Me balancing on a fence near Shasta
Osteoporosis and Fall Prevention
Osteoporosis has been on my mind lately.
I’m curious about the way patients are informed about what they shouldn’t do once diagnosed.
Here are some things I’ve heard from students/clients:
- “never flex your spine again”
- “never twist again”
- “cat/cow is not safe for your spine”
- “if you fall you will break your hip”
Honestly, I don’t know how we move through our lives without some spinal flexion or rotation and telling someone they will break something if they fall promotes self limiting behavior that may impact overall function.
I’d sure like folks to be given ideas about what they can do if they have a diagnosis rather than language that promotes fear about what they shouldn’t do.
In the last couple years I’ve been focusing on teaching women to strength train as a means to build and/or maintain bone mass, wherever they land on the scale of bone density.
What I hadn’t been specifically considering related to osteoporosis is balance and fall risk/fall prevention.
I know, of course, that strength correlates to better balance for anyone. I also understand that training balance is critical for an aging population.
I’ve just been hyper focused on strength training as bone building/bone density maintenance.
The study I read yesterday morning put some things into perspective for me.
It broadened my focus, which is good for me not only as a post-menopausal woman, but as a movement teacher working with mostly “older” adults.
Here are some important facts from the study:
- One in three women worldwide is at risk for an osteoporotic fracture
- Falling is the main reason these fractures occur
- Falling is related to balance issues and decreased strength in the lower limbs (foot/ankle/lower leg/upper leg to pelvis)
- In older adults, high levels of lower limb strength and balance acuity are essential requisites for living independently and performing activities of daily living
Back to the study results.
Two groups of women, 50 – 72 years old, diagnosed with osteoporosis were randomly assigned to a control group or an experimental group.
The control group was asked not to change their behaviors regarding movement/exercise.
The experimental group was assigned a 6 month/3X weekly exercise protocol made up of 10 min warm up, 10 min static balance exercises, 10 min dynamic exercises, 20 min of low intensity muscle/strength exercise, and a 10 min cool down.
During the 6 months of the exercise protocol, the timing, repetitions, and load of the exercises were increased in 3 phases. In other words, participants were asked to do more over time.
This follows the principle of “progressive adaptation”.
Progressive adaptation is basically the idea that we add more load/we ask more of the body in smart and safe ways to induce a change (get stronger and more able) in tissues/the stuff we are made of.
Apply a load, the body reacts, then the body adapts, and then the load is perceived differently (and hopefully the action is easier).
Opinion Alert:
This is where I think many of us lose out. We go to the gym or take our same walk or do the same yoga routine. We do pretty much the exact same thing over and over, never increasing the load, the range, the timing, or the difficulty. While we may maintain what we already have, the body is not asked to deal with new and novel or increasing difficulty and so the tissues/the stuff we are made of doesn’t really change. We don’t get stronger, or create more range in the joints, or more ability/function.
And, please hear me, if you are moving and don’t want to or know how to change things up, then keep doing that because all movement is better than no movement!
Back to the study results.
The women in the exercise group improved significantly in strength, static balance and dynamic balance compared to the control group who did not change their movement habits in the 6 month period.
In fact, the women in the control group saw fairly substantial declines in their static and dynamic balance in only 6 months.
This alone should be a big red flag to all of us concerned with bone density because the risk of fall increases as our static and dynamic balance decreases.
This study suggests what we CAN DO to live with osteoporosis, to increase our strength, to increase our balance capacity and decrease fall risk, and to maybe gain some confidence in order to not self limit as much, reducing function for activities of daily living.
What the study suggests to me is that with a fairly short period of exercise time consistently performed over a rather short period of time, 6 months, is worth every minute!
The women in the exercise protocol spent a total of 40 minutes 3X a week on balance exercise and low load intensity strength training, using things found around their homes like bottles filled with water, as their strength equipment.
Of course, we wouldn’t want to stop after 6 months. I’m not aware of a study follow up being done, but I can only imagine that a continuation of progressive adaptation and practice would continue to provide results leading to even more strength and balance acuity.
Unfortunately, the actual exercises used in the 6 month study are not available to the me, the reader. I’m asked to consider what I would use in a 6 month program. I have that ability, thank goodness!
And, the next question is… do I create and offer a 6 month program?
Whether that happens or not, you will be seeing some of this in all my classes and one-on-one training sessions.
