Managing Osteoporosis With Physiotherapy: Exercises For Stronger Bones

Imagine bending over to reach for an object and suddenly hearing a loud noise, ‘crack’, accompanied by excruciating pain, resulting in a spine fracture. A harmless movement or a daily activity causing a fracture is relatively unheard of unless you have Osteoporosis.

Osteoporosis, what is this?

Osteoporosis affects the bones, causing them to become less dense and weak, eventually resulting in fractures. It is a silent disease because it often goes unnoticed until a fracture happens. Approximately 60 million Indians are osteoporotic, 80% of which are females.

Causes and Risk Factors

Osteoporosis is usually common in people over 50 years of age; peri-menopausal and post-menopausal women are at a greater risk. Some risk factors include advancing

• Age

• Low body mass index

• Gender (more common in females than males)

• Sedentary lifestyle

• Hormonal changes

• Ethnicity (greater predisposition in Indians)

• Alcohol and cigarette smoking

Treatment and Prevention

1. Pharmacotherapy

− A high-protein diet

− Calcium and Vitamin D supplementation

− Combination therapy of Bisphosphonates and Hormone therapy

2. Physiotherapy

Osteoporosis causes chronic pain and discomfort, reduced physical activity and increased dependence due to fear of falls, thus affecting the overall quality of life of an individual.

Physiotherapy not only helps in osteoporosis prevention but also improves once it has set in.

Weight-bearing exercise:

Weight-bearing exercises help in improving spinal bone density.

• Walking

• Stair climbing and

• Low-impact aerobics activities like Zumba

Improving strength and mobility:

Resistance training using free weights like dumbbells and therabands or body-weight exercises helps to increase muscular strength.

• Biceps curl

• Wrist curl

• Wall-supported mini-squats

• Hip abduction

Balance training:

• Balance training using audio, visual and verbal cues helps to prevent falls and fractures. Yoga

• Tai-Chi

• Exercises to train stability like reach-outs, small perturbations, obstacle course training Dynamic balance training

• Co-ordination exercises

Posture and flexibility:

People with Osteoporosis are at a greater risk of developing spinal deformities and vertebral compression fractures. Postural re-education and training

• Stretching exercises to improve flexibility and mobility

• Thoracic extensions

Fall reduction and prevention: Muscle weakness, poor posture, balance, and vision commonly lead to falls. Analysis of environmental factors for fall risk is crucial. These factors include poor lighting, wet or slippery floors, unstable surfaces and the absence of handrails in washrooms or along stairs. To reduce or prevent fractures:

• Balance and gait training

• Use of assistive devices

• Hip protector belts to reduce fracture risk

• Use a low-heeled shoe with rubber soles for better grip

Patient and caregiver education:

Education about the condition to ease anxiety and reduce fear.

• Lifestyle modification

• Pain management and relaxation techniques

• Educational materials

• Fall prevention methods and how to get up after a fall

Regular follow-ups, bone density scans, tailored exercise routine and educational campaigns can improve the quality of life for those affected by Osteoporosis. Let’s build stronger bones to fight Osteoporosis!