Osteoporosis and Physio

Osteoporosis is a degenerative condition that affects the bones, where the bones are breaking down faster than they can rebuild.

The word “osteoporosis” literally means porous bones and it results in decreased bone strength as a result of the reduced bone quantity and quality. Thus a person with osteoporosis has an increased risk of breaking a bone.

Unfortunately Osteoporosis is usually asymptomatic and can progress silently until a broken bone occurs. This can even be by a minor mishap. Asking your GP for an assessment is a good place to start to.

Contributing factors

Our bone density often changes as we age and become more at risk. However other things can impact our likelihood of getting this condition and include: medications particularly corticosteroids and chemotherapy drugs, early menopause, your calcium and vitamin D levels and your lifestyle factors particularly how physically active you are.

Several other factors may contribute to osteoporosis including:

Genetic factors – poor bone health may run in the family
Coeliac disease – malabsorption disorders
Taking of glucocorticoid medications for long periods-(≥ 3 months glucocorticoids Prednisone ≥ 7.5mg)
Low body weight
Post Menopause
Alcohol and smoking
Type 1 and Type 2 diabetes
Rheumatoid arthritis
Recurrent falls with trauma fractures

Osteoporosis is 4 times more common in females than males, especially after menopause and can involve fractures most commonly in the spine, ribs, wrist and hips. Prevention strategies and pro active management are vital to help prevent falls and debilitating fractures.

How can Physiotherapy help

In the management and treatment of Osteoporosis, Physiotherapy has been shown to be effective. It assists in pain management strategies, improves posture and balance, and strengthens muscles and bones.

Through strengthening and gentle range of motion exercises physiotherapists also aim to improve overall posture. Gradual fractures of the thoracic vertebra and wedging of the vertebra is due to the increased flexion through the thoracic spine. The condition can worsen with poor posture. Upper back and core strength can be increased with the help of exercise in turn helping with maintaining a good posture.

Although so often Osteoporosis itself is asymptomatic, there can be co existing back pain of a different cause- READ our PHYSO'S GUIDE on Managing Back Pain HERE

Why else is exercise important?

Exercise is necessary to help prevent and treat osteoporosis and weight bearing exercise and strength or resistance training are the most important. Participating in strength training loads the bones and helps stimulate the rebuilding of bone tissue. From this we generate higher bone density to help protect against osteoporosis and reduce any decline. Exercise also helps with our balance thus reducing our falls risk if we have been diagnosed and reducing the likelihood of fall related fractures.

Osteoporosis can also be helped with lifestyle changes and, often, the use of prescription medication. Paying attention to diet (adequate calcium and vitamin D intake) and getting regular physical activity are important lifestyle changes.

Recommended Exercise and Guidelines

The types of exercise we can help you with for bone health include:

Weight-Bearing Exercises - Brisk walking, stairs, tennis, and netball.

Higher impact Exercise - Running, jumping or skipping.

The recommendations for impact exercise are…

For people with osteoporosis but without fractures: at least 50 moderate impacts a session (i.e. jogging, low level jumping, and hopping) are recommended and should be interspersed with walking activities. This may need to be modified for people with spinal or lower extremity pathology or for people with balance issues.

For people with vertebral or low trauma fractures brisk walking is recommended assuming that the individual is not at risk of falls

Resistance or Strength Training using weights and bands.

Some general guidelines for weight training for people with osteoporosis are as follows

Frequency: at least 2 times/week

Intensity/Time: 1-3 sets of 8-12 repetitions of each exercise

Type: 1 exercise per body part

Balance Training Exercises

Daily balance exercise of up to 15-20 minutes per day is also recommended but obviously can be rather unfeasible due to time constraints. Balance needs to be challenged in order for it to be effective and balance exercises must be maintained as balance can decrease quickly.

Again – this needs to be adjusted based on the individual. Some can tolerate this (or more) and some can’t.

More Tips for a good exercise program for bone health:

Work with physiotherapist or an exercise physiologist when starting.
Exercise needs to be regular, varied and fairly vigorous.
Exercise should be performed in short, intense bursts. Regular, short periods of strength training are better than fewer, longer sessions.
Start slowly and progress gradually.

We know that different people have different needs. We pride ourselves on delivering personalised and flexible exercise programs according to what each individual needs.

For all those who are suffering from Osteoporosis there is no single exercise regimen. Based on a medical evaluation of muscle strength, fracture risk, level of physical activity, range of motion, gait, fitness, and balance each regimen for the individual patient should be specially tailored.