Do you know if we can do squatts by holding on to a chair for balance?
Exercises for our thighs and hips like standing and holding a chair and move one leg out and then repeat with other leg?
Standing and holding on to chair and moving leg from side to in front on the other side and back and then repeat for the other leg?
Standing feet slightly apart and lifting leg backward and then repeating with the other leg?
Thank you! Victoria
Hi Victoria:
Squats can be done two ways. Holding on to the back of a chair is a good choice.
The better choice is to do squats by leaning your back against a fitness ball on the wall.
Stand close to a wall with your back facing the wall. Place the fitness ball between your back and the wall. Allow the ball to roll up and down the wall as you do your squats. All the rest
of the exercises you suggest are good as well.
Woody
Thank you so much for your post. I live in a very small apartment and I don't have a wall to stand against. I don't know about the ball and would be afraid to use it...besides I don't have the space. I hope what I am doing will still work good enough. Again, thank you for your post and if I ever move from here I will use this method. Blessings to you. Victoria
Squats such as described can be tricky without proper instruction -- preferably from a PT with expertise in this area. I would not suggest doing this "on your own"; an exercise ball can be very useful and make it more fun. Not everyone can manage the ball -- at least at first --and it does take up room -- even in moderately-sized houses.
The main thing with squats is NOT to bend forward from the waist but to keep one's back straight as you bend your knees and hips for the squat.
Done properly, squats can strengthen back, hip and knee musculature and help in posture training.
Posture training is KEY to proper exercising. This seems to get short shrift in the media and from non-PT health poviders, unfortunately.
Lucy Buckley PT
Even though it may take up room, a fitness ball is indispensable for a wide variety of exercise activities. In non exercise times, you can even use the ball in lieu of a chair in front of your computer. Just by sitting on the ball, you are strengthening core and leg musculature while you do other things. It is money well spent to learn how to safely and effectively increase your activity to help improve bone and muscle strength. A knowledgeable physical therapist or personal trainer can show you how to perform the exercises properly.
Woody
I think we are -- perhaps -- thinking of our own particular age groups and not the whole range. Certainly training is needed for all ages.
The age range I work with need -- and want -- lots of supervision. This is not always possible in home settings.
The age range I work with is generally from early 60's to early 90's.
Good balance is KEY in fracture prevention and the balls help a lot. However, safer equipment such as Nordic poles for walking can be a safer alternative for independent exercise.
Lucy Buckley PT
Hi Lucy, begin I begin, I want to thank you for stating you are a PT. I might add to your post, if you don't mind, that one shoe doesn't fit all when it comes to exercise even within a particular age group. I am 61, fracture free, last dexa showed hips/spine in the -3 range. I have a repeatt dexa summer 08. I am physically active taking Pilates Reformer twice weekly; yoga daily practice, resistance bands and weights; bosou balance exercises, at least 1 hr daily walk; not to mention my normal activities. I've also had a posture alignment evaluation. My only health concern is osteoporosis. I hope you will agree that much comes into play when putting together an exercise/balance program; ie; overall health conditions, physical ability. My intention is to remain fracture free, standing tall and strong. In fact, I'm about to begin a gentle ballet class for the "mature" woman. (smile). I know that PT's in general must err on the side of safety and caution, but I wouldn't want my exercise program determined by a group age. Sandi
Woody, maybe you could share how people with osteoporosis can find a knowledgeable physical therapist. What do people with osteoporois do if the physician will not give a referral to work with a PT? How do we get more PT's interested and involved with osteoporosis? How do we get more physical therapy departments to start an osteoporosis program that is low cost for people that can't get a doctor's referral, but would be willing to pay per class/hr. Without a doubt, it is money well spent to work with a professional that has knowledge of bone loss. But often, it is easier said than done. I think you might agree that an exercise move done incorrectly may cause more harm than good. Also with posture, we may think we have good posture because another part of our body will compensate. I've taken Yoga and Pilates mat and Reformer for years, and still have corrections made. How can anyone working on their own be sure their alignment is correct? While a dvd and/or book may be helpful, the problem is still within one's own eye. I find this area very frustrating because it is a area that needs to be addressed with more how to get what we need. Thanks for reading. Sandi
Good Lord, Sandi -- you are the busy, active one!
It is possible to overdo (the elite young women athletes who exercise to the point of being dysmenorrheic will lose bone) -- but your overall health (and hours in the day) must be very good to allow you to carry on such a vigorous program. Don't get too skinny now.
In no other age group is there such a wide range of physical abilities than in over 60. Yes, we PTs are cautious, but we do focus on one person at a time so aim to improve that one person's ablities and capacity -- whether a great 61 like you -- or a more sluggish one like others your age. Indeed, the fastest and most faithful Nordic walker in our group is over 90.
Good luck with your program!
Lucy Buckley PT
Hi Sandi:
The greatest difficulty with any of these discussions comes from the fact that osteoporosis comes in many flavors. In other words, different people have different degrees of bone loss and also need varying amounts of supervision.
With that said, I would start with your local NOF support group and ask if there is a good physical therapist, personal trainer or other fitness professional that specializes in osteoporosis. Lucy Buckley, who has commented above, is more qualified to talk about physical therapists. Finding a good personal trainer starts with looking for nationally recognized certifications, continuing education in adult exercise and real world experience in the field. Ask your friends; see who they have used and who they like. Finally, just like a job interview, ask for a free consultation to talk to the trainer in person. If you don’t like what you hear or they don’t listen, move to the next applicant. If you offer to bring several friends many times you can share the cost of the hour making it quite affordable. But the old saying goes” you get what you pay for” still applies here.
Finally, let’s go back to the safety issue. I am a little less concerned about the safety issue given the low loads and weights being used. Sure you can hurt yourself but I think if you use some common sense, the benefits gained by movement far outweigh the risks. The human body was designed for just about unlimited movement. I would not exaggerate the whole posture issue. Many daily lifts we perform with suitcases and grocery bags are not in advantageous positions. Try taking a bag out of the trunk of your car sometime. So it is good to train your body in many different positions. Presumably you won’t be using 50 lb dumbbells so the risk is very low. With that said, I still suggest professional help as your best option. Besides there are always birthdays and Christmas; make sure you put a visit to the trainer on your next list.
Hope this helps,
Woody
The Section on Geriatrics, American Physical Therapy Association, has means for locating a PT with special interest in osteoporosis care throughout the country.
Go to: www.geriatricspt.org and click on Find-A-PT on the left side of the home page. This allows you to find someone with the background and location suitable for you. Useful information for the consumer is also available at this website.
The Section on Geriatrics also has a Special Interest Section for Osteoporosis for Section members with this particular concern.
Any PT should have basic education in OP management: Geriatric Specialists even more. The growth in this area has grown tremendously in the past 10-15 years.
Lucy Buckley PT
Thanks ... Great Info and website
Lucy, thank you for the information. Would you mind rewriting your post with subject titled www.geriatricspt.org. Unfortunately, this helpful information will get lost otherwise. If you don't have the time, do I have your permission to rewrite the information with credit to you for the information? I've tried accessing the information several ways, but once your post leaves the front page, anyone that has interest in finding a PT will not be able to find the info under Woody/finding a PT. Thanks. Sandi
You can call NOF to request a copy of the patient education piece called "Guidelines for Safe Movement". These guidelines were designed to give general information about safety measures to take when moving for exercise, lifting, bending and other common activities. To request a copy, call NOF at 202-223-2226 or toll-free at 800-223-9994.
Lucy, another question if you don't mind. I checked the site you suggested which did give several names of physical therapists that were within 20 miles from me. In the state of California, a doctor's referral is required for physical therapy whether though insurance or out of pocket expense. With that in mind, my question for those people that may have the same rule in their state, how do we interest physical therapists in providing an osteoporosis support group and exercise program? Working with a fitness professional; even asking the important questions is different than working with a PT that has the knowledge of bone loss. I am fortunate to have an excellent osteoporosis support/exercise group with an excellent physical therapist that has an interest in osteoporosis and provides individual exercise care. A doctor's note is required, but it is not a referral to work with a specific PT. I don't live in the area, but was able to attend. I also paid out of pocket, but the cost was low. Unfortunately, it took me two years to find the program. What words does it take that will help PT's and PT departments; as well as hospitals with various programs to realize the importance of an osteoporosis program. Not only in major cities, but wherever there are hospitals and physical therapy centers. I realize you don't have all the answers, and I don't mean to put you on the spot, but sometimes, it's knowing the right words to say or the right people to contact that can make a difference. Thank you. Sandi
Sandi:
I would be delighted to have you retitle my message.
I am very new to this group and working my ay about is a "learning experience".
Perhaps -- for purposes of clarifing the scope of the discussion, we might title it
"Finding a PT" or some such wording.
Thanks,
Lucy Buckley PT
Sandi:
This brings up the matter of ACCESS ---- to knowledgeable physicians or specialists or physical therapists.
I gather you are in California -- quite a bit has been happening out there over the years thanks to organizations like NOF and FORE. With our older citizens Medicare coverage is paramount. Unless they actually have pain, they cannot get excited about the osteoporosis.
BUT -- Medicare PTcoverage requires "medical necessity" with realistic goals and expectations. We are not discussing face lifts and such. Foe example, fall prevention is KEY for anyone with bone loss. Younger, active people with bone loss are not so much of a risk as our older folks whose very life -- and certainly -- independence is at risk with a hip fracture, for example. A "first fracture " is strongly indicative of subsequent fractures, fo example. Not treating/ educating someone who has just had a vertebral fracture or a wrist fracture is most neglectful.
There are many centers now throughout the country for the comprehensive care of those with bone loss. NOF has many of them listed. Do a websearch and you'll be drowned in what hits you. (Not all of it is sound but web-users should know that).
The big problem is that women (and men are worse) tend to ignore that which "doesn't hurt" and lose precious time while their bones lose density. As with other health problems early intervention is KEY. Yes, it is never too late to do something for your bones, but why delay?
**Teaching is a huge part of PT management of OP -- that is where we have a chance to explain and answer questions so that the patients/clients understand WHY they must follow the protocols that have been lined out for them. Handing out lists of exercises -- or foods -- or whatever -- doesn't work very well. Good health habits are HARD to put in place -- especially when we hardly comprehend just why this advice is going to help. Take a pain pill and our headache goes away; take our OP pill (whether specific medicine or a good diet or posture or exercise ) and the results are not immediate or even noticeable sometimes.
** despite all the publicity in the past 10-15 years, we still have too many doctors who give short shhrift to the need for their patients with OP to have some exposure to PT ( and nutrition, for that matter). They are so geared to writing a script and sending them on their way. God knows, it is far better now than in the early 80's when I started teaching our patients and women in the community about osteoporosis. Fortunately Cape Cod -- a retirement community -- has double to triple the % of older folks, especially women. They need attention. They learned to demand it.
The docs -- who had scoffed in earlier days at what they considered the inevitablility of "old lady fractures" -- had to wake up. In being part of national work groups in these intervenig years, I realized that my little Cape Cod was ahead of most parts of the country because of our demographics and these older women advocating for their needs.
Egad! I apologize for my soapbox rhetoric. Suffice it to say:
Much work remains to be done -- but -- much work HAS been done.
This internet medium is wonderful and can reach so many more than we could have dreamed.
Lucy Buckley PT
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