Osteoporosis – is there anything I should know?
I’ve written this blog to help some of my clients understand why I run a specific Bone Health class and choose to teach certain exercises whilst completely omitting other exercises (that may have been favourited by some more experienced Pilates fans) from my general classes.
I’ve linked in a variety of references which you can explore to give you more info, I’ve just covered the very bare ‘bones’ of it (sorry), to highlight the condition.
What is it?
Osteoporosis a disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break (fracture) from a fall or, in serious cases, from sneezing or minor bumps (nof.org).
As a very rough guide children and young adults build more bone than they lose making their bones stronger, adults up to about the age of 35 build and lose bone in equal quantities and middle aged to older adults build less bone than they lose, so the bones get weaker. It’s more common in women due to hormonal changes during menopause but children and men can develop it too.
How likely is it that I’m at risk?
The World Health Organisation (2004) state that osteoporosis causes more than 8.9 million fractures annually worldwide with Europeans being at highest risk. The lifetime risk for a wrist, hip or vertebral fracture has been estimated to be in the order of 30% to 40% in developed countries – similar statistics to those for coronary heart disease!
Unfortunately osteoporosis doesn’t show any outward symptoms and the first sign of osteoporosis is often a broken bone which not only causes pain (although is sometimes pain free) and inconvenience, but can lead to much much more serious health issues. However if you have any of the risk factors seen in the link above it’s worth speaking to your GP. She/he may refer you for a DEXA scan. This will tell you if your ‘bone density’ (how strong your bones are) is within normal limits, is lower than it should be (osteopenia) or significantly reduced (osteoporosis).
What can I do about it?
Plenty!!!! But first you have to take it seriously and ACCEPT it, which I know can be incredibly hard especially if you’re fit, active, young and pain free. Understanding what it is and knowing what risks it brings will empower you to monitor it and make changes to hopefully stabilise it and even improve /reverse it in some circumstances.
Do I need to be careful if I have Osteopenia?
It’s definitely worth being knowledgeable about the condition because your bones are still comparatively weaker making you at increased risk of fracture. In addition if you have a family history of osteoporosis or a lifestyle or medical history which increases your risk you may go on to develop it, so think of it as an opportunity to prevent a diagnosis of osteoporosis and all that comes with it. Please don’t take my word for it though, have a look at this link.
Will Pilates help me improve my Bone Health?
I know I’m completely biased but as a middle aged nurse and Pilates teacher I understand how important this information is for all of us as we get older, and I can see how focused exercises can help us move well, stay strong and reduce the risk of injury.
Exercise is great, fantastic, essential BUT in this circumstance it’s the specific type of targeted exercise that’s important because not all exercise builds bone! To stimulate bone growth you need the muscles to pull on the bone during weight bearing exercises to tell the bones they’re required to support you. The brain then stimulates the laying down of new bone but only for 10 minutes, after that it switches off. So going for a 2 hour hike with ankle weights on won’t work or we’d all have bones the size and weight of tree trunks! Also the increase in bone will only occur at the site being stimulated so you need to cover all major joints.
Well planned Bone Health Pilates classes will do this for you. Expect to do lots of work strengthening the spine in neutral and working your back with extension type exercises to combat the affects of gravity seen in conditions such as Dowagers hump.
The classes can still be incredibly challenging but in a much more bone benefiting way. You’ll still be doing a lot of your usual Pilates moves but with the flexion stuff stripped back. Loaded flexion is COMPLETELY contraindicated (e.g. curl up type exercises) as it can cause fractures, as are exercises which take both legs off the ground such as Double Leg Stretch and Toe taps. You also have to be careful with loaded rotation too. These should be replaced with strengthening resistance work using body weight, hand/ankle weights and therabands, inclusion of many more reps for exercises such as Oyster, Pilates Squats and Lunges and frequent additions of timed holds.
Balance and co-ordination work is also essential helping us to be as ‘sure footed’ as possible, to prevent falls. So exercises such as Standing on 1 leg variations are obvious ways to improve balance but cross patterning exercises such as Knee Drop with opposite Fly arm (weighted of course!) and Windmill all help massively.
For those of you who don’t think you’re into Pilates (maybe you haven’t found the right teacher!!!), I’m confident that many other forms of exercise can help build bone too. I would urge you read around your chosen exercise and look for information about specific bone health approaches within it. Time and money are precious so make sure you spend it in full knowledge that you’re doing something rewarding and beneficial !