Osteoporosis
Will Osteoporosis be a part of your future?
Now is the time to "bone up" on some of the new evidence-based guidelines and programs to ensure safe and effective practice for these patients.
Although medications, such as the bisphosphonates Fosamax, Actonel, and Boniva, have been developed that help reverse osteoporosis and reduce the incidence of fracture to a degree, many patients cannot tolerate their side effects, and there is new concern regarding a condition called osteonecrosis of the jaw that may limit the target population. A safe and effectively prescribed and performed exercise program is therefore still a patient's best option for prevention of the harmful consequences of osteoporosis such as kyphosis, pain, and fracture of the hip, vertebra, and wrist.
Medication, calcium, and hormone replacement can only do so much to assist. A program of Physical Therapy strengthening, endurance, and flexibility exercises, as well as balance retraining has been shown to be a necessary and effective way to help prevent the negative sequelae associated with osteoporosis. There is also evidence that whole body vibration can stimulate bone growth in the hips of post menopausal women.
Click here for more information about Whole Body Vibration
A study from the Journal of Bone and Mineral Research in 2004 showed that a 6 month whole body vibration training protocol improved strength and significantly increased bone mineral density in the hip of post-menopausal women. No changes in bone mineral density was noted in the group of women in the study who performed conventional resistance training.
Recent studies have provided evidence for the value of appropriate exercise in treating osteoporosis. In a landmark study, Mehrsheed Sinaki, MD, professor of physical medicine and rehabilitation at the Mayo Clinic College of Medicine in Rochester, Minn., reported that at a 10-year follow-up exam of women who had undertaken an exercise program to strengthen the back extensor muscles, the incidence of vertebral fractures was significantly reduced compared to women who had not learned the exercises.
Another study by Stephen L. Wolf, a professor and physical therapist at the Center for Rehabilitation Medicine at Emory University in Atlanta, in the USA, and others found that in an elderly population, tai chi chuan practice significantly reduced the number of falls, which for a person with osteoporosis often results in a bone fracture.
The Benefits of Physical Therapy
For a person with osteoporosis, exercises should not be self-selected - a physical therapist understands the disease process. It is very important to design the exercises and exercise period to fit each person's daily schedule and to adapt the exercises to meet each individual patient's needs. This is why the expertise of a physical therapist is required.
People are risking further, unnecessary injury by doing the wrong exercises. A lot of what people are going to the gym and doing exercises such as lat pull-downs and abdominal crunches, and these exercises are not suitable for someone with osteoporosis and indeed can lead to compression fractures.
Since 80% of compression fractures are silent, people may be having fractures and getting worse, and not aware of it. Power or Ashtanga yoga classes, may be also be causing some bone injuries.
Many gym exercises and/or classes are contraindicated for those with osteoporosis. They use a lot of flexion and sitting exercises, which are the positions that produce the most compression on the spine.
The Maher Sports and Wellness Centre offers an extensive Osteoporosis program which focuses on: assessment, education, site-specific exercises (particularly for strengthening muscles related to back extension, the hips, and the abdomen), body mechanics to particularly arrest or reverse the forward-bending, kyphotic posture that many people with osteoporosis have.
The program emphasises the principles of safe movement and thinking about protecting the bones during movement.
In working with patients with osteoporosis, you have to treat the whole person, perhaps more so than for a typical person coming in with a knee or back injury, The therapist will educate you about fall prevention measures in the home and how to do things in your daily life without injuring yourself.
Find out more about Fall Prevention