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

2. 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

3. 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.

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Medication Options Antiresorptive Calcitonin Hormone Therapy
Bone Forming

19. 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

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

21. 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

22. QUESTIONS?

23. Call For Your Screening
Shara Arnofsky, MS PT
Core Strength Physical Therapy, LLC
1430 2nd Avenue
between 74th & 75th st
Suite 102
(212)