Sticks and stones may break your bones, but so may osteoporosis. At least, in your middle-age years. Half of all Americans age 50 and older—54 million—are at risk for breaking a bone.

Licensed physical therapists Karen Beale and Brittany Pabon, rehabilitation experts with Lee Health outpatient rehabilitation services at Cape Coral Hospital, share tips for keeping your bones healthy to reduce your risk of osteoporosis. If you already have the condition, you’ll also learn important steps to slow its progression and improve your quality of life.

Karen and Brittany are Bone Fit Trainers that are certified through the Bone Health and Osteoporosis Foundation. Bone Fit is an evidence-based exercise training workshop for healthcare professionals and exercise practitioners who work with clients with osteoporosis.

“Osteoporosis is a risk factor for fracture, like high blood pressure is a risk factor for stroke,” Karen says. “A condition that causes bones to become thin and porous, osteoporosis is often called the ‘silent thief’ because bone loss occurs without symptoms. Some people don’t even know they have sustained a fracture or have low bone mineral density.”

Building a strong skeleton in childhood and adolescence will provide benefits as we age. Women and men begin to lose bone in their mid-30s. And women, when they go through menopause, lose bone at a greater rate than men, Brittany says.

  • What’s the difference between osteoporosis and osteopenia?

    Osteopenia is when your bone density is decreased. Osteoporosis describes a condition in which bones are more porous and at a higher risk for fracturing. Karen and Brittany stress that both conditions are treated the same because you remain at risk for fracturing a bone from both osteopenia and osteoporosis.

    “Just because you have osteopenia does not mean it will progress to osteoporosis,” Brittany emphasizes.

  • How did I get osteoporosis?

    Osteoporosis doesn’t have a single cause. In most cases (75 percent), it’s genetics, meaning the condition has a tendency to run in families due to genetic factors. Osteoporosis can also be caused by medications (such as steroids and cancer treatments), a variety of disorders (neurological, autoimmune, endocrine, and blood). Also, hysterectomies are associated with an increased risk of osteoporosis and bone fracture.

  • What can I do to lower my risk for bone loss?

    A few things you can do to lower your risk for osteoporosis include:

    • Avoid smoking
    • Limit your alcohol intake (women, this means fewer than two drinks per day; for men, fewer than three drinks a day)
    • Engage in more weight-bearing exercises
    • Decrease caffeine intake (fewer than three cups a day)
    • Improve your diet (consult your physician or dietician)
  • How is osteoporosis treated?

    Healthy lifestyle choices such as proper diet, exercise, and medications can help prevent further bone loss and reduce the risk of fractures.

  • Are there different treatment options for premenopause and postmenopause?

    If you’re premenopausal, Karen and Brittany recommend high-intensity progressive weight training, running, jogging, and dancing.

    If you’re postmenopausal, both Physical Therapists recommend walking, single leg stance (with arm support if you have poor balance) for at least one minute, three times for each leg. They also recommend resistance exercises (strength training) for your arms and legs.

    If you’re physically limited or require a more structured exercise, please get a physical therapy referral from your doctor for a physical therapy evaluation with a therapist who works with people who have osteoporosis.

    Before starting any exercise program, you should first consult with your healthcare provider. If you do lift objects in your program, make sure you know to lift them properly. A physical therapist can guide you. 

    If you go to the gym and are working with an exercise specialist, please tell them you have osteopenia or osteoporosis.

  • Do I have any restrictions when exercising?

    No exaggerated, repeated, forceful bending, lifting, and twisting (BLT). Try to avoid staying in those positions for a long time. Avoid abdominal crunches/crunch machines, and don’t try and touch your toes or do sit-ups.

    Be careful lowering heavy weights/objects from overhead or with outstretched arms. Make sure how to learn to properly lift objects from a trained individual.

  • If I break my restrictions, what can happen?

    Individuals can sustain bone fractures, most commonly in the spine and hip. Wrist fractures are also common, but usually occur when the individual breaks a fall with their hand.

    Physical therapy teaches methods and structures goals towards preventing fractures, falls, and exercising safely.

  • Can I continue to play golf? Pickleball? What about yoga and Pilates?

    This a very tricky question. If you’ve been playing for a long time, it may be safe to play your sports. However, if you’ve have sustained compression fractures, you may need to time to discontinue your sport.

    If you’re practicing yoga and Pilates, there are some positions you should modify or avoid altogether. To learn about how to adjust positions in yoga, we recommend Yoga for Better Bones by Margaret Martin.

    Also, if you’re a golfer who has osteoporosis, you can improve your safety and body mechanics by following these guidelines.

  • Where can I receive treatment for osteoporosis?

    Many Lee Health providers have attended continuing education courses with Sara Meeks, a Physical Therapist who is nationally recognized in treating osteoporosis and one of the contributors to the Bone Fit training material.

    There are also providers that are certified through the Bone Health and Osteoporosis Foundation.

    Find a licensed professional in your area.

  • Additional resources on osteoporosis

    Lee Health offers a variety of resources (talk with your doctor and/or physical therapist). You can also participate in educational programs offered by Lee Health’s Healthy Life Centers. Visit this link to see an event happening near you!

    Bone Health & Osteoporosis Foundation

    Too Fit To Fracture: Managing Osteoporosis Through Exercise – Bone Fit

    BoneTalk podcast

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