Impression: OSTEOPENIA in the right hip and lumbar spine.
Can’t be. She spent more time pounding the pavement than most women.
Good diet – check.
Calcium and vitamin D supplements – check.
Regular weight bearing exercise – check.
Janet had few risk factors: she didn’t take steroid medication; she didn’t smoke and despite all her dieting, she wasn’t underweight.
No wonder she was flabbergasted by the diagnosis.
Janet had been doing everything she could imagine to keep her bones strong, but clearly something was missing. More and more older people were turning to Pilates and yoga for exercise because they seemed gentle and safe. Why not?
Yoga made her sore, but it was a new kind of exercise, so maybe, she thought, she just needed to get used to it. She already had neck and back pain, so what the heck? If a little was good, more would be better. Resolute, she added a few more classes.
By the end of a fortnight, Janet couldn’t sleep – she could barely walk. The pain was relentless. Her doctor confirmed the really bad news: she had several compression fractures in her spine. Smart as she was, Janet did not know how to protect and strengthen her bones during yoga or Pilates. Don’t be like Janet. Though these exercise forms can be gentle, knowing how to modify them when you have bone loss is critical.
Are you at risk? We think osteoporosis affects women “of a certain age” because we usually hear about bone loss occurring after menopause. Yet we all experience changes in bone density in our lifetime. Most bone is formed between the ages of 15 to 20, and bone density peaks in your mid-thirties. After that, you lose as much as 10 % of your bone per decade. A poor diet, smoking, alcohol and even stress accelerate bone loss. And Asian and Caucasian ethnicities are more at risk.
Bone density is measured using a DEXA scan and is compared to the average peak bone density of young adults of the same gender and race. A score of -1 to 2.5 SD means you have osteopenia and if it’s below -2.5, you have osteoporosis. The lower your score, the higher your fracture risk. The encouraging news is that there are measures you can take to prevent fractures and even increase bone density.
The numbers are dismal.
- Every 3 seconds someone in the world fractures a bone due to osteoporosis.
- Worldwide, 1 in 3 women and 1 in 5 men will have a spontaneous fracture because of bone loss.
- In the US: 10 million people have osteoporosis, 34 million have osteopenia, and 18 million more are at risk for developing the disease.
- The financial cost is huge: 17 billion dollars per year.
- The personal cost is hard to fathom: pain, poor health, and loss of independence. Imagine rolling over in bed and breaking your back. It happens every day to someone with osteoporosis.
- Medication: There are drugs to address bone loss. Unfortunately, many have severe side effects. Discuss these treatments with your doctor, and examine the risks carefully.
- Diet: Dietary changes can also improve bone health. Diets high in calcium, Vitamin D and K, and magnesium support bone health. Green and black tea, onions and garlic, olive oil, tomato, soy are some ingredients that have been suggested as potential alternative therapies for bone loss.
- Physical Activity: And then there is the panacea for almost all ailments: exercise. But to treat fragile bones not just any exercise will do; some forms of exercise and movement can actually make the problem worse.
Bone growth and strengthening require stress. Not the kind of stress that promotes anxiety, but the kind of stress that stimulates. A consistent walking program is often enough to prevent bone loss, but to build bone you need impact. For this same reason, space travel is not recommended. So before you book that first passenger flight to the moon, consider your bone health!
Walking with a weighted vest, running, or jumping provides impact. However, your joints may protest. Maybe swimming or cycling? While they are kind to your joints, they may actually decrease bone density. Now what? This is where an ALTA physical therapist can help you maximize your tolerance for activities, and develop an appropriate, safe approach to bone health.
Janet was doing repeated forward bending and rounding her spine in yoga class. These flexion movements probably caused multiple spinal fractures. Had she been well informed, she would have known these movements were contraindicated and made modifications in her practice that would have been salutary.
Our goal at ALTA is to provide the education and information you need to keep your bones healthy and strong. It is for this reason we are going to host an educational lecture in February, and offer a Pilates-based floor class for healthy bones in March. After the lecture and taking the class, you should have the principles you need to modify a class to make it safe and effective for your own bone health.
The Pitfalls and the Promise of Pilates
a lecture by Jonathan Oldham, MSPT, PMA-CPT
Thursday, February 27th ; 6:00 pm
at ALTA Physical Therapy; 2955 Baseline Road, Boulder
Please call to RSVP 303-444-8707 ext. 100