Two years ago, Jean Hoepfel was just starting out for a jog when she tripped over a piece of metal and fell hard onto the sidewalk. The 68-year-old could tell immediately that she’d broken her arm. Amid a rush of adrenaline, she drove herself to the emergency room, where she was treated and referred out for physical therapy at Memorial Hermann IRONMAN Sports Medicine Institute.
“I was so angry,” Hoepfel, now 70, recalled. “I’ve been active my whole life, and I don’t even have osteoporosis.”
But the incident shook her. How could she avoid this—or worse—in the future?
The answer, it turns out, was weight training.
A growing body of research shows that physical activity involving weight-bearing exercise can improve muscle mass, strength and balance, increase bone density and also reduce the risk of developing osteoporosis. One in two women will break a bone in their lifetime due to osteoporosis; the incidence is greater than that of heart attack, stroke and breast cancer combined, according to the National Osteoporosis Foundation. And a 2014 study published in the Journal of Family & Community Medicine found that weight-bearing exercise programs increased bone mineral density more than non-weight-bearing exercise in patients ages 60 to 67 who already had osteoporosis.
“As we age, we literally need to lift heavy things,” said Brian Duncan, a physical therapist and director of human performance and residency programs at Memorial Hermann IRONMAN Sports Medicine Institute. “In our 50s and 60s, we start to rapidly lose strength unless we’re providing the body a stimulus, and if we do that, then the body reacts based on the amount and the intensity of our stimulus.”
Duncan explained that while most individuals understand the concept behind growing muscle, they don’t realize that the same principle applies to maintaining bone strength.
“People think of muscles as reacting to stress—like if I do a bunch of bicep curls, eventually my biceps are going to perform better, and then if I keep going and I eat enough, they’re actually going to grow in size, or what we call hypertrophy,” Duncan said. “Our bones and our cartilage react in a somewhat similar manner. Your bone doesn’t hypertrophy, but it becomes more dense, and cartilage and tendons become better at handling a load, so they are less likely to rupture or fail.”
After completing her physical therapy, Hoepfel wanted to begin her weightlifting journey with a trainer whose expertise could safely guide her through the gym. Her goal was to maximize benefit without injuring herself. As a lifelong runner and professional exercise epidemiologist, she knew the importance of doing it right.
Hoepfel engaged the help of Chris Slocum, a senior performance coach with Athlete Training and Health and Memorial Hermann IRONMAN Sports Medicine Institute.
“I wanted to work with somebody who was really well-qualified, who had their master’s degree in exercise science and all the top-tier certifications,” Hoepfel said. “It’s got to be under supervision, that’s the only safe way to do it, and here you have physical therapists and athletic trainers, so it really is the ideal situation.”
For the past two years, she has shown up at the Memorial Hermann IRONMAN Sports Medicine Institute’s Human Performance Lab three times a week for bench presses, sled pushes, bent over barbell rows, pull-ups, battle ropes, triceps pushdowns and medicine ball slams. She has even worked up to a 190-pound deadlift, a powerlifting exercise in which an individual lifts a loaded barbell off the ground to her hips, then slowly lowers it.
“She doesn’t go that heavy all the time, but she was very proud of that; I was very proud of that,” Slocum said. “It was a big statement.”
An even bigger statement? Hoepfel’s dual-energy X-ray absorptiometry scan—known as a DXA scan—which measures bone mineral density. Her measurements have improved since she started lifting.
“The bending and compressing forces tell your bones, ‘Hey, we need to be stronger, we need to stay dense,’ and we see those changes over the span of a year in the DXA scans, particularly with women,” Duncan said.
By using free weights under the supervision of a trainer rather than simply engaging machines at a gym, Hoepfel is also maintaining her balance, which becomes increasingly important as individuals age.
“With free weights, we’re also training the nervous system, so our ability to react and our reaction time improves,” Duncan said. “What’s particularly important is that when you stumble going up the curb or hit a crack in the sidewalk, can you get your foot out in front of you in time to maintain your balance? And then if you do, are you strong enough? Can you initiate a rapid muscle contraction and develop force rapidly enough so that you don’t collapse? Falls are very dangerous, especially the older people get.”
Free weights, Duncan added, help an aging body expect the unexpected.
“As we age, a lot of times we don’t go out and kick a soccer ball, we don’t do things that are somewhat unpredictable and so when something unpredictable faces us in life, we struggle to react to it,” Duncan said. “When training with free weights, while it’s not unpredictable, there’s a little more of that unpredictable nature to it.”
In addition to launching a new exercise routine, Hoepfel met with a sports dietitian at the Human Performance Lab to discuss the importance of eating adequate protein. While it won’t build muscle or strengthen bone on its own, the diet will complement the weightlifting as she works to stave off osteoporosis. Her main goal, she said, is to embrace exercise and nutrition over medicine.
“I don’t take any drugs at all,” she said proudly. “Why would you want to take a drug with side effects when you can prevent doing that by changing your lifestyle?”
It’s a good question—and one many patients, especially those marching past middle-age, should ask their doctors.
“Exercise is something you have to do the rest of your life,” Hoepfel said. “We all have 24 hours in a day, and in my age group, a lot of women may not be gainfully employed outside the home anymore, so we have the time. If you have time to go to book club or to start quilting or knitting, you have time to go to the gym.”
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