‘Spine-spar­ing’ strate­gies can help com­bat os­teo­poro­sis

Ottawa Citizen - - SENIOR LIFESTYLES - LOUISE RACHLIS Post­media Con­tent Works

Ac­cord­ing to a pre­dic­tion from Os­teo­poro­sis Canada, by 2020, 50 per cent of people over the age of 50 will be at risk of bone frac­ture.

“To put this in per­spec­tive, frac­tures from os­teo­poro­sis are more com­mon than heart at­tack, stroke and breast can­cer com­bined,” says Bonnie Lind­say, a per­sonal trainer and cer­ti­fied Nordic walk­ing in­struc­tor.

Os­teo­poro­sis is a dis­ease char­ac­ter­ized by low bone mass and de­te­ri­o­ra­tion of bone tis­sue, which can lead to an in­creased risk of frac­ture. The most com­mon sites of os­teo­porotic frac­ture are the wrist, spine, shoul­der and hip.

While os­teoarthri­tis put an end to Lind­say’s run­ning ob­ses­sion, Nordic walk­ing be­came a big part of her re­cov­ery af­ter bi­lat­eral knee re­place­ments and a hip re­place­ment.

She says it also im­proved her pos­ture, cor­rect­ing one of the ear­li­est signs she had os­teo­poro­sis. Af­ter lots of train­ing with her poles, she was able to com­plete a half marathon, hike down to and back up from the Colorado River in the Grand Canyon, and walk some 600 km of El Camino de San­ti­ago trail.

Os­teo­poro­sis causes 70 to 90 per cent of 30,000 hip frac­tures an­nu­ally, says Lind­say, 73. “Of those who suf­fer a hip frac­ture, 23 per cent die within a year, and of those who sur­vive, 50 per cent are left with dis­abil­i­ties that leave them need­ing as­sis­tance in many ac­tiv­i­ties of daily liv­ing.”

There are many things you can do to help, says Lind­say, but there are just as many things you might be sur­prised to find that you shouldn’t do. “Ap­prox­i­mate 60 per cent of yoga pos­tures are risky for those with low bone strength, ei­ther be­cause of the pos­ture it­self, or what one has to do to get into them,” she says. “Yoga is great, but a per­son with low bone min­eral den­sity should learn al­ter­na­tives to risky moves and pos­tures.”

As well, she says, “people prob­a­bly don’t think that re­peat­edly un­load­ing their wash­ing ma­chine, dryer and dish­washer, or pick­ing up small chil­dren might be risky ac­tiv­i­ties if not done with spine-spar­ing tech­niques. And they prob­a­bly don’t re­al­ize that sit­ting in­creases the pres­sure in their spine.”

She points out the risk fac­tors: age and gen­der (fe­males are more at risk); low body weight or body weight 10 per cent less than at age 25; parental hip frac­ture; rheuma­toid arthri­tis; glu­co­cor­ti­coid use (e.g. cor­ti­sone); smok­ing; al­co­hol in­take of three or more drinks a day; his­tory of falls or poor bal­ance; prior frac­tures.

While we can’t change many of th­ese are fac­tors, people can stop smok­ing, re­duce al­co­hol in­take, get help with bal­ance ex­er­cises and build up mus­cle strength and mass, she says. “Pre­ven­tion ideally starts in one’s child­hood through early adult years, when we are most able to build bone. The greater your ‘bone bank,’ the more you could lose with­out be­ing at great risk.”

Bone build­ing at any age re­quires good nutri­tion, es­pe­cially cal­cium and vi­ta­min D, she says, and chil­dren and young adults build stronger bones if they are ac­tive run­ning, jump­ing, climb­ing or play­ing soc­cer. “Begin­ning in our mid-20s, we start to lose bone min­eral den­sity, and by the time women ap­proach menopause, they lose bone at two to three per cent per year, in­creas­ing to two to five per cent af­ter menopause.”

If you al­ready have or think you have low bone min­eral den­sity, what can you do to pre­vent or re­duce fur­ther loss? Here are some sug­ges­tions from Lind­say:

As­sess your cal­cium, pro­tein, fats and car­bo­hy­drate in­take and mod­ify as ap­pro­pri­ate. Have vi­ta­min D level checked.

Do 150 min­utes a week of mod­er­ate to vig­or­ous weight-bear­ing aer­o­bic ex­er­cise, done in bouts of 10 min­utes or more. (Brisk walk­ing is not rec­om­mended for those at high risk of frac­ture.) Do pro­gres­sive re­sis­tance mus­cle strength­en­ing two to three times a week for 45 min­utes. To build bone, strains need to be un­usual, un­ac­cus­tomed and more than done in one’s ac­tiv­i­ties of daily liv­ing, but not for pro­longed pe­ri­ods.

Do pro­gres­sive bal­ance and fall pre­ven­tion ex­er­cises daily, in­clud­ing pos­ture and core sta­bil­ity ex­er­cises.

Ap­ply spine-spar­ing strate­gies in your ac­tiv­i­ties of daily liv­ing. Avoid re­peated, rapid or end-range flex­ion, ro­ta­tion and side bend­ing.

Avoid mul­ti­ple plane spinal moves (e.g. flex­ing and ro­tat­ing at the same time) and end-range hip ro­ta­tion.

Squat to take clothes out of front-load­ing wash­ing ma­chines, dry­ers and ovens.

Use golfers’ bend or squat to pick things up from the floor or un­load a dish­washer.

No slouch­ing!

If you are not sure what to do or how to do it, en­gage a per­sonal trainer or phys­io­ther­a­pist who spe­cial­izes in os­teo­poro­sis, read ma­te­rial on the Os­teo­poro­sis Canada web­site and sign up for their news­let­ters and sem­i­nars.

As for her own role in help­ing people, “Mostly I am a nag,” Lind­say says. “That means: ‘Watch your pos­ture, stand up straight, carry your head level and right over your spine. If you’re do­ing strength ex­er­cises, do as many as you safely can while stand­ing up.’ ”

Although she has done some group strength, bal­ance and fall pre­ven­tion classes, she prefers work­ing with in­di­vid­u­als or very small groups so she can bet­ter mon­i­tor and cor­rect tech­nique, and de­velop a pro­gram that people will ac­tu­ally fol­low and ben­e­fit from.

“Much of what drives me is a de­sire to pass on to oth­ers what I have learned,” she says, “so they don’t make the same mis­takes I did. I’m pas­sion­ate about the po­ten­tial for fit­ness train­ing to im­prove phys­i­cal, men­tal and emo­tional well­be­ing and al­low us to thrive as we age.”


Bonnie Lind­say demon­strates one method for keep­ing a neu­tral spine while un­load­ing a dish­washer.


Lind­say cred­its Nordic walk­ing with im­prov­ing her pos­ture, cor­rect­ing one of the ear­li­est signs she had os­teo­poro­sis.

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