the outer hip, the stability at the hip and lower back is compromised. This in turn can create abnormal stress into the hip, outer hip muscles, lower back, the knee, and even the lower leg/foot. The following conditions cause outer hip pain and dysfunction:
Causes of Outer Hip Pain
- Glute Medius Muscle Strain
- Tensor Fascia Latae Strain
- Gluteus Medius Tendinopathy
- Trochanteric Bursitis
- Iliotibial Tract Syndrome (IT Band Syndrome)
- Sciatic Nerve Entrapment
As mentioned above, the out hip plays a role in lower back and hip stability. If the outer hip is painful or dysfunctional the following conditions may also be present:
- Low Back Pain
- Facet Joint (Lower Back Joint) Irritation
- Hip Impingement
- Knee Tracking Issues
- Outer Knee Pain (IT Band Syndrome)
- Shin Splints
- Plantar Fasciitis
Evaluation
It is important to be evaluated by a running doctor and sports chiropractor. We will help diagnose your outer hip pain and any potential compensatory injuries that may be occurring simultaneously. A combination of range of motion, orthopedic, functional movements, and strength/endurance tests will be used to pinpoint the exact cause of your pain.
Gait Analysis
We currently offer at home gait analysis for current patients. After being evaluated in our office, if it is deemed necessary, we have our patients video tape themselves running on a treadmill and send it back to us for evaluation. For outer hip pain, many runners with outer hip pain run with what is known as a cross over gait. Check out our previous blog posts here on what a cross-over gait consists of.
Potential sites for injury with cross over gait
Treatment for Outer Hip Pain
Active Release Technique is an excellent tool for helping runners with outer hip pain get out of pain quickly. A targeted home rehab approach is then prescribed b our running doctor as a way to prevent the injury from coming back again. Schedule with us today at our Mission Valley, San Diego running injury clinic today!
The Running Clinic Certification
Congratulations to Dr. Travis Rose, DC CCSP for successfully completing the course in “New Trends in the Prevention of Running Injuries”! This course, taught by The Running Clinic, teaches health care providers about the latest methods to treat and manage running injuries. Dr. Rose is currently the only healthcare provider with this certification in Mission Valley, San Diego.
The following is a quick Q and A with Doctor Rose regarding running injuries.
Q: Having taken this latest course, put on by The Running Clinic, what were the main takeaways to prevent running injuries?
Dr. Rose: The main takeaways for injury prevention and increasing running efficiency were the following: 1. Run with a cadence between 170-180 steps per minute, 2. Limit the up and down motion while running (decrease vertical loading associated with injury), and 3) Use as little of a shoe as possible as this allows you to run more naturally.
Q: Was there information that surprised you or went against conventional running information?
Dr. Rose: The biggest “eye opener” was the fact that there is zero research to support prescription of specific shoes for specific types of feet. Many people put their trust in companies to tell them which shoe to buy based on treadmill analysis. Unfortunately there is research that shows that shoes don’t limit pronation like they claim to do. So why give somebody a big bulky shoe when it doesn’t do what it is designed to do? Instead, work on the items listed above and become a better runner!
Q: What is the biggest cause of injury in runners?
Dr. Rose: It is when a runner changes something. For example, a runner runs 25 miles per week, same distances for each run. But then decides to run an extra 10 miles one week. That change in volume is what will likely cause an injury to pop up. Another example is always running on concrete or hard trails, then deciding to run 10 miles on soft sand. The body was not ready to support a long soft sand run and an injury occurs.
Q: There is a lot of information for exercises online to help improve running technique, can a runner do home exercises and fix their running flaws?
Dr. Rose: Unfortunately no. I used to be under that assumption when I was an injured runner. I would get frustrated when I would do a ton of strength exercises and core work to then run 2 miles and have that all too familiar pain come back. Running gait needs to be corrected to take strain off the injured area. Using myself as an example, I suffered from repeated shin splints due to cross over gait. It did not matter how much glute or calf strengthening I did because once I ran incorrectly again, the tendon would get overloaded and I would be back to square one. Once I learned to run with a wider step width and have a faster turn over (faster cadence), my injury went away almost immediately and I was able to slowly build back up.
Q: Any other advice on running injuries that you learned?
Dr. Rose: When in doubt, get it checked out. Running should be fun and injury free. I hear too many stories from patients about how tight and sore they are after every run. Or that pain is something “you deal with as a runner”. Not true! Get evaluated by a running doctor who can get your gait back on track. If there is not a running doctor in your area, there are a few pieces of wearable technology that can help. One being Lumo Run which gives feedback on cadence, vertical bounce, hip drop, hip rotation, and braking force. If you already run with a running watch, usually they have features that you can use (like cadence) to start really emphasizing proper technique.
Dr. Travis Rose DC CCSP and Dr. Kevin Rose DC DACBSP are Chiropractors trained to treat a wide variety of sport related injuries. Schedule a visit at our Mission Valley, San Diego office!
Benefits of Sports Chiropractic
Sports Chiropractic Benefits
In general, chiropractic care is excellent for treating many different muskuloskeletal conditions. Many people also seek sports chiropractic care to recover from sport related injury, improve sport performance and avoid potential re-injury through regular maintenance visits. Unfortunately, not all chiropractors are trained to specifically diagnose and treat sport related injuries. If you are seeking care for a sports injury, it is important to know how to find a chiropractor who specializes in treating sport injuries.
Sports Chiropractic Board Certification
There are two main sport chiropractic certification courses that chiropractors can take after graduating chiropractic college. Both certifications are governed by the American Chiropractic Board of Sports Physicians (ACBSP). The first certification is a Certified Chiropractic Sports Physician® (CCSP®) which is a 100 hour post graduate program designed to educate chiropractors in the most common sports injuries and best practices to treat them. Successful completion of the program requires a passing score of 250 question multiple-choice questions. The second certification is a Diplomate American Chiropractic Board Sports Physicians® (DACBSP®) is a continuation of the CCSP® program with an additional 100 hours of field training with a research project, and requires successful completion of both a written and practical examination. A sports chiropractor will have either the CCSP® or DACBSP designation behind their name.
Treatment Types
A sports chiropractor is trained in many manual and passive therapies to help an athlete recover from injury and prevent future injury. Our Sports Chiropractors at our office in Mission Valley offer the following therapies and modalities:
- Joint manipulation/mobilization– Restores proper range of motion and function to an injured joint.
- Muscle Stimulation– Electricity is transmitted via pads to the muscles surrounding the injured area. This helps loosen muscles, and increase blood flow to the area.
- Active Release Technique– Active Release technique is the “gold standard” in soft tissue treatment. It helps break down scar tissue that developed from acute trauma or chronic micro trauma to a structure.
- Graston Technique– Graston utilizes a set of stainless steel instruments to break down scar tissue in the muscles and the fascia that surrounds the muscles.
- Therapeutic taping– RockTape is used in our office to promote body awareness in a dysfunctional area and to support injured tissues during athletic competition
- Therapeutic exercise– Flexibility, mobility, strength, endurance, etc. exercises are given to each patient for specific goals in the treatment.
- Training advice– A progressive return of the athlete to their sport is vital for the full recovery from injury.
Sports Chiropractic at Peak Form Health Center Mission Valley
Our sports chiropractors at our Mission Valley office are board certified to treat sport related injuries. We treat athletes of all abilities, from the weekend warrior to the professional athlete. We are also athletes ourselves, and understand the importance of feeling your best for optimal performance. Our office is conveniently located off the Texas Street exit in Mission Valley. Please schedule today to get your training back on track and perform at your highest level!
Dr. Travis Rose, DC CCSP (Left) is an accomplished Ironman Triathlete. Dr. Rose successfuly completed the Ironman World Championship in Kona Hawaii 2017.
Dr. Kevin Rose, DC DACBSP (Right) is a former professional baseball player. Dr. Rose pitched for the Philadelphia Phillies organization.
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Our Office
Peak Form Health Center
2635 Camino del Rio South, Suite 301
San Diego, CA 92108
TEL: (619) 818-4306