Did you know that as many as 50% of women and 25% of men over the age of 50 will fracture a bone due to osteoporosis? May is #osteoporpsisawarenessmonth so before we get to the end I just had to draw our attention to these quite shocking figures! 🦴👀🦴
As a Pilates teacher I work with several clients who have been diagnosed with varying degrees of bone-density loss and of course there are some real considerations to take on board once we know this is an issue. But, as with my treatment approach to any part of the skeletal system, I don’t like wrapping people in cotton wool, particularly those who are regular exercisers, so the approach I take is very personal taking into account the history, severity of the condition and any specialist advise.
Many people are diagnosed after suffering a broken bone so obviously my first port of call is to introduce Pilates if they do not already practice to start the process of rehabilitation. We can then explore the movements which we now need to avoid or adapt to safeguard the joints. Loaded forward flexion and deep twists put too much pressure on the spine and can contribute to compression fractures, so although something may feel OK at the time, we need to be mindful.
So what do I do now and what need’s to change?
Well, as I say, it all really depends on how your scan looks and what you were used to doing up to this point. From a nutritional point of view, vitamin D and calcium levels are vital to be maintained but this doesn’t necessarily mean eating loads of dairy. Poppy seeds, sesame, chia and almonds are all great sources of calcium!
When is comes to exercise, the advise from various societies which you find online really all seems to be based around someone who has never exercised before, so if you are not a regular exerciser then do heed that advise and find a Pilates instructor who understands the condition and can help you. There are even separate teacher training courses available on bone health so you should be well catered for. If you are taking classes already – do let your teacher know so they can advise you.
As a practical example however, one of my clients was a regular marathon runner until some severely bulging discs put pay to last years’ events. We had great success with massage alongside her physiotherapy in dealing with her back pain but, as she started to run again, a new pain occurred. Thanks to the wonders of private health insurance we didn’t have to wait long for scan results to show a fracture of the sacrum and, because of her age as a factor, she then had a DEXA bone scan which revealed quite severe osteoporosis throughout the spine. It can be a real blow as a diagnosis as all the advise seems to say STOP RUNNING! But is that really the case with someone who is so experienced and would really miss the mental health side of her running. So many people use their chosen method of movement as self-care which we desperately do not want to lose, so this was her first question to the specialist and surprisingly we were told not to rule it out. Working alongside the physio again, we have switched to 1:1 Pilates sessions in place of massage for the moment and with the strength gained she has been able to run again for nearly an hour. Marathons may be a thing of the past, but we are functional!
So the moral of the story is, don’t give up hope. You may well be told that yoga is not suitable for you any longer but it can be adapted to avoid deep twisting and loaded forward flexion. I wouldn’t suggest taking up Ashtanga if you are a beginner and newly diagnosed, but we do need to keep strong. Bones need some stress to be maintained so perhaps take up tap-dancing instead, it is surprisingly effective! Bones lose their density through lack of use too so it’s essential to keep working. Weight-baring exercises are vital, so walking is great if you do nothing else. In Pilates we need to work on abdominal strength without the head leaving the floor so sit-ups are out, but that’s no problem as there are so many other options. Resistance bands and small weights add another layer of interest and really help build and maintain your strength without having to hit the gym. Another client of mine in her 80’s took up Pilates the moment she was told her bone density was diminishing and has kept it stable for 6 years using just that method. Let’s stay mindful of those bones – if you get a pain that just won’t go away or a fracture without a fall, it’s worth investigating.