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Bone Building Exercise for Osteoporosis

Bone Building Exercise for Osteoporosis

Building Bone – the foundations

Osteoporosis is a common disease in Australia. Osteoporosis affects over one million Australians, and is more common among women than men. It is a condition where the bones become weak, fragile and brittle. When bones lose minerals (such as calcium) faster than the body can replace them, this leads to a loss of bone density, which in turn, leads to an increased risk of fractures. Even a small bump or fall can cause a fracture. The most common sites for these fractures are the wrist, hip and spine (Osteoporosis Australia, 2014). Bone building exercise for osteoporosis is essential for optimising bone health.

Osteoporosis is likely under-reported, as many people typically have no symptoms at all until they experience a bone fracture, usually after a fall. Osteoporosis can be diagnosed with a simple and painless scan, known as a bone density test.

WHO is most at risk?

Factors that increase risk of developing Osteoporosis are:
(Osteoporosis Australia, 2014)

  • Your gender, women are more likely to develop osteoporosis than men
  • Increasing age. The older you get, the higher the risk
  • Race – you are at greater risk of osteoporosis if you’re of Caucasion or Asian descent
  • Peri and post-menopausal women, due to the rapid decline in oestrogen levels during menopause
  • Family history of osteoporosis
  • Medical history
    • Prolonged corticosteroid use
    • Thyroid conditions
    • Coeliac disease, inflammatory bowel disorder, due to malabsorption
    • Eating disorders,  severely restricted food intake and being underweight can weaken bone
    • Some medications for breast/prostate cancer, epilepsy and some antidepressants
  • Lifestyle factors
    • Smoking
    • Excessive alcohol consumption
    • Dietary factors
    • Little or no physical activity
    • Weight – both ends of the spectrum (thin body build or excessive weight)

WHAT can we do about it?

There are several interventions for osteoporosis management and prevention (outlined below).

We will focus mainly on bone building exercise for osteoporosis and the three important Bs – body, bones and balance.

Body, BONES & Balance – WHY exercise is important for bone density

Exercise is vital for both the treatment and prevention of osteoporosis. Regular, ongoing, physical activity and exercise has been shown to help maintain and improve bone mineral density (Osteoporosis Australia, 2014) (Sözen, T et al., 2017).

Bone is living tissue and this means it responds to exercise by getting stronger, as muscles do (NIH, 2019). Even when we are young, the exercise we do contributes to peak bone mass and therefore the more active we are, the higher the peak bone mass (NIH, 2019), (Sözen, T et al., 2017). Sometime during our 30s, this bone mass peaks and then we can begin to lose bone (NIH, 2019). Regular weightbearing exercise can help build your bone stock in your youth and prevent bone loss and maintain muscle strength and balance throughout your life. Exercise is especially important for someone diagnosed with osteoporosis.

There are specific exercises that are better bone building exercise for osteoporosis . These are called osteogenic exercises. These exercises help to improve bone strength due to a certain amount of impact or strain placed on them. Generally these exercises include resistance based or weight bearing exercises – exercises where your feet are on the ground and gravity is adding to the load through your bones. Swimming for example, would not be the best choice as an exercise to improve bone density, as there is very little gravitation loading or weight placed on your bones. Your bones react to the weight on them by building themselves up and getting stronger. Exercise examples include, but are not limited to, weighted squats and lunges, jumping, landing and stamping (Montgomery, G., et al., 2019). Impact loading can be tailored to the individual and gradually progressed from simple, safe landing techniques, to more challenging tasks once good skill and confidence in early tasks has been achieved.

It’s never too late to start a bone-building exercise program, even if you already have osteoporosis. You may worry that a bone building program may cause or aggravate a problem you may have, like back or knee pain. A professionally designed exercise program, customised to your individual circumstances, will allow you to strengthen your bones and muscles and improve your balance and coordination while minimising risks of aggravating pre-existing pain or injuries. In most cases, a customised program will have the added benefit of assisting you with these additional musculoskeletal problems.

So, no time like the present! Time to move that body and build those bones!

 

PhysioTec provides a unique and specialised group program based on the most current research available. It is designed to increase bone health and density through weight training. Our program incorporates posture and body awareness training along with balance and proprioceptive exercise aimed at reducing the risk of falls, joint overload and injury. Body – Bones – Balance (Body integration – Bone strength – Balance control) incorporates a group warm up followed by a targeted station-based exercise program that stimulates the whole body, with a special focus on improving health and strength of bones, muscles and tendons and optimising dynamic balance. Before entry into the program, you will have a detailed assessment with a physiotherapist who will individualise your starting program.

Read more information about our class here.

What exercises can I do at home after having a baby?

What exercises can I do at home after having a baby?

The experience of bringing a new baby home is exciting and wonderful. But this period can also be terrifying for a new mother, and at times, isolating. It’s a word we have been hearing so much of lately, but for other reasons – “Stay at home. Self-isolate. Social distance”. The concept of this is hard for anyone, more so for a new mother. As new mothers, we rely on getting out of the house and being social with our family, close friends and mother’s groups for support. We rely on access to our medical and allied health professionals so that we can look after ourselves and in doing so, care for the new baby we have brought into this world. Even though Covid restrictions are now easing,  it can still be challenging to leave the house with a new baby in those first weeks or months, for reasons other than the essentials. Looking after yourself and getting into some regular exercise might be low on your list of priorities.

 

Exercising from home

While the recent Covid crisis has been challenging, especially for new mums, this crisis has produced a tremendous surge in online exercises and exercise programs. We are lucky to have technology and the online platform to access exercise programs from home, however new mothers wanting to start exercising need to be cautious in selecting exercises. Some exercises place extra load on the abdominal muscles or pelvic floor which new mums need to avoid soon after having a baby, as these can have adverse results. Getting professional guidance before embarking on an online exercise program is vital.

At PhysioTec, we have two Women’s Health physiotherapists, Megan Power and Irene Li, who can assist you through this uncertain time. If you can’t make it to the clinic in person, we are able to provide an online ‘Telehealth’ video consultation. We will take a thorough history inclusive of your pregnancy and birth experience. We will also look at your posture and a variety of movements. From this we will give evidence-based advice and, if appropriate, recommend a personalised exercise program you can do safely at home.

We can address any of the following during a consultation:

  • Pelvic floor muscle and function
  • Abdominal separation
  • Safe exercise options/exercises to avoid
  • Pelvic pain

We also offer an App for your exercise program and this includes video, audio and text description. It also allows in-app messaging to stay in touch with your physiotherapist.

 

The Importance of the Pelvic Floor Muscles

Like any other muscle in our body, the pelvic floor muscles may be weak, too active, a source of pain and can also be different side to side. These muscles, along with connective tissue, support the pelvic organs. In women, these are the bladder, uterus and bowel. The pelvic floor is important for prevention and management of prolapse, management of urinary incontinence and also for its role in sexual function. Following childbirth, the pelvic floor needs time to recover and then we can start to gradually build up strength and coordination of these muscles again.

The main recommendation of the most current guidelines state that pelvic floor muscle training is associated with a reduction in prenatal and postnatal urinary incontinence (Mottola MF, et al., 2018). These exercises can be performed daily HOWEVER, it is crucial that women seek instruction from a knowledgeable health professional  to ensure proper technique in order to obtain the best outcomes/benefits from performing these exercises. This is especially the case for women who have never trained these muscles.

 

What about running?

In March 2019, three highly experienced physiotherapists – Tom Goom, Gráinne Donnelly & Emma Brockwell combined their areas of expertise to release a paper on returning to running after childbirth and the guidelines for this population. The main findings were that women in the post-natal period benefit from an individualised assessment and guided pelvic floor rehabilitation in order to prevent and manage pelvic organ prolapse (Hagen, S et al., 2014), manage urinary continence (Bø, 2003) (Dumoulin, C et al., 2018) (Price, N et al., 2010) and improve sexual function.

 

Based on expert opinion, the following suggestions were made:

  • Return to running is NOT recommended at all prior to 3 months post-childbirth OR beyond this time point if any symptoms of pelvic floor dysfunction are identified before or after attempting a return to running
  • Pelvic health, load management and strength testing should be assessed in order to establish if a patient is ready to return to running in the post-natal period
  • Additional factors that should be considered in the postnatal evaluation are weight, fitness, breathing, psychological wellbeing/status, abdominal separation, breast support and feeding, running with a buggy and relative energy deficiency in sport (RED-S)

 

How can a Physiotherapist help me?

At PhysioTec, our physiotherapists who specialise in Women’s Health can address your postnatal concerns and advise you on the safest exercises, individually tailored to your symptoms and current capacity. If you are wishing to return to a level of activity similar to pre pregnancy, your physiotherapist is able to guide you on load and intensity and how to graduate safely back to full activity. We are passionate about what we do and our continuity of care. We are here (in person at Tarragindi or online via TeleHealth) to help and provide you with the best advice and support!

Book Online or call us on 3342 4284 to speak to us today!

 

References

Bø, K. (2003). Is there still a place for physiotherapy in the treatment of female incontinence? EAU , 145-153.

Dumoulin, C et al. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews(10).

Hagen, S et al. (2014). Individualised pelvic floor muscle training in women with pelvic organ prolapse: a multicenter randomised controlled trial. 282(9919), 796-806.

Mottola MF, et al. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52, 1339-1346.

Price, N et al. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315.