Remember! Our guides are to be used following an assessment with a qualified medical professional. Do not attempt these exercises if you have not been given a formal diagnosis, or given consent to complete these exercises by a Physical Therapist!

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Osteoporosis Physical Therapy Guide

What Is Osteoporosis?

Osteoporosis is the most common metabolic disorder of bone, and affects more than 200 million people worldwide! The literal definition of Osteoporosis is “porous bones”. Osteoporosis causes bones to become fragile and brittle, which makes them more susceptible to fractures if they are involved in a traumatic injury such as a fall. The disease may be classified as primary or secondary. Primary Osteoporosis is the most common disorder affecting post-menopausal women, however secondary can affect any age group or gender equally, and can be caused from sustained use of certain medications such as corticosteroids.

Human bones are constantly growing throughout our lives, they are never static and are remodelled depending on the amount of stress that is placed through them. Bones grow by dissolving the old bone and regrowing new bone with specialized cells called osteoclast and osteoblast cells; with this lifelong turnover of bone cells, you replace most of your skeleton every 10 years.  Osteoporosis is the mismatch/disparity between this bone formation and bone reabsorption. The central mechanism that causes the development of osteoporosis is excessive bone absorption, coupled with inadequate formation of new bone. This simply means that the skeleton has not developed adequate mass and strength during the bone growth phase, and lacks density.

What Causes Osteoporosis?

As many as 10 million Americans have osteoporosis and 34 million more of those have a clinically low bone mass, called osteopenia. You can check your likelihood of sustaining a hip fracture due to osteoporosis here! The main causes that increase your likelihood of developing osteoporosis are:

  • Age: A Human’s peak bone density is around 30 years old. After that, bones will begin to lose mass and “thin” very slowly over time. The older you are, the more likely you are to develop osteoporosis.
  • Gender: Women who are over the age of 50 are the most likely group to develop osteoporosis due to reduced estrogen following menopause. Women are 4 times more likely than men to develop the condition due to their lighter, thinner bones and longer life spans.
  • Genetic Link: Individuals who’s parents or grandparents suffered osteoporosis or hip fractures may be more likely to develop the condition themselves.
  • Previous fracture: A history of bone fractures may result in the overall bone health being reduced.
  • Ethnicity: Research suggests that Caucasian and Asian women are the most likely to develop osteoporosis than women of other ethnic backgrounds. Hip fractures are also twice as likely to happen in Caucasian women as in African-American women.

Osteoporosis Risk Factors

There are many changeable risk factors that can increase your risk of developing a metabolic bone condition such as osteoporosis. These are also considered “lifestyle changes” as you can improve your bone health by removing these factors. Th

  • Cigarette smoking: Several studies have identified smoking as detrimental to bone health.
  • Alcohol consumption: Heavy drinking leads to thinning of the bones structure and makes stress and traumatic fractures much more likely.
  • Malnutrition: We’re taught from a young age that calcium builds strong bones. Anorexia and poor general nutrition are proven to rapidly accelerate the thinning of bones.
  • Steroid use. 

Signs & Symptoms

It is quite common for people to go undiagnosed with a metabolic bone condition until they actually break a bone! For this reason, osteoporosis has gained a novel nickname “The silent thief” as bone is taken away but not fully replaced. This makes osteoporosis very dangerous for people over the age of 50, as osteoporosis increases your chances of fracturing a hip, vertebrae or rib. The main symptoms are:

  • Lower back pain, caused by a fractured or collapsed vertebra.
  • Loss of height over time due to collapsed vertebra.
  • A stooped poking chin posture.
  • A bone fracture that occurs much more easily than expected.
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Stop Smoking Kit

People who smoke are much more likely to develop osteoporosis and other metabolic bone conditions! Not only this, but smoking also destroys healthy tissues in the heart, lungs and vascular system, leading to a whole host of other diseases and illnesses. Smoking is known for its addictive nature but there a hundreds of products and apps that can help to curb the craving and improve your bone health at the same time. Our favourite smoking cessation kit is available here! 

What Are My Treatment Options?

Management and treatment of Osteoporosis and metabolic bone conditions include a combination of lifestyle changes, adequate nutrition, medication and exercise therapy. Lifestyle changes are related to altering the risk factors mentioned above such as reducing alcohol consumption and stopping smoking. Physical Therapists focus on exercise prescription and fall prevention strategies to reduce the risk of further fractures and their associated complications.

Exercises need to focus on high impact weight bearing to encourage the formation of new bone growth and improve the density of affected bones.  If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises. If you’re not sure, you should check with your healthcare provider.

Osteoporosis Exercises

1) Brisk Walking

The simplest and most effective exercise to harden your bones and reduce your risk of metabolic related fractures is walking and hiking! Weight bearing will encourage the growth phase in bone remodelling, strengthen muscles and improve your overall cardiovascular fitness.  Aim to increase the distance that you hike and up the difficulty every day! The exercise can be progressed by using ankle weights which will increase the load that is placed through your knees, hips and all of the other commonly affected osteoporosis joints.

2) Dancing

Dancing is an excellent whole-body workout that’s incredibly fun and can be easily completing in groups, pairs or solo. It’s great for your cardiovascular system, it makes your muscles stronger, and importantly it will help with your balance and coordination. A 30-minute dance class burns between 130 and 250 calories, about the same as jogging for the same period. Dancing is known to enhance your life in many other ways including confidence, self-expression, social, relaxation, and enjoyment!

3) Step Aerobics

A step aerobics exercise session typically consists of sets of choreographed movements performed on a raised platform or step. The movements are usually accompanied by high tempo music and are designed to work the whole body and when performed correctly will have a great benefit to your health. The step can be any type of raised bench, but we prefer to use a step platform! If you’re stuck for ideas there are hundreds of video routines that you can follow on youtube, check out Jenny Fords beginner class here! 

4) Squats

Squats are a fantastic exercise to strengthen the hips and reduce your risk of falling. Not only this, but as we get older standing from a chair can become quite difficult, becoming a master at squatting will ensure that this will never be a problem.

How to do it:

  • Rest your hands on the back of the chair for stability and stand with your feet hip-width apart.
  • Slowly bend your knees as far as is comfortable, keeping them facing forwards. Aim to get them over your big toe
  • Keep your back straight at all times.
  • Gently come up to standing, squeezing your buttocks as you do.

Repeat 10 reps, 3 sets, 3 times per day.

5) Posture Re-education 

Poor posture is one of the first symptoms of osteoporosis as the vertebrae are prone to collapse. It is important therefore to improve your posture and ensure you are not putting too much stress on the injured spinal segment. There are many exercises to do this that involve strengthening the lower lumbar spine and large posterior muscles. However, the simplest and most effective way is to use an Upright Posture tool. Upright Posture is a novel postural training device that is also piece of wearable technology. You attach the device to your lower lumbar spine and it is configured in such a way that it alerts you when you slouch! It does this by gently vibrating. The Upright posture device is a very interesting piece of tech, and invaluable for people who work sitting at a desk for long periods of time.

You can buy the Upright Posture Trainer here!

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Osteoporosis Prognosis

Osteoporosis is an extremely treatable condition, especially if the problem is detected and treated early on by your health care provider. Bone density, even in cases of severe osteoporosis, generally can be stabilized or improved following treatment, lifestyle change and exercise therapy. This will also substantially reduce the risk of fracture and improve your overall health. It is important to remember that the absolute worst thing you can possibly for your osteoporosis is nothing! It gets mentioned often throughout our site, but movement is medicine!