EXERCISE AND BONE HEALTH Tracy OMahony MISCP Senior

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 cycling o Swimming o Walking at a regular pace o trampolining

BUT Not all effective exercises are appropriate exercises Each person must be individually assessed

Aims of physiotherapy in osteoporosis and osteopenia ü Maintain / increase BMD ü Education to improve knowledge ü Minimise early bone loss post menopause ü Maintain / improve muscle strength ü Prevent fractures ü Improve posture

Aims of physiotherapy ü Prevent / Reduce falls ü Personal empowerment ü Improve balance / co-ordination ü Improve psychological wellbeing

How? Ø Design individual exercise programme Ø Balance training Ø Posture correction Ø Ergonomic advice / lifting technique Ø Pain management (incl acupuncture /TENS) Ø address other conditions e. g. pelvic floor insufficiency or weight-bearing joint OA

Exercise programmes for osteoporosis v Low impact v Stair climbing v Tai Chi v Aqua-aerobics v Modified pilates v Strength training (short levers)

Exercise programmes for mild / moderate osteopenia v High impact if pre-menopausal § Skipping, jogging, walk / jog v Medium impact if postmenopausal § Stair climbing, step aerobics, § Brisk / power walking § Resisted gluteal / quads

Exercise for marked osteopenia v 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 ü School students especially early pubertal ü Peri / post menopausal women ü Pregnant and post-natal women ü breastfeeding mothers ü Teenage pregnancies ü Women with 2 pregnancies close together