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INDIANAPOLIS--Abdominal crunches, sit-ups, and other common exercises that bend the spine can cause back pain and even spinal fractures, according to physical therapist Sara Meeks in remarks prepared for the annual meeting of the American Physical Therapy Association.

"The results of these exercises can be catastrophic," said Meeks, chair of the APTA's special interest group on osteoporosis, and author of Walk Tall! An Exercise Program for the Prevention & Treatment of Osteoporosis. "Bending forward compresses the spine. Spinal vertebrae that have been weakened from bone loss can crush or break easily."

Meeks says that most instructors and personal trainers are not aware that crunches, toe touches, and other flexion exercises are harmful to many people. Research has shown that they can cause back fractures due to compression of the vertebrae.

Meeks, a geriatric clinical specialist, says she "considers everyone at risk until a bone density test shows normal bone mass." She has developed a program for safely building bone and muscle in everyone, even those who have osteoporosis. The program also improves posture and balance, relieves back pain, and leads to weight training at the gym.

"It's frightening that most people with low bone mass are not aware of it," Meeks says. "They think osteoporosis is a disease that only affects older Caucasian women. But my patients include children, young adults, men, and people of all ethnic origins."

She is especially concerned about senior centers, where exercise classes are usually done in the seated position. Sitting compresses the spine, and risk of fracture is increased by bending forward.

Osteoporosis, a condition characterized by the progressive loss of bone density, results in weak, fragile bones that break easily. It is a major health threat to over 28 million Americans. For more information, visit

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