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Unsafe Movement

sdivas
1 Recommendation

From NOF booklet "Boning Up On Osteoporosis"
To maintain proper alignment, avoid the following positions or movements:
Having a slumped, head forward posture
Bending forward from the waist
Twisting of the spine to a point of strain
Twisting the trunk and bending forward when doing activities such as coughing, sneezing, vacuuming or lifting
Reaching up for items on high shelves when you could lose your balance and fall
Some exercises can do more harm than good. If you have low bone density, osteoporosis, or slumped posture, you should avoid exercises that involve bending over the waist, such as:
Sit-ups
Abdominal crunches (also referred to as stomach crunches)
Toe touches.
Many exercises and activities such as yoga, Pilates, tennis and golf may need to be avoided or modified because they often involve twisting and bending motions. Bending forward during routine activities also puts stress on the spine and can lead to fractures of the vertebrae.
Booklet may be purchased at www.nof.org with 26 pages of exercise and safe movement.

Explore topics in this discussion:

Exercise Scoliosis Back pain Forteo Fractures Physical therapy Reclast Pain Yoga and Pilates Osteoporosis Stress

28 replies

millie123

Thanks, Sandi: Maybe people will come here and print out your post.

karenatheklineback

Always great to have a reminder of safe exercises and movements. No reason to stop doing what you love but a little modification can go a long way to keeping you safe and fracture-free. My book expands on the information that the NOF offers. OsteoPilates. Good luck and best of health, everyone!
Karena

sdivas

Thank Karena for your post. Personally, I take exception with avoiding Pilates and Yoga. I think both programs can be done if we are able to find an instructor that will look at osteoporosis books/dvds to educate themselves on working with people that have bone loss. The basics of no twists and no forward flexion should be easy enough for an instructor. But it's interesting to me that PT's that often cannot work out of their respective physical therapy department and require a doctor's referral could possibly work with more people that have bone loss if PT's would also become certified as a Yoga or Pilates instructor. PT's with proper certification (not the quick week or two certification) could expand by having bone classes at a Yoga studio or Pilates studio. With the addition of physical therapy knowledge, it would be very beneficial for people with bone loss.

summerhour

Hi
I agree that it would be great for people with the knowledge of physical therapists to learn to teach yoga as well and I do know Pt's that teach yoga -
however yoga is much more than physical therapy and must be taken up for greater reasons than safe exercise only.

I am hoping that one of these days yoga therapists will be on the same page as PT's as to what is safe

SaraMeeks

Interesting comments. I am a PT/Yoga Teacher (since 1984) and also have completed 5/6 required sessions of Polestar Pilates Rehab training. More than "a little modification" is required for safety in both Yoga and Pilates; however, it can be done and the whole practice becomes much more meaningful.
As for Yoga therapists being on the same page as PT's, I think that might be a long time coming. PT's undergo very extensive education on anatomy, kinesiology etc that other exercise professionals do not. We are also especially trained to assess and then to base exercise prescription on that assessment. Not all PT's necessarily do it well as they are driven by reimbursement and productivity issues; however, that is basic to our training and unique to our profession.
PT's who go on to take Yoga/Pilates teacher training are at another unique advantage to use their basic education with the nuances of other exercise forms and can thus modify movement for safety.
Now, lest you think that I think PT is the only profession that can do this, I want you to be sure you understand that I have met, and believe there are, many people who have an inherent understanding of human movement and take advanced studies to better themselves in their chosen field.
We all need to work together for the benefit of the individual diagnosed with osteoporosis so that they can partake of exercise classes and have a safe and therapeutic experience. What NOT to do with osteoporosis is important but, then, what DO you do to modify becomes the question. Designing programs to maximize the forces on bones in a safe way involves more than just avoiding flexion, rotation and side bending (which is actually not totally necessary in all cases.)

Jacqueline

Thanks, Sara, for all your posts. Your responses are enormously helpful. I feel a ray of sunshine
sweeping over me whenever I see your photo.

Loods

Listen to your body. You will soon get to know how far you can take exercise and when to stop. Half an hour of gentle exercise a day is far better than a longer workout that leaves you in pain the next day. I have learnt this from experience!

DeskJockey101

INTERESTINGLY ENOUGH I JUST STARTED A NEW EXERCISE PROGRAM DESIGNED FOR THOSE WITH OSTEOPOROSIS AND I AM HAPPY TO SEE THE RESPONCES, IT ASSURES ME I AM DOING THE RIGHT THING HERE.

SARAH, YOUR BOOK, WALK TALL, IS VERY HELPFUL TO ME RIGHT NOW, THANKS.

ACTUALLY ALL OF YOUR FEEDBACK HAS BEEN SO ENCOURAGING THAT I FEEL SO MUCH BETTER SINCE I JOINED HERE.

PS TYPING IN CAPS BECAUSE OF VISUAL DIFFICULTIES.

Mordita

Hi, I would love to find an exercise program for people with osteoporosis. Where did you start yours? Do you know of one that can be accessed in the internet?
I love to exercise and after reading what everybody say about bending forward, I know I have been doing a lot of wrong things. I even bent forward with weights and I do crunches (up to 100 at the same time).
I need to know exactly what I should do.
Thanks for your input.

sdivas

Mordita, please check: SherriBetz - www.therapilates.com
SuzaFrancina (check Search - Profile has contact info)
Sherri has a listing on her site with Pilates instruction for osteoporosis
Suza may be able to help you with Yoga in your area.
Also, there is a support group in San Luis Obispo (805) 473-7662.
I know as in So. Ca, areas are very spread out, but you may be given other leads for osteoporosis exercise and support. Also, Sara may be able to give you the names of PT's in your area that have studied under her.

sdivas

Also, please check with Karenatheklineback; also a community member. Place Karena in Search.

Mordita

Sdivas: Thank you so much for all the info. I will check them to see what I find to help me.
What do you do for osteoporosis? Do you do the pilates program?
Do you take meds? Vitamin D? I only take 800 iu with the calcium, but after reading so many posts I don't know anymore what is the right amount.
Also, any difference between Vit. D and D3?

sdivas

Mordita, I've been fortunate to work with specialized fitness professionals for Yoga and Pilates Reformer that have bone loss knowledge, but my initial education came from reading the books of the people I suggested that you contact. Please place calcium in Search as well as any of other related osteoporosis information. Past discussions will come up on Vitamin D and calcium. Also, please Search NOF. All the past NOF journals with information will come up and will be helpful. Sandi

Tulsagal

Re exercises: "Bending forward from the waist" is something listed that we with osteopororis should NOT be doing?? How can you function and not do that? I misunderstood something? I sure didnt now sit-ups were a no-no. I'd been doing those for my pot belly.

sdivas

Tulsagal, I've bumped up some previous discussion posts that may be helpful for you. If you have any additional questions, please feel free to ask. Thanks. Sandi

Tulsagal

I still dont understand the quote below about 'do not bend at the waist.'
"From NOF booklet "Boning Up On Osteoporosis" To maintain proper alignment, avoid the following positions or movements:
Bending forward from the waist."
One cannot FUNCTION without doing that. You bend forward from the waist to fill up the dog's bowl, put your shoes on, pick up the tv remote, get in a car, sit on the pot. What am i misunderstanding here?
P.S. I posted in another topic column today that NOF says denosumab (spelling?) might be approved by the FDA this fall (any day now, 9/09) and the FDA website concurs; also I found that Eli Lilly has been working on a Forteo PATCH for 1.5 yrs now. I am too scared of Reclast and Forteo even tho my doc wants me to take one. (-3.3) plus severe scoliosis. My doc only has two patients on it right now.

sdivas

Tulsagal, did you read all of the discussion posts I bumped up on exercise? I think if you read those discussions posts from Karena, Mothergoose, SaraMeeks, SequoiaHealth and others, you will have a better understanding of why we do not want to round our spine. We either squat or hinge from the hips, but it is better for you to read the posts from the professionals. If you still do not understand after reading all of the previous post discussions, please let us know.

Tulsagal

Yes, I did read them. Maybe it means don't bend forward from the waist WHILE EXERCISING. I paid attention all day yesterday at the number of times I HAD to bend over--impossible NOT to do.

sdivas

Tulsagal, no bending over (touching toes) for any reason; exercise or otherwise if you want to avoid the possibility of fracture with bone loss. It's not impossible as most of us have learned alternative ways of safe movement for daily activities. A new discussion thread may help you have a better understanding.

sdivas

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