[KristasMom]

I know this is complicated, and maybe there is no good answer -- that's an answer too!
But, every doctor that I see says that exercise is the most important thing I can do to keep my health, and to enjoy the rest of my life. I am feeling a little trapped.
A little background - I've been around for a while - Lost about 45 lbs a few years ago, then had dental surgery, and stopped working out and eating well - gained 25 back.
About a year ago, I got back on track, and started lurking. Started water aerobics and lap swimming, as, hard to believe, but I was once an athlete, and I loved the feeling of moving effectively. About 20 yrs ago, I got aseptic necrosis from asthma steroids in the joint, and have no cartilege, so much of the weight was from inertia - knees don't hurt when you don't move!
Was diagnosed with osteoporosis, so started trying to add weights, but found the gym really daunting, and the overview of machines not real helpful. But started recumbent bike for cardio.
Got slammed with breast cancer, but found that concentrating on controlling my food helped me handle the anxiety. Lost 35.
Decided it was time to take care of myself, started with a knee specialist - she referred me to PT - they taught me a bunch of exercises to strengthen the knee - side leg lifts, front leg lifts, Nu-Step and other recumbent bikes for strength. Leg press - about 100 lbs + high reps, with machine set up to minimize back use. No lunges or squats, ever. Or at least until after replacement surgery. Loved it.
Took those exercises to a trainer at my health club, and we started adding upper body weight training with machines and free weights - I'm currently using 4s and 8s with high reps. I found that as I increased weights, I started getting pinched nerves in my back - so off to chiropractor. He loves that I'm exercising, but no working on obliques - he's worried that I keep throwing my hips out of alignment. Only temporary relief.
So, off to back specialist. He ordered lots of expensive tests - I have a middle-aged, out-of-shape back for which the best I can do is go to chiropractor. He highly recommends squats and lunges, no leg press, and minimal lifting above the shoulder. I should be strengthening obliques.
He'll write me a prescription for more PT, if I want it, and he recommends acupuncture if the pain is out of control.

What I have done this week - 2 30 min sessions on recumbant bike, 1 water aerobics class - swam 0.5 mile, 1 workout - most upper body machines with a low weight - reps at least 30 - abs machine, leg lifts, etc.

Muscles are feeling worked and happy. Everything else is feeling tender, and not in a good way. Chiropractor appt tonight. Knee has an ice pack on it. Lower back feels like I'm 20 yrs older than I am.

Any ideas what I should be doing, or where I should be going to ask for more help?
Thanks for your patience.

Sue

[mandalinn82]

When you were going to a PT, you felt good, right? Whoever you were working with managed to work with your body without exacerbating any of your other issues?

I'd say to go back to PT, explain all that is going on, and get a comprehensive program. It seems like individual doctors are giving you individual bits of advice based on their individual expertise...a knee doctor recommending exercises that are good for your KNEE without considering what they'll do for your BACK, a chiropractor recommending things to help your back that will kill your knees, etc. Someone aware of ALL of the issues, with experience working with all of them, would be really helpful, I'd think.

A well-rounded, experienced PT should be able to give you a program that addresses everything. Just make sure you cover all of the issues you've experienced at your intake visit.

One other word of advice - I think personal trainers are GREAT, but often extend out of their area of expertise and start acting like doctors. If you have a specific medical issue, a PT is the best one to treat that. Good personal trainers know this limitation and won't train people with medical conditions they don't have experience with, but advocate for yourself...until you have these issues worked out, I'd avoid working with trainers other than your therapist.

[Mel]

Wow! That's a daunting history My hat is off to you for your attitude.

As a trainer, I second what Amanda has said. Very few trainers have any knowledge of how to train people with chronic injuries or conditions, and in your case multiple conditions. For example, putting you on machines is probably doing nothing or little for your osteoporosis. Numerous studies have shown that for any bone mass increase, the weight has to be transferred down your spine, through your hips, and through your feet. In fact, there is more than one study that found that jumping 200 times per day is effective. The most effective exercises for the osteoporosis are the ones also the ones most likely to hurt your back: top loaded squats and overhead military presses. (I also have osteoporosis and have done a LOT of research.) But jumping is going to be dreadful for your knees and back.

If swimming feels good, do it It's great cardio exercise, and can also build some strength and endurance. It won't help your bones, but there really is something about moving through water that just feels great.

Hang in there!

Mel

[KristasMom]

Thanks so much for the thoughtful responses.

Madalinn - you're absolutely right. It's not fair of me to expect my trainer to act as my therapist. She works largely with older patients (she's also a very good nutritionist, and we have worked on fine-tuning my diet), and since I look younger than I am, and stronger than I am, it's easy for both of us to assume that I can do more than I realistically should.

Mel - I tried the other attitude - the I-hurt-and-it's-not-fair-and-I'll-just-sit-here-until-the-world-changes attitude. If it had worked, I would still be there. In fact, I'm a little ashamed that I stayed there as long as I did.

I do have a question, though - how did those researchers find enough people to study with osteoporosis who could jump several hundred times a day without their backs dying?

I am scheduling an appointment with the physical therapist. I like him, he's been doing this for a long time, and I think I can talk to him about what my body is going through.

Last night, just leg strengthening exercises, a little core, light arm weights. Tonight, water aerobics.

I'm going to take advantage of this self-improvement growth spurt, for as long as it lasts.

[WaterRat]

If swimming feels good, do it It's great cardio exercise, and can also build some strength and endurance. It won't help your bones, but there really is something about moving through water that just feels great.

I'll second this. I've just gotten back to swimming this fall and am really enjoying it. It's something I did all through college and grad school (I won't tell you how many decades ago that was ). It's a so much easier on my knees cardio, though I realize it's not giving me impact I need so I do some treadmill/elliptical too.