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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
Is Running BAD for your discs?
Running and Your Spine: A New Look at Intervertebral Disc Health
There’s a common myth that running is bad for your back. But a new systematic review published in Sports Health tells a different story. This review combined 13 studies with 632 participants to investigate how running affects the health of intervertebral discs—the cushions between the vertebrae in your spine.
How Running Affects Your Spine
The review looked at two types of studies: some measured how running affected spinal height, while others used MRI to observe changes in disc composition. Here’s what the research found:
- Temporary Compression: Running causes temporary compression of the discs. This means that during a run, discs lose some water content and slightly shrink in height.
- Supercompensation Between Runs: After the run, your discs supercompensate by drawing water and glycosaminoglycans back in. These are important for keeping your discs hydrated and healthy. Over time, this process can actually improve disc health.
- Stronger, Healthier Discs: Habitual runners were found to have healthier and stronger discs than non-runners. So rather than damaging your spine, regular running appears to build resilience in your intervertebral discs.
Takeaways for Runners
This study is great news for runners and those hesitant to start due to back pain concerns. Here’s what you should know:
- Running is Safe for Your Back: The temporary disc compression during a run is completely normal and healthy. The key is the recovery between runs, where your body replenishes lost fluids and nutrients.
- Regular Running Builds Stronger Discs: Over time, the cycles of compression and supercompensation make your discs more resilient, reducing the risk of spinal issues.
- No Need to Fear Running: If you’ve been avoiding running due to fears of back injury, this study shows that running is not only safe but can actively improve your spinal health.
Incorporating regular runs into your routine can be a powerful way to maintain a healthy back. So, lace up those running shoes and start reaping the benefits for your spine!
Reference: Shu D, Dai S, Wang J, Meng F, Zhang C, Zhao Z. Impact of Running Exercise on Intervertebral Disc: A Systematic Review. Sports Health. 2024;0(0). doi:10.1177/19417381231221125
Manage Triathlon Injuries and Training
Triathlon season is in full swing here in San Diego. With local races nearly every weekend, many triathletes have trouble balancing time between training, family, jobs, and racing competitively. Many triathletes begin to notice nagging triathlon injuries that are consistently getting worse as the season continues. Should they take a break to heal? Maybe. It depends on the athlete, their goals, and how they take care of their bodies during the season. Below are the top 5 triathlon injury management techniques we recommend to our athletes.
- Sports Chiropractic Care– We may be slightly biased here but this is the reason why we do what we do. We offer the best manual therapy and exercise methods to keep our triathletes swimming, biking and running. Triathlon injuries are managed effectively with a combination of Active Release Technique, Graston technique, joint manipulation and rehabilitative exercise. Have you seen or are you currently seeing a Sports Chiropractor? Sports chiropractic utilizes all the techniques previously mentioned as well advice on training through the injury; you can read more about the difference between a general chiropractor and a sports chiropractor here: Benefits of Sports Chiropractic.
- Maintain a Self Care Program– After being screened by a Sports Chiropractor and prescribed exercises, it is important that you do them! A daily routine of foam rolling, stretching, strengthening to the areas that have been causing injury. Daily is best but if you can squeeze in 3 times per week to manage triathlon injuries, you will see positive results.
- Sleep– It is important when training to stick to an appropriate sleep schedule. Getting quality sleep allows your body to regenerate after you break it down during hard training. In a nutshell, deep sleep allows growth hormone and other rebuilding hormones to be released which will allow you to bounce back faster. If sleep is constantly sacrificed for more work, or more training, the body will become catabolic and slowly break down. When trying to manage triathlon injuries, if you do not allow the body to rebuild, the injuries will never fully heal.
- Nutrition- Proper nutrition gives the building blocks to your body to allow for proper recovery. The more high quality fuel you give yourself, the high quality output and recovery you will get. Just like a sports car, you will not put regular unleaded gas in tank, you will put premium gas in to get the most out of the high performance engine. In general, high quality carbohydrate (lots of veggies, whole grains), lean proteins, and plenty of healthy fats are what you want to strive for! After exercise sessions, especially high intensity interval sessions, drink a mixture of carbohydrate and protein to refuel the glycogen stores in the muscles.
- Periodization- We see countless athletes in our office who suffer from over training syndrome. A lot of it stems from the fear of not doing enough to get ready for a race or losing too much fitness between exercise sessions. With a proper training plan in place, you will become fitter, faster, and having to manage triathlon injuries will become a thing of the past. In short, get an experienced coach, or at the very least get a training book and follow it.
Those are the top 5 tips to help manage triathlon injuries and avoid new injuries moving forward. We recommend getting a physical assessment by one of our sports chiropractors located in Mission Valley, San Diego. We are located near the neighborhoods of Hillcrest, Serra Mesa, Clairemont Mesa, La Mesa, Pacific Beach, Ocean Beach, and Point Loma. Our Sports Chiropractors are trained in musculoskeletal diagnosis and treatment, running gait analysis, bike fitting, and can order the proper diagnostic tests if necessary (MRI, X-ray, etc.).
Dr. Travis Rose, DC CCSP and Dr. Kevin Rose DC DACBSP are both avid triathletes and are passionate about helping triathletes manage triathlon injuries. Knowing first hand how frustrating a nagging injury can be, both Dr. Travis and Kevin utilize Active Release Treatments and chiropractic treatments to keep them healthy and performing at their best!
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!
Anterior Knee Pain and Running
Pain in front of the knee is a common complaint that runners seek advice for from a running doctor. There are many conditions that can cause anterior knee pain including:
- Patellar tendinitis/tendinosis
- chondromalacia
- Patella tracking issues
- Quadriceps strain
- Hip flexor strain
- Capusular ligament sprain
- Meniscus injury
- Fat pad syndrome
- Osgood Schlatter’s disease
It is important to seek treatment from a sports physician and running doctor to get a correct diagnosis, and begin correct treatment immediately.
What to expect at your appointment
At our Mission Valley office, our running doctor will take a thorough history of the running injury. After the history is completed an exam will occur which will include some or all of the following: range of motion, orthopedic, neurologic, functional movement, and strength/endurance tests.
Gait analysis is another important aspect for certain running conditions. We currently offer remote gait analysis where current patients can take a treadmill video of themselves running, then email it to our running doctor for evaluation. General recommendations for running technique can be found on our blog here: Increase your Cadence, and Improve Running Posture
Treatment for anterior knee pain
A combination of Active Release Technique, Graston Technique, and a home exercise program resolves many cases of anterior knee pain. We see significant results within 4-8 visits. Our goal is to our runners back to running pain free as soon as possible and have exercises to do to prevent the injury from reoccurring.
If you have been dealing with anterior knee pain during your training, please call our Mission valley office to schedule today. Our running doctors are certified to treat running injuries and get you back to running pain free fast!
Dr. Travis Rose DC is a certified health professional through The Running Clinic. Both Dr. Kevin Rose DC DACBSP and Dr. Travis Rose DC CCSP have treated hundreds of runners including Boston marathon qualifiers, and Olympic trial marathon runners.
Cross-Over Gait Correction
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How to Fix a Cross-Over Gait
The best way to work on cross–over gait is to perform running drills! Many runners are simply unaware that they run with a cross-over gait. Specific running drills to address a this type of gait will significantly improve running efficiency and decrease risk for injury. At our Mission Valley sports injury clinic, we stress the importance of running drills to all of our running patients.
There are three main drills that significantly reduce cross-over gait: increasing cadence, running wider, and activating the hip stabilizers while moving through gait.
- Cadence– I talk extensively about cadence in our blog post here. In a nutshell, by increasing running cadence, there is less time for your feet to travel across midline. Slow cadence allows more time for your feet to creep over midline.
- Run wide using a track line– Run around a track with lane lines (or white bicycle lane line). Run so the line is in the middle of your body. The goal is to land with the inner right foot touching the right outer border of the line and vice versa for the left foot. It may feel like you are running VERY wide but with practice it will feel more normal. Practice this drill on the straight away on the track about 4-6 times. Over time you will start to run wider naturally.
- Walking hip hikers– The goal is to activate the gluteal muscles, and hold while taking a step. This builds the mind body connection to the hip/core muscles while moving during gait. Watch the video below for a detailed look at the walking hip hiker.
What About Increasing Core Strength?
Core and gluteal strengthening drills alone will not magically get rid of a cross-over gait; again working on correcting the gait will do that. That being said, working on the core and gluteal muscles in conjunction with gait retraining, will support proper running gait. The stronger the supporting muscles are, the more capable they are to resist fatigue during workouts and races. Some runners have no issues with their gait for runs between 3 and 10 miles. Once long runs increase to the 12, 14, 16 mile range, gait issues begin to occur. In this scenario, strengthening workouts to the core and gluteal muscles are paramount to avoid running form breakdown during longer runs. Here are a few of our favorite core and gluteal strengthening exercises:
Gluteal bridge
Lay flat on your back, knees bent, and feet flat on the floor just wider than hip width apart. Brace your abdomen to engage the core. Press through your heels to lift the pelvis upward until it is in line with the knees and shoulders. Avoid arching through the back. Add a band around the knees for more gluteal activation. Sets: 3 Reps: 10-20
Monster walking
Place a medium resistance mini-loop band
Crab walking
Place a medium resistance mini-loop band
Dead bug
Lay on your back, with your knees and hips bent to 90 degrees and arms held straight in front of shoulder. Brace your core by squeezing back and abdominal muscles. Slowly lower one leg towards the ground, resisting the back from arching up off the ground. Alternate legs keeping a slow pace the entire time. If this version of the dead bug is too difficult, keep the knee bent when moving the leg and perform heel taps. Sets: 3 Reps: 10 per leg
Side plank
Begin by laying on your side with the elbow tucked underneath the shoulder and feel sacked. Keep the body as straight as possible and lift the pelvis off the ground. Focus on contracting the muscles on the side closest to the floor. Perform the side plank on both sides. Sets: 3 Reps: 1 Hold: 30-60 seconds
Self Myofascial Release to the Gluteal muscles
Take a look at the video below. By using a lacrosse/massage ball
These strategies help with correcting a cross-over gait. If you are experiencing shin, knee, hip, back, or foot pain from running, I highly recommend getting the injury evaluated. A targeted approach to your specific injury can prevent time lost to injury. At our Mission Valley office, we perform Active Release Technique, Graston technique, and rehabilitative exercise to keep our endurance athletes competing pain free!
Preventing Soccer Injuries
Soccer is an excellent way to build endurance, improve speed and stay in shape, all while enjoying being a part of a team. Nevertheless, soccer does involve quick start-and-stop motions and physical contact, which can lead to injury. The risk of injury is no reason not to play soccer however. Players simply need to be aware of the risks and know what steps they can take to play as safely as possible.
Sprains and strains are very common injuries in soccer, with varying forms of severity. Other injuries could include stress fractures and muscle strains from repeated overuse and direct blows to the body. Soccer players are also prone to shin splints, patellar tendinitis, and Achilles tendinitis. These injuries occur in the lower extremities, whereas neck sprains and concussions are common in the upper extremities. Injuries to the head, neck face are sometimes unavoidable. Just like wrist sprains, fractures and shoulder dislocations are unfortunately common due to falls and player-to-player contact.
The best place to start in prevention of these injuries is to have a pre-season physical examination and follow your doctor’s recommendations during the season. Using well-fitting cleats and shin guards is important in prevention. Molded and multi-studded cleats may be safer than screw-in cleats. Stay hydrated when out on the field and maintain proper fitness throughout the sport’s season. Injury rates are known to be higher in athletes who have not adequately prepared physically and remember to stretch adequately before and after your time on the field. After being inactive in the sport, progress gradually back to full-contact soccer through activities such as aerobic conditioning, agility training, and strength training.
Some of the greatest advice in preventing soccer injuries is to avoid overuse injuries. When it comes to the health of your body, more is not always better. Many sports medicine experts believe that it is helpful to take at least one season off each year. Although it’s hard, try to avoid the pressure that is now forced on many young athletes to over-train. Always listen to your body and decrease training time and intensity if pain or discomfort continues to increase. It will reduce the risk of injury and help avoid “burn-out.” Most injuries can be prevented to an extent. The last thing anyone wants to do is put an early end to his/her soccer career because they didn’t listen to their body and take care of themselves. As always, speak with a sports medicine professional if you have any concerns about injuries or soccer injury prevention strategies.
In order to keep kids and adults out on the field long-term and enjoy the sport of soccer, injury prevention, early detection, and treatment are significantly important.
Debunked Workstation Myths
There are many commonly accepted guidelines for a safe and comfortable workstation that are actually myths. Some postures and furniture can actually harm you and lead to discomfort, if rigidly followed. These debunked workstation myths will help you to manage the health risks of your home or work office:
Debunked Workstation Myths
Myth #1: Sitting correctly at a desk will eliminate discomfort and reduce injuries.
In actuality, sitting with picture-perfect posture for long periods of time can actually lead to more discomfort, as it is extremely fatiguing. It can also lead to joint-pain and muscle strain because the torso is placing constant pressure on the lower disks in your back. Even in the ergonomically correct position, your arms and hands can still incur injuries. Any time you are sitting or standing in a static position, you increase the risk of prolonged physical conditions. To avoid any injuries at your workstation, try alternating between sitting and standing while working. Choose dynamic positions that will increase blood flow and alleviate stiff muscles. Also, include small rest breaks and stretch frequently to help avoid injuries.
Myth #2: Always sit upright, and never recline at the workstation.
4 out of 5 workers would prefer to recline their chair slightly when working. In fact, a reclined position creates much less fatigue than sitting upright. Being slightly reclined is also much easier to maintain and alleviates gravitational pressure on the lower disks in the back. However, be cautious to avoid slouching, which can cause injuries from a lack of sufficient back support.
Myth #3: Ergonomic chairs are one-size fits all.
A single chair size won’t fit every shape and size. Women are shaped differently than men, and their hips are generally wider. Men usually have longer legs and consequently will need a deeper seat. There are many different body types, and each one requires a different seating solution. In addition, different chairs are appropriate for different tasks. When selecting an ergonomic chair, consider the tasks you will be doing and your body size and shape.
Myth #4: Adjust the chair height according to the table height.
Unfortunately, this is not always the case. Although it may seem like a simple solution, this does not always result in a safe sitting position. Instead, keep your chair at the appropriately adjusted position for your body type. If your chair is too low, it can add extra pressure to your legs and back. If the chair is set too high, it can result in discomfort from your feet dangling. You can get a footrest to avoid this, but the best way to avoid injuries is to adjust the table height or the task at hand.
Many people don’t realize that these commonly believed workstation postures are in fact myths. By educating yourself with the above recommendations, you can avoid unnecessary workstation injuries and added discomfort.
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Peak Form Health Center
2635 Camino del Rio South, Suite 301
San Diego, CA 92108
TEL: (619) 818-4306