Fit For Life Exercise Newsletter!
This week we are looking into #osteoporosis!
What is Osteoporosis?
Osteoporosis, meaning porous bones, is a common disease which causes your bones to become weak and brittle. This increases your risk of having a fracture e.g. from a fall.
Bone is a living tissue that is constantly being broken down and replaced. In osteoporosis, you don’t replace enough bone tissue for that which you have lost. Normal bone structure looks like honeycomb when viewed under a microscope. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break.
Signs & symptoms of Osteoporosis
Osteoporosis is sometimes called the silent disease as it doesn’t present with significant signs and symptoms in the early stages. Often the first sign of osteoporosis is a fracture. We regularly work with Older Adults with osteoporosis who may have had wrist, hip or pelvic fractures after a fall. Vertebral body and rib fractures can be common in Older Adults also, though often these occur without significant load or accident.
Signs and symptoms of undiagnosed osteoporosis may include:
- Sudden, severe episodes of upper, mid or lower back pain (may be due to vertebral body collapse or fracture)
- Loss of height (>2cm) is a red flag, especially if they have back pain or their posture has changed.
- Kyphotic (stooped) posture or a ‘hump’ developing in the back. Research shows that every 6-12 months this person may develop another vertebral collapse. This also causes the person’s center of gravity to change which can increase their risk of falls.
- A broken bone from a slip or fall especially if multiple fractures and/or the load was low. Also, if a person has an unexplained fracture, they should have a DXA scan.
- Change in body shape or size. A person with osteoporosis may lose height and become kyphotic (due to vertebral collapse) which may progress to their rib cage resting lower or on their pelvis. This may lead to a pot belly and can cause pain and difficulty breathing and swallowing.
Osteoporosis is diagnosed with a DXA scan. Your GP will also assess you and may do other tests to determine if something is contributing to your osteoporosis. Osteopenia is the early stage of osteoporosis. Following your DXA scan you may be diagnosed with osteoporosis or mild, moderate or severe osteopenia. There are lots of risk factors for osteoporosis and certain medications can increase your risk. A comprehensive list can be found here: https://www.irishosteoporosis.ie/about-osteoporosis/risk-factors/
Benefits of exercise for Osteoporosis:
- Increase your muscle strength
- Improve your balance
- Decrease your risk of falls and bone fracture
- Maintain or improve your posture
- Relieve or decrease pain
Recommended exercise for osteoporosis:
- Weight bearing physical activity 30mins exercise per day (~5 days per week); e.g. walking & add a couple of times walking up/downstairs
- Posture awareness and exercises daily
- ROM & Flexibility exercises (see previous newsletters)
- Stability and balance exercises daily e.g. Tai Chi – very important for falls prevention.
- Strength training exercise's x2 per week: very important for lower limb and the back and for falls prevention.
*Exercise must be tailored to the individual.
See Irish Osteoporosis Society factsheets: https://www.irishosteoporosis.ie/factsheets-about-osteoporosis/
Avoid:
- High-impact exercises e.g. jumping
- Jerky, rapid movements
- Bending forward and twist your waist or reaching to your toes with your legs straight
- Lifting heavy things or excessive weights
- Vibration machines
- Dynamic abdominal exercises e.g. ab curls
Week 8 exercise program
Below you will find examples of exercises that may be suitable for someone with Osteoporosis. This really will depend on the person’s functional ability and the progression of their osteoporosis. It should be individualised and prescribed by a qualified therapist. Please review the range of motion and posture exercises in the previous newsletters too, as those may be suitable also!
1. Daily walking program – the Older Adult should do walking or other aerobic weight bearing exercise most days of the week, aiming towards the guidelines of 150mins moderate intensity per week.
2. ROM (range of motion) and posture exercises – do on most days, see previous newsletters for examples.
3. Strength training x2 per week – see below for examples of strength exercises. This really will depend on the person’s functional ability and the progression of their osteoporosis. It should be individualised and prescribed by a qualified therapist.
4. Balance training – should be done a couple of times per week. This really will depend on the person’s functional ability and the progression of their osteoporosis. It should be individualised and prescribed by a qualified therapist.
You can download the home exercise program here:
Fit For Life newsletter 8 HEP
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Patricia O'Donnell GSR CAT BSc MSc