Jon MacNider can't remember exactly what mile he was on when his back broke.

A lifelong runner-turned-high-school-track-coach, MacNider, was out for a run with his team when, "something popped, it felt like someone had shot me and I didn't know what it was."

But, he had his team to consider.

The state championship was fast approaching and the young runners guided by MacNider needed their coach's counsel and support. So, true to his tough, athletic roots, he put his pain—which was sometimes so severe that he couldn't breathe—on the back burner and kept coaching, running and inspiring for several weeks.

Increasing agony finally sent him to a chiropractor who, after a series of tests, informed MacNider that he had fractured his spine due to advancing osteoporosis.

Osteoporosis: painless but problematic

Osteoporosis is a disease which gradually causes a person's bones to lose density and become weaker and more prone to fracture. One in two women and one in four men over age 50 will break a bone as a result of osteoporosis, according to the National Institutes of Health.

Osteoporosis is also a painless ailment, making it problematic to diagnose. "You can't feel your bones thinning," says Tom McNally, M.D., an orthopedic surgeon with Suburban Orthopedics, just outside of Chicago, Illinois.

MacNider was certainly unaware of his decreasing bone density. "I had no idea I had osteoporosis—I was only 56 at the time. I thought there was no way I had fractured my spine."

McNally say that the only way to gauge a person's bone health is by administering certain diagnostic tests, including a dual-energy x-ray absorptiometry (DEXA) scan and traditional x-rays.

Exercise as treatment for osteoporosis

Medications, adhering to a bone-healthy diet and engaging in regular exercise are all part of the typical treatment plan for a person with osteoporosis.

Each of these elements is important in its own right, but exercise is especially essential for seniors because it helps reduce fall risk while strengthening bones.

Physical therapists play a vital role in in helping construct a successful exercise program for osteoporosis sufferers, says Linda Rizzo, M.S.P.T., the physical Therapy Clinic Coordinator at Magee's Watermark Outpatient facility in Philadelphia, PA.

Helping a person maintain their bone density and preventing future deformity are the primary goals when dealing with the disease, according to Rizzo.

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Here are a few guidelines for an effective osteoporosis exercise program:

  • Check with a doctor: "Especially if you're over age 65, jumping into an exercise program is not a wise thing to do without asking your doctor," McNally says. "Different stages of your life carry different risks that are important to be aware of." According to Rizzo, working with a physical therapist can help you understand the important considerations of exercising with brittle bones, including: the importance of maintaining good body posture, how to prevent falls and what movements may cause fracture (motions that cause abdominal twisting or flexion).
  • Start slow: Even after a doctor gives the all-clear, a person suffering from osteoporosis needs to be careful and gradually ramp up their level of physical activity. Begin with taking brief walks (either on dry land, or in the water for extra resistance) or cycling on a stationary bicycle for 15-30 minutes.
  • Mix it up: There's no one miracle exercise program that people with osteoporosis must adhere to. Instead, Rizzo and McNally suggest engaging in a mixture of cardiovascular conditioning (walking, biking), strength training (using stretch cords or seated, with light hand weights), and flexibility exercises (yoga, tai chi, Pilates).
  • Don't forget about your diet: According to chiropractic physician and author of, "The Whole-Body Approach to Osteoporosis," Keith McCormick, it's especially important to remember the role that diet plays in facilitating good bone health. "Nutrition really is the basis for making bones healthy again," he says. Following a well-rounded nutrition regimen can ensure that you have enough energy to exercise. It's also vital to make sure you eat foods that are rich in calcium--an especially critical component for building stronger bones that your body cannot produce by itself. Calcium can be found in a variety of foods, including almonds, milk, cheese, green, leafy vegetables (broccoli, bok choy), and calcium fortified cereals and juices.
  • Know your options: If you do sustain a fracture, whether while working out or during the course of your daily routine, there's no need to panic—just be aware of your options. Medications, rest, braces and surgery are all effective ways to treat breaks, according to McNally. "Getting a person with osteoporosis back on their feet as soon as possible is important for preventing additional bone loss," he says.

A hard-won lesson in respecting your limits

After undergoing kyphoplasty—a surgical procedure that uses bone cement to repair a fracture—MacNider was up and running in time to take his team to state.

"The championship meet was my last hurrah as a coach. I just wanted to be running alongside the team when they won," he says. "After my back broke, I was like, ‘Please, don't take this away from me.' To be able to be there, in spite of my fracture, was the realization of a lifelong dream."

What's coach MacNider's exercise advice?

If something feels painful or wrong, don't ignore it—go see your doctor. And, don't be afraid to take a day off if you need it.

"My philosophy is one day at a time. If I get a run in today—that's great. If I don't, that's okay too," he says. "I have to be smarter about my limits now because I want to still be able to run when I'm 90."