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What is it Osteoporosis?
Osteoporosis is a condition of reduced bone mass, bone density and bony structural integrity. These changes within our skeleton occur over a long period of time, however, can be exacerbated by certain factors such as:
- Medications which reduce bone density such as corticosteroids
- Decreased levels of oestrogen caused by a variety of factors including early menopause, excessive exercise during puberty
- Liver or kidney disease
- Dietary calcium intake
- Lack of physical activity
These factors can reduce our body’s capacity to strip our bones of old cells and replace them with new cells, which leads to decreased quality of bone over time.
Mobile Clinicians supporting Osteoporosis
How do I find out about my Bone Density?
A Bone Mineral Density Scan is currently the gold standard assessment for assessing bone density. Your GP may refer you for this scan if they determine that you possess the relevant risk factors. This machine works like an X-ray machine, however, you will be lying down in a similar fashion to an MRI test. The assessment takes between 10-15 minutes to complete
Why is my bone density important?
Bone density is correlated with the likelihood of a fracture upon high-level impacts, such as a fall. By increasing your bone density, you minimise your risk of fracture and consequent complications.
How can exercise help with Osteoporosis?
Whilst the dietary concern of consuming regular calcium is well known within the community as a way to combat and manage osteoporosis, there is less widespread community knowledge surrounding the role of exercise.
An exercise which increases the impact load upon the skeleton has been shown to be the most effective way of improving bone health. Whilst walking is one way to increase the load on bones, the evidence tells us that short bouts of high-intensity loading is more effective than continuous loading at the same intensity (walking at the same speed).
Loading your bones in the most common areas of fracture, particularly the hip, spine and wrist should also come into consideration when devising an exercise plan.
Examples of exercises can include squats, lunges, step-ups and using hand weights.
It is important to note that research has found that resistance training is not only beneficial for people living with osteoporosis but also safe. The LIFTMOR trial demonstrated that high-intensity resistance and impact training was safe for postmenopausal women with low bone density and resulted in increased bone density!
What are the Causes of Osteoporosis?
There is a lot of research looking at what causes osteoporosis.
Like many disease processes, osteoporosis can be multifactorial and impacted by many things.
Typically, osteoporosis can have a genetic component, which will require further research in the future to see how that can be tested and potentially addressed at a genetic level. However, it is well known that both dietary and lifestyle choices of physical activity will impact bone density.
It’s very important to have a healthy diet with sufficient calcium and vitamin D exposure through lifestyle exposure to sunlight or through supplementation of vitamin D and appropriate physical activity. As mentioned previously, having adequate resistance and impact on the body helps facilitate bone density.
What Can I Do to Prevent Osteoporosis?
It is always beneficial to seek guidance from General Practitioners (GPs), Physiotherapists, Dietitians and other healthcare in regards to osteoporosis management.
If someone is concerned about their risk of developing osteoporosis because they have members in their family that have had it, or they are looking to optimise health and decrease the risk in the future, one simple strategy is achieving the Australian physical activity guidelines. This, for almost all age groups, stipulates at least 150 minutes of moderate physical activity a week, as well as twice-weekly strength and balance exercises.
In regards to osteoporosis, we know strength-based exercises are extremely beneficial.
People should strive to eat healthy foods, as well as intake adequate calcium and vitamin D (which is also possible through supplementation).
What exercises are the cornerstone of an osteoporosis rehabilitation program?
There have been several research studies on what exercises are most beneficial for people living with osteoporosis. It has been shown that it is safe, and most effective to utilise rehabilitation programs with quite difficult resistance exercises, as well as impact exercises if the patient can tolerate it.
By resistance exercises, we’re referring to lifting weights, dumbbells, barbells, or even resistance bands.
In regards to impact exercises, a particular research study aptly named the LIFTMOR study asked participants to pull themselves upwards on a chin-up bar, then let go and land on their feet. The results suggested impact and resistance through the bone is theoretically facilitating an increase in bone density as well. Importantly, those research studies showed no adverse effects in terms of bone injuries or fractures when completing these exercises.
Are there movements a person with osteoporosis should avoid?
At a broad level, the answer to that is no.
We know that physical activity, specific exercises, resistance and impact are beneficial, and will help maintain or build bone density. However, people with osteoporosis should have a Physiotherapy assessment to determine safe and clinically appropriate exercises. The most important thing is finding what is a safe level to start from.
How is the effectiveness of Physiotherapy for Osteo measured?
So if someone has osteopenia, the starting of osteoporosis, or osteoporosis, they would have had a bone mineral density scan.
This scan can be repeated periodically in the future, preferably three to six months later after commencing a Physiotherapy program, targeting bone density, the scan will show if there has been any change.