EXERCISE AND BONE HEALTH Tracy O’Mahony (MISCP) Senior Physiotherapist 3/10/2015

EXERCISE AND BONE HEALTH

Tracy O’Mahony (MISCP)

Senior Physiotherapist

3/10/2015

Key messages for exercise and bone health

Exercise needs to be unusually loading i.e. something the bone is

not used to doing all the time

Key messages for exercise and bone health

Moderate weight bearing exercise protects the bone

Too little (inactivity) or excessive loading results in

bone loss

Effective exercises for maintaining bone health

• Stair climbing

• Aerobics

• Skipping Jumping

• Dancing

• Jogging Sprinting

• Any bone loading activity

Ineffective exercises for bone health

o Flat road cyclingo Swimming

o Walking at a regular paceo trampolining

BUT

Not all effective exercises are appropriate exercises

Each person must be individually assessed

Aims of physiotherapy in osteoporosis and osteopenia

Maintain / increase BMD Education to improve

knowledge Minimise early bone loss post

menopause Maintain / improve muscle

strength Prevent fractures Improve posture

Aims of physiotherapy

Prevent / Reduce falls Personal empowerment

Improve balance / co-ordination Improve psychological well-

being

How? Design individual exercise

programme Balance training

Posture correction Ergonomic advice / lifting

technique Pain management (incl

acupuncture /TENS) address other conditions e.g.

pelvic floor insufficiency or weight-bearing joint OA

Exercise programmes for osteoporosis

Low impact Stair climbing

Tai Chi Aqua-aerobics Modified pilates

Strength training (short levers)

Exercise programmes for mild / moderate osteopenia

High impact if pre-menopausal Skipping, jogging, walk / jog

Medium impact if post-menopausal

Stair climbing, step aerobics, Brisk / power walking

Resisted gluteal / quads

Exercise for marked osteopenia

Low / medium impact Stair climbing Brisk walking

Strength training (short levers) Aqua-aerobics

Tai-Chi Hydrotherapy

Pain relief

Precautions – The “Don’ts”

• Avoid trunk flexion – no dynamic abdominal exercises

• Avoid lifting more than moderate weight

• Avoid twisting trunk

• Avoid touching toes or low bending from waist

• Avoid high / medium impact loading activities

Key groups practice nurses may see

School students especially early pubertal

Peri / post menopausal women Pregnant and post-natal women

breastfeeding mothers Teenage pregnancies

Women with 2 pregnancies close together