Osteoporosis

(Image by Freepik)

Written by: Andrew Kao, Registered Physiotherapist

Osteoporosis, in literal terms, means “pores in bone”. Bone is actually not one solid material, but a mesh-like structure, similar to a honeycomb.  With osteoporosis, the holes in the honeycomb become bigger and farther apart, making it less dense and strong, and more easy to break.

What Causes Osteoporosis?

Bone is constantly in a balance of being formed and broken down, with both processes happening at the same time. In childhood and adolescence, bone is typically being formed faster than it is broken down to build up bone mass and help with growth. This rate evens out in adulthood, until about 50 years old.  After which the balance shifts in the other direction and there is a natural gradual loss of bone. However, in some individuals this loss of bone can occur faster.  When there is too much bone loss to the point where the risk of fracture is elevated, this is termed osteoporosis.

Osteoporosis vs Osteopenia vs Low Bone Mineral Density

Low bone mineral density is an umbrella term for anyone with bone mineral density, a measure for bone health, that is less than normal. This is best diagnosed using a test called a DEXA scan.
Osteopenia is when someone has a mild to moderate loss of bone mineral density but does not yet have osteoporosis. Osteopenia does put you at a higher risk of eventually developing osteoporosis. Once there is enough bone loss that there is a higher risk for fracture.

Who Can Have Osteoporosis?

While anyone can have osteoporosis, most commonly it is present in post-menopausal women, as hormone changes affect how the bone is being laid down.  Osteoporosis is also more common in older adults, as bone density decreases in age.  Other factors that can increase risk of osteoporosis include:

• Family history of osteoporosis
• Low calcium or vitamin D intake
• Sedentary lifestyle
• Smoking or excessive alcohol use
• Certain medications (like long-term steroids)

How is Osteoporosis Treated?

With osteoporosis, there are a few goals of treatment:

1. Prevent fractures
2. Maintain or increase bone mineral density
3. Minimize bone loss

Nutrition:
Ensuring that you are taking in sufficient calcium and vitamin D is important to maintaining bone health. Consult with your doctor or a registered dietician to review your nutrition and make sure your intake is appropriate.

Medication:
There are also a number of medications that can be used to slow down bone loss and increase bone mineral density. Consult with your doctor or pharmacist for more details and medication management.

Exercise:
Exercise is extremely critical to treating osteoporosis, as it can target all three goals at once, by improving your strength and balance.

Increasing strength in areas like your core, back, hips, and legs, are all important to supporting areas that are more susceptible to fracture (spine, hips) and to keep you moving for as long as possible. Improving balance is important to prevent falls, which is the leading cause of fractures.

Weight-bearing exercises are also critical to stimulate your bones to maintain and even increase bone mineral density, as well as minimize bone loss, all at the same time.

Example exercises:

Core – plank
Lie face down on the floor or a mat.
Place your forearms on the ground, elbows directly under your shoulders. Keep your forearms parallel and your hands flat or clasped together.
Press into your forearms and raise your body off the ground. Support yourself on your toes and forearms.
Keep your body in a straight line from head to heels. Don’t let your hips sag or rise.
Hold for 30-60seconds

Lower body – Squat
Stand with your feet shoulder-width apart. Keeping your arms straight ahead, sit back on an imaginary chair while keeping your weight on your heels and your back straight.

Balance – it is important to improve upon balance, but this is best performed under the supervision of a trained professional first to decrease risk of injury.

Caution: avoid high impact exercises without being cleared first, like jumping and running, as they can increase risk of fracture.

Why Physiotherapy?

A Registered Physiotherapist will accurately assess your strength and flexibility and design a treatment plan tailored to your individual needs.  A Physiotherapist is trained to observe any altered movement patterns and can safely guide you through the proper exercise techniques.

Contact The Physio Approach today to book an appointment and get started on your path to stronger, pain-free movement. We are located at Yonge Street, North York, Toronto, right next to the TTC Finch subway station. Feel free to give us a call or book a 10-minute free in-person consultation with one of our Physiotherapists!