Cover image for The silent thief : osteoporosis, exercises and strategies for prevention and treatment
The silent thief : osteoporosis, exercises and strategies for prevention and treatment
Bohme, Karine.
Personal Author:
Publication Information:
Buffalo, N.Y. : Firefly Books, [2001]

Physical Description:
xiv, 225 pages : illustrations ; 24 cm
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Call Number
Material Type
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RC931.O73 B64 2001 Adult Non-Fiction Non-Fiction Area

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Are you at risk? Osteoporosis is often called "the silent thief" because bone loss occurs without symptoms. Today, 15 million Americans suffer from osteoporosis and, with the increasing proportion of older people in the population, this disease is on the increase. Although osteoporosis commonly affects people over the age of 50, it can strike at any age.

The Silent Thief is an authoritative book for those with osteoporosis and are concerned with lessening the symptoms, as well as for those who want to prevent the onset of the disease. It fully explains osteoporosis, discusses hereditary and lifestyle factors that contribute to its onset, outlines dietary and supplementary options, and illustrates detailed exercise programs for prevention and treatment at any age.

Endorsements for The Silent Thief

"To read The Silent Thief is but half of the equation -- put its bone-building exercises into practice, and you'll recognize the full impact and great benefit of its wisdom."
- Miriam E. Nelson, Ph. D.,
School of Nutrition Science and Policy, Tufts University

"This well-written book is a gold mine of valuable information ..."
- Christine M. Derzko, M.D., F.R.C.S.,
Director of Midlife and Menopause Clinic,
St. Michael's Hospital and Associate Professor, University of Toronto

Author Notes

Karine Bohme is a personal trainer and fitness consultant who specializes in designing exercises specifically for osteoporosis. She is certified by the American Council on Exercise.
Frances Budden, MD is the Director of the Community Osteoporosis Program at St. Joseph's Health Centre (Toronto), and practices at the Metabolic Bone Clinic, St. Michael's Hospital (Toronto)



Introduction Osteoporosis is the Silent Thief that steals away our bones. It is a degenerative disease that silently weakens bones over time, causing pain, loss of movement, and fractures, and, eventually, seriously affecting quality of life. Osteoporosis is insidious because it frequently goes unnoticed until the sufferer experiences a break or fracture. The disease, in women, often manifests around menopause, and so, with an aging female population the incidence of osteoporosis will rise unless preventative measures are taken. Eighteen million Americans are at risk for osteoporosis and 10 million Americans already have the disease. If you are a woman between the ages of 50 and 75 and have been diagnosed with osteoporosis, this book is definitely for you. If you are a man or woman of any age, active or not, who is concerned about bone health, this book is also for you. You can treat osteoporosis if you have been diagnosed with low bone density, or prevent the disease if your bone density is still in the normal range. As with other diseases associated with aging, prevention starts early. Early prevention can help with heart disease, joint stiffness, malnutrition and the symptoms associated with menopause. You can make changes now that will profoundly affect the health of your bones later in life. How This Book Came About As a certified personal trainer and fitness instructor, I have spent years designing programs to help my clients improve their levels of fitness. As the baby boomer population ages, the special needs of my clients have increased exponentially. To the many questions I had been asked over the years about exercise and its effect on osteoporosis, my response was typical: "Do weight training and weight-bearing exercises." It wasn't until I was hired by Dr. Frances Budden that I became interested in the relationship between osteoporosis and the positive effects of exercise on the disease. Dr. Budden was not only my client but is also an osteoporosis specialist at St. Joseph's Health Centre in Toronto. It was a collaboration made in heaven: Dr. Budden has a wealth of information about brittle bones and areas susceptible to osteoporosis. I have the physiological and biomechanical background to design exercises to strengthen those very areas. Dr. Budden referred many of her patients to me, and as my client base grew I became increasingly aware of the need for personal instruction and program design in this area. Wouldn't it be great, I thought, if every person with osteoporosis could have a personal trainer come to his or her home to demonstrate the most effective exercises to treat the disease? Wouldn't it be great if people without osteoporosis could learn and practice the exercises that would help prevent them contracting the disease? And so the idea for this book was born. How This Book Is Different Many books about osteoporosis are disease-focused, with minimal practical strategies offered for prevention and treatment. The Silent Thief takes a different approach. An exercise-focused book for the prevention and treatment of osteoporosis, it contains strategies you can implement to outwit the Silent Thief. Many of these strategies appear here thanks to the invaluable contribution of many knowledgeable and experienced trainers and physicians. The few osteoporosis books that contain an exercise section focus on non-functional exercises that are outdated. They provide only one exercise for even the most susceptible areas and no progressions. The Silent Thief teaches the importance of progression by providing a number of exercises, of various intensities, to challenge individuals at all levels. It teaches you that you can actually enjoy your fight against osteoporosis. How This Book Is Organized The Silent Thief is organized into three parts: Part A provides an overview of osteoporosis from a medical and preventive perspective; Part B contains diet and drug strategies to prevent and treat osteoporosis; and Part C, will help you use exercise to fight the disease. Chapter 1 gives you the medical perspective on osteoporosis, provides a scientific perspective on bone health and lists the causes and risk factors of osteoporosis. Chapter 2 focuses on the importance of calcium and Vitamin D in the prevention and treatment of osteoporosis. This chapter explains the roles that these two vital nutrients play in the health of your bones and suggests how to maximize your intake. The information contained here will help you to make dietary and supplemental choices that will mean longer life for your bones. Chapter 3 discusses other important nutrients that have a positive impact on bone health: magnesium, vitamin K, potassium, phosphorus and boron. Because soy and soy products contain chemicals that mimic the characteristics of estrogen, they play a vital role in skeletal health. This chapter provides you with the best ways to include these substances in your diet. Chapter 4 presents you with drug-based strategies to prevent and treat osteoporosis, and includes a discussion of the risks and benefits of hormone replacement therapy (HRT). Chapters 5 to 8 comprise the very heart of the book, as they focus on the positive impact of exercise and functional fitness on bone health. Weight-bearing exercise, resistance training and balance training -- the three most effective ways to strengthen bones and prevent falls -- are investigated in depth in this section. Karine Bohme -- Not long ago I was weak and sore all over. My husband, Jeffrey, couldn't stand the complaining so he gave me a birthday gift. A personal trainer -- Karine! As a result of the exercises she encouraged me to practice, I am no longer sore all over anymore. As a white, 55-year-old, postmenopausal, slight-framed woman, whose mother had a dowager's hump and a fractured hip, I am at high risk for osteoporosis. I learned that exercise and functional fitness are an approach I could take to prevent getting the disease. I am an internist and a geriatrician with a special interest in osteoporosis. In 1984, I did postgraduate training with the Bone and Mineral Group at the University of Toronto with Doctors Timothy Murray, Joan Harrison and other great and caring physicians. Most of my time was spent at the Metabolic Bone Clinic at St. Michael's Hospital, where I continue to see patients. I am also the director of the Community Osteoporosis Program with Education at St. Joseph's Health Centre, Toronto. I see the greatest devastation caused by osteoporosis caring for my geriatric patients after they have sustained fractured hips, wrists, arms, legs, backs and pelvises. These fractures cause pain, loss of independence, deformity, disability, reduced quality of life, and in about 20 percent of hip fractures, death. In 1984, our ability to diagnose osteoporosis was primitive and the treatment options were limited. But we've come a long way. In 2001, osteoporosis can be prevented, diagnosed and treated! The Bone and Joint Decade was officially launched by the United Nations in January 2000 as the decade of global research for preventative and therapeutic initiatives to improve the quality of life for people with osteoporosis, osteoarthritis, rheumatoid arthritis and spinal injuries. This is Karine's and my part toward advancing this initiative. Frances Budden, MD, FRCPC Excerpted from The Silent Thief: Bone-Building Exercises and Essential Strategies to Prevent and Treat Osteoporosis by Karine Bohme, Frances Budden All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

Table of Contents

Acknowledgmentsp. IX
Introductionp. XI
Part A An Overview of the Silent Thief
1 Understanding Osteoporosisp. 3
All About Bonesp. 4
The Science of the Silent Thiefp. 8
Osteoporosis: Are You at Risk?p. 12
Acute Vertebral Fractures: An Important Notep. 16
Men and Osteoporosisp. 17
Detecting the Silent Thiefp. 18
The Bare Bonesp. 23
Part B Outwitting the Silent Thief through Prevention and Treatment
2 The Bone Boosters: Calcium and Vitamin Dp. 27
Calcium: A Bone's Best Friendp. 28
Vitamin Dp. 36
The Bare Bonesp. 41
3 More Bone Boosters: Other Nutritional Strategiesp. 43
Soy: The Plant Estrogenp. 44
Bone-Enhancing Minerals and Vitaminsp. 45
The Bare Bonesp. 53
4 Drug Strategies to Prevent and Treat Osteoporosisp. 55
Hormone Replacement Therapy (HRT)p. 56
Selective Estrogen Receptor Modulators (SERMs)p. 62
Calcitoninp. 62
Bisphosphonatesp. 63
A Plan for Youp. 65
The Bare Bonesp. 67
Part C Outwitting the Silent Thief with Exercise
5 Exercise: The Magic Cure?p. 71
Key Components of Fitnessp. 72
Exercise and the Silent Thiefp. 75
Skeletal Fitnessp. 78
Exercise Frequency and Intensityp. 83
The Bare Bonesp. 86
6 Getting With the Programp. 87
Progressionp. 88
Investing in Exercisep. 93
Motivating Yourselfp. 95
Planning Your Workout Schedulep. 96
Knowing If Your Body Is Readyp. 97
The Bare Bonesp. 98
7 The Programp. 99
The Warm-Upp. 100
Resistance Trainingp. 101
Time Requirements of Workoutp. 102
The Excercisesp. 103
Resistance-training exercises-(section A)p. 104
Resistance-training exercises-(section B)p. 140
Weight-bearing or Impact Exercisesp. 174
Balance-training Exercisesp. 180
Stretchingp. 186
8 Functional Fitness for Every Movep. 191
Functional Fitness and Agingp. 192
Which Functional Exercises Do I Need?p. 194
Incorporating Functional Exercises Into Your Programp. 195
The Bare Bonesp. 198
Appendix 1 Movements to Avoidp. 199
Appendix 2 Getting "On the Ball": Safety Tips for Using a Stability Ballp. 200
Appendix 3 More Bone-Building Exercise Optionsp. 202
Appendix 4 Progression Training: Adjusting Your Workout Schedule for Maximum Benefitp. 204
Appendix 5 Osteoporosis Resourcesp. 208
End Notesp. 209
Glossaryp. 213
Indexp. 220