Osteoporosis Protocols

Overview of Osteoporosis Safety

We're going to discuss a little bit about osteoporosis. For those of you who are not aware, there are certain motions when somebody has osteoporosis or osteopenia that are actually detrimental and potentially dangerous. Unfortunately, a lot of those motions are actually integrated within the Pilates workout. And what those motions are specifically is the forward bending of the spine, also known as forward flexion. So if you think of most Pilates mat exercises, 75% of them are actually advised against or need to be modified for those with the bone loss. So the reason for the need for modifying these exercises is that the front part of your spine-- the front part of your vertebra-- could actually fracture during these motions.

Now, you may say, I've been doing these exercises for a number of years, and I've been fine. But the problem is that we don't know if it's the 50th time or the 5,000th time that you do an exercise that it might have an unfortunate effect. And since we also know that the likelihood of a second fracture after a first one has occurred in the spine increases by 500%, we want to avoid the possibility of any fracture. And we always want to think of safety first. We've gone over a couple modifications that can be done, for those with osteoporosis. But I want to also give you some tools and an understanding of things that you should be focusing on.

Promoting Movement from the Hips - Hip Hinge

The basic concept that I like to promote is movement from the hips, not from the back. So I'm going to show you something that is called the hip hinge. So you're going to stand with your feet hip distance apart. Bending the knees and keeping your back flat, you're going to fold over. You can also do it this way-- place your hands so that your fingers point directly down toward your pubic bone. And now simply fold over your hands. Again, from the side, the way this looks is like this-- this is your hip hinge-- as opposed to bending through the back. The beauty of this is that it's not only appropriate for people with bone loss. This is a great way to avoid a disc herniation. So if you think about it, how do you pick up heavy luggage? Many of us actually reach down, curving our spines, putting a great deal of load on the intervertebral disc and get what they call a bulging or herniated disc as a result. Instead, utilize your thighs, utilize your hips, sticking your butt out, finding a little engagement through your core whenever you're picking something up from the ground. And I guarantee you your backs will be much healthier, and you will be much happier in the long run.

Strengthening the Back

Another thing that's incredibly important for osteoporosis or osteopenia is strengthening the back, because this will also help against the slouch that tends to occur in general with many people, let alone whether you have bone loss or not. Many of us need much more strength in our back extensors. On top of which, Pilates in general has so much forward bending, and I don't feel that there's enough emphasis on the back. So I think it's very important that people focus on that, so let's look at an example of this. From here in this position, I could simply have my hands by my sides, palms face up. I press my pubic bone down into the mat. I lengthen through the crown of my head. And I let my hands float up, as I rise just a little bit. So I'm working on the back-- the upper back specifically-- as well as the front part of the neck. And I lower back down. And I inhale and rise. And lower back down.

So this is an exercise that is parlayed into many of our classical Pilates exercises. We can think, for instance, of the swan rising up. We can think of swimming, again the same concept. We can even be thinking of single leg kicks, staying up right through the back and avoiding the slouch that occurs forward. So you can see there are a number of exercises, even within Pilates, in a classical repertoire, that you can make sure that you emphasize. Now, it's also important for people to know that working the back has been shown in scientific studies to also reduce the risk of falls. So it has that other benefit. Because as we were saying, osteoporosis itself is not the real danger. It's actually the fractures that occur from it. And those fractures often occur from a fall or from unsafe movement habits. So we looked before at how to properly pick something up. How to even do something such as sneezing-- as opposed to bending forward to sneeze, try and stay up right. So these are some simple things that you can do, and some exercises even within your own Pilates repertoire that you can perform to help yourself, if there is any sense of bone loss with osteoporosis or osteopenia.

Strengthening the Bones - Hips, Spine, and Wrists

The next thing I want to talk about are the ways to actually strengthen your bones. We're speaking specifically about the hips, the spine, as well as the wrists. And these are the three areas that are most commonly fractured by people with osteoporosis or with osteopenia. These are also the three areas that really need to have extra focus and extra attention in your workouts. How does bone actually get strengthened? It's through both weight-bearing, as well as through resistance exercises. For those without bone loss, it's very important also to be getting impact. Once you do have significant bone loss, you want to be careful of overloading your bones, which could possibly create a fracture. Now the other thing that's really important to remember is to move in different directions, because your bones get accustomed to the way that you're moving. But if you want to increase your bone density, and if you want to halt bone loss, it's really important that you move in different directions, that you move at different speeds, and that you use varying amounts of weight.

Theraband Exercise for Strength

So we're going to just do a quick little exercise here. Part of this is to demonstrate the importance of posture, the importance of alignment. Because if you're in a curved position, and then you start adding weights on to that, you could actually end up harming yourself. It's very important to align your spine as the very first thing, before you start doing other exercises, and, in fact, before you start doing your standing exercises. Which is why in the classes that we've done here, you'll notice that we did a class that began lying on our backs to unweight the front of our spine. And we progressed eventually to standing, and we did a standing class after that. Now one quick easy way that you can improve your posture is simply by taking a band. Poor posture results from a number of things, one being core strength-- weakness in the core-- weakness in the glutes, weakness through the back, weakness through the front of the neck.

So I'm going to have you just simply try this, by taking a band, standing tall-- particularly after the exercises that we've already done. But simply open to the sides and returning. Now I also like to have people do it against a wall. And if your head doesn't touch the wall, you can always place a small pillow behind your head. And then simply open your arms, so that you're activating the back and keeping the chin gently lowered, so that it's not jutting forward, but it's also not tucked completely. And returning. So just moving in this direction. You can also bring one arm up, one arm down. One arm up, one arm down. So it activates the back. It activates the postural muscles as well. So this will also help you stand taller and remain upright.

The Importance of Balance

The final thing that I want to mention that's really important for those with osteoporosis or osteopenia is balance. The danger of both these conditions is not the conditions themselves. The real danger is actually the fractures that occur from them. So improving your balance is critical to avoid potentially dangerous and devastating falls or fractures. I hope that you now have several concepts to follow and even an exercise to utilize, to understand better about what you can do for yourself with osteoporosis or with osteopenia. For more information about osteoporosis or bone health, you can contact me at my website at Incorporatingmovement.com. And also, I have my Pilates for Buff Bones Workout. And you can find out more about that at Pilatesforbuffbones.com, as well as its Facebook page. And of course, I'm also on Twitter, through my name.