A great article from Jen Guest who is a physiotherapist at Smart Health Training and Services. Interesting to read about the importance of Vitamin D too!

Osteoporosis or “porous bones” is a pathology which is quite relevant in the modern world. When bones lose mineral and protein content, especially calcium, they begin to degenerate internally. Often this is not known to the client until a bone breaks. It is often termed the silent pathology. Breaks, or fractures, are most commonly seen in the spine, hip or wrist. The spinal fractures are most common in the Thoracic spine where the kyphosis (forward bend) develops. The anterior edge of the vertebral body weakens resulting in possible wedge fracture through this area.

We have cells call Osteoclast which lay down bone and osteoblasts which break down excessive bone. These cells work together regenerating our skeleton entirely every 10 years or so.  With aging, the osteoclasts reach their peak at approximately the age of 30, and from 40 years old, the osteoblasts work more than osteoclasts resulting in increased occurrence of porous bone. The action of the osteoblasts further increases by the age of 50 and post 75 years old, 50% of the population are Osteoporotic.

Osteoporosis is more common in females post menopause, as the Oestrogen  levels drop dramatically. Oestrogen is a bone protecting hormone. In males, testosterone is converted into Oestrogen to protect bones and again with ageing, this reduces. By 6-7 years post menopause, bone density has reduced by 20%. Post 70 years old, females have lost 30-50% bone mass and men have lost 20-33%.

Drinking and smoking, potentially leading  to poor nutrition, leads to increased incidence of Osteoporosis. Lack of Vitamin D and also lack of exercise and a  diet low in calcium of protein predispose one to Osteoporosis. Asian and Caucasians are more susceptible to Osteoporosis but Hispanic and African less so.

Osteoporosis is diagnosed via a Bone Density Test. Those who indicate mildly lower bone density are termed Osteopaenic and should be treated in a similar fashion. There is no cure to Osteoporosis but it can be controlled, particularly the kyphotic posture that may develop with the pathology.

Osteoporosis Australia advocate Vitamin D, good calcium absorption and exercise for Osteoporosis. The exercise needs to be in the form of weight bearing more than resistance training. The weight bearing assists in bone reformation and strengthening. In particular we wish to strengthen the extensor group of muscles ( the back muscles).  This assists developing postural strength and endurance and reduce the forward bend or hump like posture. In addition we want to focus on scapular strengthening and thoracic extensor strength to protect the upper back and upper limb strength to reduce the chance of wrist fracture

Pilates is an ideal format of exercise for the Osteoporotic or Osteoporosis prevention. The exercises are controlled and balanced, with specific emphasis on the extensor groups of muscles. Weight bearing can be gained on the equipment with spring resistance. Work in closed chain or pseudo closed chain allows for controlled concentric and eccentric loading of the bones.

Whilst exercising, we would want to avoid any loaded flexion (forward bend) as we would not wish to put undue load through the anterior aspect of the spine, for fear of creating a wedge fracture. The Osteoporotic can still work hard in the Pilates Studio, building up postural support and strength, building up bone density , correcting posture and improving alignment of the limbs and ultimately reducing the effects of Osteoporosis. So lets do Pilates and build those bones people!

Jen Guest is a Physiotherapist and Senior Pilates Practitioner at  Smart Health Training and Services who holds a strong belief in working with junior dancers through their developmental years to achieve maximum potential.

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