physical therapy for weight bearing exercises

peggy_j

Has anyone seen a physical therapist about their bone health? I recently sprained by back doing yard work. It wasn't that bad but it had been a few weeks and wasn't completely healed. A friend dope-slapped me to into seeing a doctor to get it checked out. My doc did an exam (to rule out anything else) and sent me to PT. I didn't want to go. (I'm so sick of docs) but the PT said that some of my bad habits of poor posture could be contributing to the osteoporosis in my hips. i.e. sitting with my one leg crossed over my knee could be straining the ligament, causing it not to put the right pressure on my hip. And walking can be a weight bearing exercise, but since I am not walking with proper posture, I'm not putting weight on my hips. Doh! Plus, sitting with poor posture can compress the spine. She Dx'd all of this in one appt. She sent me home w/ exercises and I'll have either 2 or 3 follow-ups max. So FYI in case this can help anyone else.

chronicpain

If you already carry a clear diagnosis of true "osteoporosis" (either a history of fragility fracture or bone density at hip, spine, or forearm under - 2.5 standard deviations) you should be under the care of a doctor ( either endocrinologist or trained internist) to deal with more than just how you cross your legs and walk. Certainly lifestyle changes such as regular moderate weight-bearing exercise with proper posture is a mainstay of care for almost all OP, as is not smoking, and limiting alcohol, avoiding falls, and taking adequate calcium either from diet or supplements, and the appropriate type of calcium, and maintaining a 25- OH vitamin D level at least over 30 ng/dl. Hopefully all of this has been checked too and secondary causes of OP ( there are several, including excesss thyroid, high parathyroid hormone, occult multiple myeloma) have also been reviewed (most PT gals do not get into this as it is outside their field) .

However, these lifestyle changes other than fall prevention, though useful and important, make only a small difference in bone density and fracture risk reduction. Unless you have already done so, if you have true "osteoporosis" already ( and perhaps are on anti-hormonals, which can worsen your risk) , a doc should be talking to you about anti-resorptives such as alendronate, risedronate, zometa or denosumab ( Prolia), which markedly lower fracture risk in many ( along with fall prevention) with usually minimal overall side effects. Sometimes ladies woth osteoporosis also can subtley fracture just by lifting something heavy, and an exam alone without xray and just a PT referral can miss a fracture , depends how bad the pain is. OP itself usually does not hurt absent a fracture or chronic deformity from spinal shrinkage.

Good body posture, muscle strength etc is all important, but make sure the bigger picture is also being looked at in detail too (apologies if I am telling you something you have already been over a dozen times with your docs). Protect those bones from all angles to stay fracture-free!

peggy_j

Thanks for your concern. Yep, I've been seeing a world-class endocrinologist.