Have you recently been diagnosed with osteoporosis or osteopenia and thought, now what?
My education about osteoporosis officially began in physical therapy school, but really came from my patients over the years.
Margaret, arrived having suffered compression fractures in her lower back (lumbar spine) while bending to make the bed. She was 65 and had not yet had a DEXA scan. This is how she learned she had osteoporosis.
This began the abrupt education about this silent disease. Leading up to the fractures she had lead a “normal” life. She was active in the community, walked with friends and played with grandchildren. Now she reported she had lost her confidence with even simple daily activities.
If you have recently been diagnosed with or without having had a fracture, like Margaret you are now be faced with learning about how to continue living the life you want and enjoy all while avoiding injuries like fractures and falls. No one likes to feel frail, never mind left out. You may start worrying about what osteoporosis means to to your life and your activities like playing on the floor with or picking up your grand children, exercise class, yoga class, and walking in the woods over rocks and roots.
The encouraging news is that after working with me Margaret was stronger, more flexible and confident in her abilities to enjoy all her activities and to maintain vitality over the coming years. And you can too!
Evelyn, knew she had osteoporosis but in a rush bent and reached under the bed, she sustained compression fractures in her thoracic spine (ribcage area).
In physical therapy we treated her pain, helped her understand and practice safe postures for her daily activities, helped her regain her strength, challenged and trained her balance. She learned how to keep her spine straight with her daily activities to avoid future incidental fractures.
After working with me, she returned to her daily walking and social activities. And when I saw her a few years later she said she felt stronger than ever.
You were told, “don’t bend and twist” and “whatever you do, don’t fall”.
Just like these women, you might wonder what this really means. So, I would like to explain these “precautions”. The “don’t fall” is a little more obvious as with lower bone density you are more at risk of a fracture if you fall than when you were younger. Sadly, we don’t bounce back up like we used to. The “don’t bend and twist” is a bit more complicated.
First let’s talk about the structure of bones. There is the outer lining of the bones called cortical bone. It is like a shell that surrounds and supports the trabecular bone. The trabecular bone is a matrix or framework which looks like a honeycomb or sponge. According to Encyclopedia Britannica, it “is organized into a three-dimensional latticework of bony processes, arranged along lines of stress”. The lines of stress are the forces we put through the bone when we walk or push open a door.
Until the age of 30 we build bone faster than we breakdown the old and used up parts. After 30 the rate of breakdown of older bone has exceeded the rate of repair and building of new bone. The result is that we lose bone density because the thick latticework structure gets thinned out, with fewer pieces and parts and more space in between. It might look a little more like a lattice made of a well used sponge.
Going back to the “don’t bend and twist”. When we bend we can put upwards of 200 lbs of force through our spine compressing the vertebra, the bones of the spine. When our spine is young, the inner trabecular bone is more like a sponge that is made of wood or another solid material, if you will. It is harder to deform or change the shape either with compression or with torsion (twisting).
But as we age the bony latticework gets thinned out and it is as if the sponge is now wet, well used and beginning to show signs of wear. It is much easier to compress and wring out the sponge or cause damage. If we bend over to pick up a grandchild or to bend and twist to reach under the bed, the movements and pressures may change the shape of the structure from which it can not bounce back resulting in a compression fracture.
So like Margaret when she added the weight of the mattress with her spine bent and Evelyn bent and twisted to reach under the bed, their bones just couldn’t withstand the force. Both women wanted to have stronger bones, to build stronger bones, to regain their confidence and quality of life. But, both were unsure where to start.
In case you are curious Body in Tune would love to collaborate with you to help you learn and practice safe body postures to avoid incidental fractures with your daily activities.
Learning about osteoporosis/osteopenia is a little like tending a garden.
There are a few different types of gardeners.
The master gardener who is experienced and quickly form a plan to prepare and tend the garden. With osteoporosis they have always exercised and feel confident in their ability to continue exercising safely.
The reluctant gardener, like me is likely to throw the seeds in the ground, occasionally remember to water and weed and then wonders why the flowers and tomatoes are lacking. We are more apt to put their head in the sand and just want to muddle through with osteoporosis continuing life by stopping some activities and maybe changing some of our eating and lifestyle habits.
The anxious gardener goes all in, reads all the books, magazines and catalogs and searches online, prepares the soil in the early spring, and fusses over the watering schedule, weeding schedule and removal of destructive bugs. But you are exhausted and stressed about doing the right things, eating the right things, and going to balance and exercise classes so that you are doing the right exercises for your bones.
The novice gardener takes time, gathers information to formulate a plan and asks for support from experts to help plan the garden, learn the best techniques, tend the garden, enjoy the process and the results. In the case of osteoporosis/osteopenia you learn about posture, safe postures for daily activities, balance, stress management and exercise.
No matter which gardener you might be, you want to go from
wondering if all the exercises are safe despite having been regular at the gym for years
feeling overwhelmed by all the information that exists about osteoporosis
knowing that you love doing yoga and that yoga is good. But then a friend reminds you, you should not bend and twist and that includes plow pose which you love. So now what?
feeling scared about falling when you just want to be outside in nature
to feeling like
you now know what and which type of exercise is going to work the best for you? Spoiler alert - it is one you enjoy and can stick with on a regular basis
you have someone in your corner who understands your situation and your body at this stage in life
you have a yoga teacher who understands osteoporosis, its precautions and poses that are safe to practice with this disease. I will offer suggestions, read on…
you have a plan to improve and maintain your balance to reduce the chance of falls
Considering your osteoporosis diagnosis, which gardener are you?
Just as you tend your garden to help it grow, help flowers bloom and grow amazing vegetables, you will want to tend to your bones. This may come in the form of medications your doctor prescribes and reviewing your diet, your stress management and your level and type of exercise.
You may realize you would like support. You may seek out professionals who understand the diagnosis, understand your body at each stage of life and who can collaborate with you to make choices that set you on a path to have your bones looking like a well tended garden year after year.
By the way Body in Tune offers all levels of support for osteoporosis.