Osteoporosis is bone loss or “thinning” of the bones. The early stage of bone loss is referred to as Osteopenia, and research shows that more fractures occur during the Osteopenia stage than in the Osteoporosis stage.
Treat bone loss seriously. A quarter of all men and half of all women over 50 will break a bone due to Osteoporosis. Get a DXA scan if you have not had one yet. A DXA scan is a special type of x-ray that measures the amount of bone you have in your body. A proper reading of your DXA scan is essential for the accurate diagnosis and treatment of Osteopenia and Osteoporosis.
Exercise is good for osteoporosis, however, you should check with your doctor before you start any exercise programme to confirm that it is suitable for you.
The General Principles were developed as a guideline towards exercises in general because it is impossible to provide a list of safe exercises because no exercise is 100% safe. A patient with osteoporosis could sustain a fracture turning in bed or simply sneezing. However, exercising is generally safer than allowing your osteoporosis to get worse. Follow the General Principles and the motto “when in doubt don’t” Avoid activities that involve forward bending or twisting the spine as well as those that place you at high risk of losing your balance. Always follow these General Principles and guidelines when exercising:
Some patients with osteoporosis get fractures after they fall, or while exercising, but others fracture simply turning in bed, lifting groceries, swinging a golf club, or even sneezing. It follows that no one can give you a list of exercises that they can guarantee are “safe”. Follow the General Principles as these will help you avoid exercises which are dangerous, inadvisable or unsafe.
Does this mean I should avoid exercising?
No. Exercising is good for your bone density, and it is also good for your strength and fitness, your balance and co-ordination and reflexes. Exercise always carries a risk – but overall, not exercising is likely to be more risky. If you lose strength and fitness, and your balance, co-ordination and reflexes deteriorate, you are more likely to fall and break a bone.
Bone density in some patients improves quickly, in others more slowly – in some, not at all. If your bone density reverts to normal with the correct treatment, you can progress to some of the “higher risk” exercises. Not all patients recover enough bone density for this, but some do. Remember to follow up on your DXA scans (and make sure a proper reading of the DXA scan is carried out by a qualified healthcare professional) to confirm the state of your bone density.
If you are thinking of joining a pilates class at Pilates Lifestyle and you have been diagnosed with either Osteopenia or Osteoporosis you will need a private class first so that you can be assessed and taught modifications to some of the exercises we do in a Pilates class as not all Pilates exercises are suitable for clients with Osteoporosis.
There are several reasons why Pilates is recommended for clients with either osteopenia or osteoporosis, however, just because your healthcare professional has recommended Pilates does not mean that all exercises are safe. They are not.
If you consider that the goal of exercising when you have either osteopenia or osteoporosis is to:
then yes, regular supervised pilates classes will help you to achieve all three of these goals.
However, there will always be exercises you will need to avoid completely and some which will need to be modified. The last of the Four C’s as discussed above under the General Principles becomes the most important one to be aware of in any Pilates class. To remind you, here it is again: Contortion – activities involving bending, particularly forward bending of the spine.
At Pilates Lifestyle, we modify these types of exercises so that you can still strengthen your abdominal muscles and mobilize your spine but these will always be within the accordance of the General Principles. These General Principles are guidelines set out by the Osteoporosis Society of Ireland and endorsed by Chartered Physiotherapists who specialize in patients with Osteoporosis.
To help you in your Pilates class, what follows is a set of rules for participating in a pilates class and a list of exercises and photographs showing you what movements and positions do not contravene the General Principles.
So what is there left to do? Plenty!!
It is really important to let your teacher know if you have either Osteopenia or Osteoporosis before you start. It is equally important to notify your teacher when your DXA scan results change as this may affect what you currently can and can’t do.
I have written this article based on research I have undertaken in my role as a Pilates teacher. I am not a chartered physiotherapist. For this reason, I would like to especially thank Mr Richard Shortall, MISCP, of the Dublin Spine and Sports Physiotherapy Clinic (https://www.physiotherapyclinic.ie/) as well as my clients with whom I have worked to produce this information sheet. Should you require any further information on Osteoporosis or Osteopenia please visit http://www.irishosteoporosis.ie. or contact your healthcare professional.