CAN PHYSIOTHERAPY HELP OSTEOPOROSIS?

Physical activity: weightbearing exercise, resistance & balance training help osteoporosis

WHAT IS OSTEOPOROSIS?

Osteoporosis is a condition in which the bones lose their density and become more fragile. This occurs when the body is not able to replace minerals – such as calcium, at the same rate at which it is losing them. This can occur due to hormonal changes (e.g. due to menopause) or calcium and vitamin D deficiencies. Having weaker bones increases a person’s risk of sustaining a fracture.

WHAT IS OSTEOPENIA?

This term refers to a decrease in bone mass, which is not yet low enough to be classified as complete osteoporosis.

RISK FACTORS

The following (among other factors) increase the risk of osteoporosis occurring:

• age 50 years and older

• female

• menopause

• genetic predisposition (family history)

• lack of physical activity (especially weight-bearing and resistance training)

• alcohol (> 3 drinks/day)

• tobacco

• caffeine (> 4 cups/day)

HOW CAN PHYSIOTHERAPISTS HELP?

Physiotherapists can help by providing individuals with sound exercise advice. Physical activity – specifically weightbearing and resistance training – are an effective way to slow down or even reverse the process of bone density loss.

1. Weight-bearing

This means exercise where the individual’s bones are placed under the stress of their own bodyweight. For example: walking, hopping and squats. Bones adapt to the load that is placed on them, maintaining/ increasing their density when weightbearing activity is done consistently. Someone who is sedentary (i.e. spends a lot of time sitting down) will therefore not reap the potential benefits.

2. Resistance training

Resistance training involves exercising against an opposing force, i.e. using equipment such as reformer machines, dumbbells, kettlebells, barbells, therabands and other tools. Once again, this increases the stress placed on the bones which, when done consistently, can lead to an increase (or at least maintenance) in bone mineral density.

3. Balance training

Special exercises, such as one-legged stands can also help reduce the risk of falls, thereby reducing the likelihood of a fracture occurring.

4. Pain management

Physiotherapists can also help provide treatment for specific pain associated with osteoporosis, such as back and hips. Specific physiotherapy treatment methods, such as soft tissue massage, mobilisations and electrotherapy (including drug phoresis and SCENAR therapy) can be very useful, particularly if the pain is limiting the person’s ability to exercise.

5. Hydrotherapy

Hydrotherapy (exercising in warm water) can be a great way for people to exercise when rehabilitating from a fracture, or when certain exercises are simply too painful to perform on land. It is important, however, to ensure land-based exercise is also performed in order to address the reduced bone mineral density.

6. Exercise under a qualified physiotherapist

People who are diagnosed with osteoporosis, must be careful when undertaking these forms of exercise, as doing them incorrectly or with too much sudden force can result in damage to the already weaker bones. This is why Clinical Pilates is a very effective exercise method as all the exercises are performed under strict supervision of a qualified physiotherapist. It is also important to undergo a full body assessment prior to commencing the program in order to make sure that the exercises are tailored specifically to the needs of each individual, considering their areas of strength and weakness as well as any specific medical conditions they might have.

Summary

Regardless of where you fit on the spectrum – be it osteoporotic, osteopenic or even someone with completely healthy bone density – a physiotherapist can devise an appropriate exercise program for you. This may be implemented in the form of a guided one-on-one program, group therapy or a personalised home exercise program. It’s important to stay on top of all aspects of your bone and joint health and keeping physically active will go a long way in assisting you to achieve that.

Margarita Gurevich is Senior Physiotherapist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialises in sports injuries, women’s health (including incontinence) and gastrointestinal issues. Margarita may be contacted via her website.