Osteoporosis: What Can I Do About It? Presented by: Shara Arnofsky, MS PT Core Strength Physical Therapy, LLC 1430 2ND Avenue (212) 861-1870 Celebrate National Osteoporosis Awareness and Prevention Month "Standing Tall for You" MAY 2007

What is Osteoporosis? A disease characterized by low bone mass and structural deterioration of bone tissue A loss of 10%-20% of bone mass indicates the onset of osteoporosis Known as the “silent disease” due to its symptom free nature. The fractures often are undetected, delaying treatment & prevention of further fractures Can lead to collapsed vertebrae which causes the symptoms of severe back pain, loss of height, or spinal deformities including stooped posture

May Is National Awareness Month Osteoporosis Ambassador Entertainer, businesswoman and NOF Ambassador, Joan Rivers was diagnosed in 2002. Motivated to become an advocate for osteoporosis awareness when her doctor told her, “if she keeps going on stage, she may break a hip and die.” She emphasizes need for all genders, ages, and ethnicities to be aware of osteoporosis and take care of their bones. Ms. Rivers stresses the disease is largely preventable and treatable.

Osteoporosis Statistics 1 in 2 women & 1 in 4 men > 50 yrs will suffer an osteoporosis related fracture Fractures can be spontaneous and caused by everyday life activities 1 in 5 hip fracture patients end up permanently in a nursing home People on bed rest lose ~1% of bone density per week

Osteoporosis Risk Factors Females Thin and/or small frame body type Advanced age Family history of osteoporosis Estrogen deficiency due to menopause Abnormal absence of menstrual periods (amenorrhea) Anorexia nervosa Low lifetime calcium intake

Osteoporosis Risk Factors Vitamin D deficiency Use of certain medications (corticosteroids, chemotherapy, anticonvulsants and others) Low testosterone levels in men Inactive lifestyle Current cigarette smoking Excessive use of alcohol Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

Osteoporosis Detection Bone Mineral Density (BMD) testing An increase in BMD testing and osteoporosis treatment was associated with a decrease in hip fracture incidence Medicare reimburses for BMD testing every two years Posture and Balance Screening

Osteoporosis Prevention Maintain a diet rich in calcium and vitamin D Perform weight-bearing and resistance-training exercises Follow a healthy lifestyle with no smoking or excessive alcohol intake Regular visits to one’s healthcare professional to discuss bone health Schedule periodic bone density tests and take medication when appropriate

Exercise and Osteoporosis Just as a muscle gets stronger with use, a bone becomes stronger and denser when stressed Research has shown that the progression of bone loss can be stopped by exercise alone

Types of Exercise Strength training The use of weights or resistance to build muscle and strengthen bone

Types of Exercise Weight bearing aerobic Doing aerobic activity while on your feet Swimming and biking have many benefits, but are non-weight bearing

Types of Exercise Flexibility Increase the mobility of joints, preventing muscle injury and improving posture

Exercise Precautions High impact exercises These can increase compression on the spine leading to fracture Flexion based exercises Causes excessive compression on the anterior of the vertebrae (trabecular bone) which is weakest in those with low BMD Side Bending and Rotation in Flexion

Spinal Extension Exercise The posterior surface of the vertebrae have denser type (cortical) bone which is less at risk of fracture One study shows that those with strong back extensor muscles had higher BMD in the spine Another study shows that strong back extensors correlated with fewer vertebral fractures

What is Pilates? Method of exercise developed by Joseph Pilates Program designed to stretch, strengthen, and balance the body Movement principles focus on whole body health, whole body commitment, and breath

Safe Initiation of Pilates for Osteoporosis ALWAYS obtain MD clearance before starting any exercise program Obtain a safe evaluation of function, strength and balance Receive proper education on osteoporosis Do’s and Don’ts Learn proper posture and body mechanics Learn proper breathing techniques

Bone Building Through Pilates Focuses on body awareness, lengthening and alignment Focuses on abdominals without using risky “crunches” Requires the maintenance of optimal spinal posture during most exercises Encourages thoracic spine extension to prevent hunch back posture

Medication Options Antiresorptive Calcitonin Hormone Therapy Bone Forming

NOF’s Updated Recommendations 1200 mg of calcium / day for adults 50 and older 800 – 1,000 I.U. of vitamin D3 / day for adults 50 and older

Fall Prevention Clear Floors Bathroom Safety Bright Lighting Kitchen Safety General Precautions

Summary What Can I Do About Osteoporosis? Be screened by a licensed healthcare professional Maintain a healthy lifestyle Establish a safe and effective exercise program

QUESTIONS?

Call For Your Screening Shara Arnofsky, MS PT Core Strength Physical Therapy, LLC 1430 2nd Avenue between 74th & 75th st Suite 102 sarnofsky@corestrengthpt.com www.corestrengthpt.com (212) 861-1870