I can’t tell you how many clients have come to me and said,
“I have Osteoporosis, is Pilates weight-bearing exercise?” Osteoporosis is a diagnosis that is
often handed out at the Doctor’s office with a “Be careful! Your bones might
break,” or a “You’re not getting any younger,” or “Here’s a prescription for
Fosamax, or Boniva, or estrogen replacement,” or “You haven’t been drinking
your milk!” Sometimes the
diagnosis is treated as hopeless, and simple directions like “do weight-bearing
exercise,” can be as confusing as anything else. Often, when people come into The Pilates Studio with news of
osteoporosis, there is a little slump in the shoulders as if the inevitable has
happened, old age is approaching…However, osteoporosis doesn’t have to be a
slow and anxious wait to a hip fracture!
It is not the inevitable disease of the aged, and the best part of an
exercise program geared towards bone growth is the side effects of
increased strength and proprioception! What are the side effects of Fosamax again?
This past weekend I had the opportunity to take a course
with Polestar Pilates Educator
Sherri Betz, PT, GCS. Sherri is a Physical Therapist who has spent the past 20
years studying osteoporosis in both a research and clinical setting.
In her course we reviewed what
movement leads to bone growth, and what movement might increase the risk for
fracture.
We reviewed several
research studies and discussed the role of nutrition and posture to bone
growth! There is so much information that I want to share, but most importantly
I want to celebrate the strength and power that can be gained along with the
bone growth.
In this weekend,
Sherri taught a class that was designed for older adults (85 and over).
We started the class sitting in chairs
and progressed to standing, while using the back of the chair for some balance
practice.
This was not an “easy”
class.
I broke a sweat and the
muscles in my hips were sore and stronger!!!!
As I was taking this class I thought to myself:
What
if we lived in a world in which the wisdom of our elders was more apparent than
their frailty?
As you can see I’ve been inspired and plan to share as much
of this information with you as I can.
In this post, I want to explore what components need to be in a bone
building movement program, and over the next few weeks I hope to share even
more information with you. Let’s
look at the following three components:
A bone-building workout must:
1. Include
weight-bearing exercise that increases osteoblastic activity (bone generation),
2. Eliminate
movement in certain planes of motion that increase the risk of vertebral
fracture.
3. Include movement
that prevents fracture by preventing falls. (Balance challenges)
The complexity within these three categories can be mind
boggling and overwhelming, but it is my hope that with a little information
over the next few weeks, osteoporosis won’t be such a scary word! And that this blog will give the
resources necessary to find the strength and power that comes with an increase
in bone density!
First, what is
weight-bearing exercise that increases osteoblastic activity?
Here are some of the tidbits that Sherri shared in regard to
weight-bearing exercise!
First, “exercises need to be site specific,” For instance if
you have osteoporosis in the hip the movement that you choose must challenge
the muscles in and around the hip socket, and if you have osteoporosis in the
spine you must challenge the muscles that run along the back of the spine.
Secondly, the weight bearing exercise must be challenging,
and should “include activities that impose bone loads substantially greater
than those experienced during activities of daily living.” In other words, if
you can do 20 reps without fatigue then the exercise is not challenging enough!
And finally, once strength has increased and a once
challenging exercise becomes easier, it is imperative to progress the exercise
so that the load on the bone is increased! (Increase resistance or proprioceptive challenges, or change
exercises)
With the above
information can you think of ways that your pilates exercise might have to
change?
What movement needs
to be eliminated? Sherri Betz made sure to emphasize that we are not trying
to turn people into “a box on legs.”
When thinking of movement elimination, we want to keep as much mobility
as possible without increasing the risk for fracture. In osteoporosis of the spine, flexion of the spine and the
combination of flexion with rotation (bending forward, and bending forward with
rotation) puts a load on the
vertebral body that leads to compression fracture and increased kyphosis
(increased curvature of the thoracic spine). Yet, there is a bright side! Eliminating flexion and increasing the
extension of the spine improves posture!
At The Pilates Studio, one client called the swan (spine extension
exercise) her fountain of youth!
Now think about your
pilates workout? What exercises
need to be replaced? What
exercises might be added? The
elimination of thoracic flexion from your pilates workout will in no way
decrease the amount of core strengthening available to you! Believe me when I say The Hundred with
the head down requires even more abdominal strength than The Hundred with the
head lifted in thoracic flexion.
The final component
of this new Osteoporosis friendly empowering and strengthening workout is
fracture prevention, by improving balance to prevent falls.
The Pilates Studio is no stranger to balance practice.
Do you remember last spring’s
balance challenge?
If a person has a
diagnosis of Osteoporosis it is a clear assumption that improving balance will
decrease the chance of a fall, which will then decrease the chance of
fracture.
How is your balance? Can you stand on one foot? Sherri Betz showed us many ways to
challenge the balance. Here are a
just three standing exercises to try:
For all of these exercises stand next to a wall in case you
have to suddenly catch your balance.
1.
Stand with your feet together, and by together I
mean the entire foot is hugging the midline!
Close your eyes and notice how your weight shifts from side.
Hold this for approximately one minute.
2.
Stand with one foot in front of the other.
Line your feet up heel to toe and keep
your balance.
Start with your eyes
open and if you need additional balance then close those eyes
3.
Repeat #2 with the other foot in front
How did it go? Could you commit to doing these three
exercises everyday?
There you have it, a small tidbit of information that was
presented in a wonderfully full weekend.
I hope to share some more over the next three weeks with the following
three posts:
1.
In next week’s post I want to outline a fabulous
opportunity for the clients at the Pilates Studio. It is now a possibility for clients at The Pilates Studio to
be a part of a national study.
Over the next year we can gather data and increase the information out
there about pilates and osteoporosis!
It will be a great way for individuals to increase bone density, and
also an excellent way to contribute to the greater fight against frailty and
old age!
2.
The week after that I will interview our very
own Naturopath, Dr. Allison Willette.
As many of you know she has a plethora of knowledge about exacting
nutrition. And I might even
include a bone building recipe or two.
3.
And the final osteoporosis post will outline a
home program that will build bone health, and make everyone who commits to it
strong!
What a fabulous fall it promises to be! I can’t wait until the spring when we
emerge from our New England winter ready to climb mountains!
Katrina Hawley C.M.A, PMA - CPT
