Osteoporosis: How Physiotherapy Can Help!

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue, which can lead to an increased risk of fracture.  We often think of our bones as solid structures, but the fact is, our bones have a rich blood supply and cells called osteoclasts are constantly breaking down and reabsorbing old bone while osteoblasts are creating new bone. In osteoporosis there is an interruption in the balance of this activity and more bone is broken down than created. As a result, the bones become more porous with a “honeycomb” like structure. 

There are no “symptoms” of osteoporosis in that low bone density itself does not cause any pain. An individual often does not even know they have osteoporosis until they suffer a fracture. The most common fractures associated with osteoporosis are in the hip, spine, wrist, and shoulder.

How Physiotherapists can help those with Osteoporosis:

1. Prevention of disease progression. While there is no cure for osteoporosis, and we cannot reverse the process of the bone deterioration, steps can be taken to prevent the bones from becoming more brittle. Weight-bearing exercises are exercises that “load” the bone with more stress than they have at rest, and have been shown to stimulate osteoblast activity and therefore bone remodelling. Examples of weight-bearing activities include walking (in which you take weight through your spine and the long bones of your leg) and lifting weights.
   
   

2. Fall Prevention.  When you have osteoporosis it is important to take extra measures to prevent a fall as that is the most common cause of fracture. A physiotherapist can help you prevent falls in the following ways:

   1. -provide appropriate balance exercises to improve your balance and sense of equilibrium

   2. -assess your need for a mobility aid such as a walker or cane, fitting it to you and teaching you how to use it properly

   3. -assess your home environment to identify common fall hazards

   4. -provide strength and flexibility exercise to optimize your mobility 
      
      

3. Posture.  With progression of osteoporosis, the vertebral bodies of the spine tend to collapse, creating a more rounded spine. When this becomes quite progressed an individual will present with a “Dowager’s Hump” in the upper back. A physiotherapist is a highly educated medical professional who can provide guidance on what exercises are safe for an individual with this condition to maintain good posture and prevent further rounding as much as possible. For example, there are some types of exercises that should be avoided (typically anything involving flexion of the spine such as sit-ups) and other exercises that should be focused on (such as strengthening of the spinal extensor muscles and the deeper abdominal muscles).
   
   

4. Fracture Rehabilitation: Sometimes, despite our best efforts, a fall will happen and a fracture will result.  After the appropriate period of immobilization has ended and the fracture has healed (which usually requires 6-8 weeks), a physiotherapist can provide guidance on how to reduce any joint stiffness and improve the strength of the injured area to get back to the pre-injury status.

A diagnosis of osteoporosis does not have to be scary, there are steps that can be taken to optimize bone health and prevent complication and injury.  Talk to a physiotherapist today to learn how we can help you!