Osteoporosis & Exercise | Keeping Active the Safe Way

Osteoporosis affects over 1 million Australians! As the population of Australia enters into an “aging” era, the incidence and prevalence for the rate of Osteoporosis is on the rise.

Osteoporosis is referred to as ‘silent disease’. This is due to the lack of symptoms until an event such as a fall.

Considering this population subset, it can lead to a fracture. Common areas that we see here at Sport and Spinal Physiotherapy is hips, wrists, shoulders, vertebrae and ankles.

What is osteoporosis?

The disease causes bones to become brittle in nature. This equates to a higher risk of fractures compared to normal, heathy bones. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them.

This process results in a loss of bone thickness – either through bone density or mass. I find it surprising in the clinic that people have a very grave view of osteoporosis.

Yes, it is problematic if untreated. However, the gains in strength and balance can play a large factor in reducing the risk of a fall, thus reducing the role of osteoporosis in injuries.

Osteoporosis and Physiotherapy

As a physiotherapist at Sport and Spinal Physiotherapy, I often see many people with osteoporosis. How this works in a physiotherapy sense is that this is not usually the primary reason for a consult at the clinic.

Rather, they have had a fall at home and fractured something – for example, a wrist. After they have immobilized the joint and come out of a cast, this where we come into play:

How Can Physiotherapy Help with Osteoporosis

From experience, I know the best solution is a two-pronged attack

1. Get the limb in question moving. This involves specific movements to enable the joint to ideally re-gain the full range of movement. Stretching is a key component here. Furthermore, strengthening the associated limb and surrounding musculature is a feature. Essentially standard physiotherapy post-injury rehabilitation.

2. Target the osteoporosis. This is a multi-faceted approach. I analyse a client’s normal routine to understand what they like, where they can improve and to keep them motivated. With my role as a physiotherapist, it is crucial to provide reassurances and movement variety. By mixing up the exercises, the client becomes more engaged and energized.

In the clinic, it has be shown through various sources, that the most effective physical activity for an individual who has osteoporosis is to exercise at the highest intensity they can tolerate.

I am often astounded as to what some 80 year-olds can achieve! By making the activity or exercise tough but achievable, the goals for clients can often be met. If too easy, they loose interest. If too hard, they won’t bother with them.

 

Strong, Steady, Straight Exercises for Osteoporosis

A guiding principle that has been at the forefront of promoting exercise for people with Osteoporosis is found above. Strong indicates weight being exercises. This is to build healthy bones as they like a certain amount of force transmission.

Impact exercise is recommended to be kept to the lower side of things with those who have a previous history of fractures.

We also need to be strong in many different planes of movement. Bones need to be strengthened to be able to handle the rigours of everyday life. For instance, movements that include bending, pulling and/or pushing.

The balance component is a measure of being steady. Using unstable surfaces in the clinic, such as a wobbleboard, can mimic certain conditions we are likely to experience in the real world.

An example of this is bushwalking. We need to have a strong core, good flexibility and fast reaction time when bush walking.

The undulating nature of a trail can momentarily lead to a significant challenge on a person’s ability to remain upright and correct their body position.

Safe lifting techniques is a priority to be “straight.” This involves using the leg muscles for power, not rotating whilst lifting and to keep the spine straight (and neutral).

Likewise, a tailored program by one of our physiotherapists can determine what areas you need to uptrain.

 

How Often Should you Exercise with Osteoporosis

Osteoporosis Australia recommends regular exercise. Specifically, the minimum standard is three times a week, for at least 30 minutes.

This should involve a variety of activities, such as walking and resistance training. It should target a number of different boy systems – legs, arms and core.

Furthermore, incorporating into your daily regime is a good start. We all know stairs are better than the lift in terms of physical activity. Building habits take time. And patience!

Pilates for Osteoporosis

Fellow physiotherapist Jenna has written an extremely timely piece regarding the importance of core work

Pilates is a whole body workout. I structure my group classes to have a low impact on the joints but a high energy output. A strong focus is flexibility and balance.

Core re-training is a terrific way to build a solid base and foundation for any type of movement.

Test Your Calcium Levels

Osteoporosis Australia also recommends testing your calcium levels. As the body ages, the re-absorption of calcium is reduced. This is why we need to monitor this closely as the body uses calcium at a lesser rate during the normal ageing process.

Similarly, having a balanced diet is also key to keep minerals and vitamins to an optimal level.

Summary

In conclusion, Osteoporosis is likely to have a greater impact on the health of ageing Australians in the coming decades. Above all, we aim to keep you healthy and active.

In other words, movement is the key! Furthermore, your physiotherapist is an expert in movement patterns. By building a program tailored to you, the gains in strength, balance and general fitness are enormous.

 

Resources

“Strong, Steady and Straight – an expert consensus statement on Physical Activity and Exercise for Osteoporosis” – Jack March

Osteoporosis Australia