Exercise can play a major role in preventing osteoporosis
and fractures. Teréza Hough, CEO for the National Osteoporosis Foundation of
South Africa (NOFSA) discusses this.
In addition to this, it also has a crucial role in
rehabilitation. Remember, muscle strength and bone strength is related. Muscle
strengthening exercises can help to rebuild bone in those who have developed
osteoporosis and it can also provide relief from one of the most debilitating
symptoms of osteoporosis: pain.
Chronic pain is perhaps most problematic in people with
curvature of the spine. This is a consequence of osteoporosis that is very
often seen in older women and is commonly attributed to “just another symptom
of ageing.” In fact, this is almost always due to osteoporotic fractures of the
vertebrae, particularly in the region of the upper back.
When vertebrae become weakened, they can no longer support
the weight of the body and they begin to get compressed. This compression,
typically at the front edge of the vertebrae, leads to forward curvature of the
spine, commonly recognised as a Dowager’s spine. This causes loss of height,
poor posture and a shift in the centre of gravity. Because of these changes,
people with kyphosis have a greater risk of falling and possibly having a
In the worst cases, the curvature of the spine is so severe
that the rib cage is pressed down against the pelvis. This most often happens
when vertebral fractures lead to an additional loss of height. Forced into this
posture, patients can suffer chronic, severe pain, and can also have trouble
breathing. Patients with this condition find it difficult to cope with daily
life and are prone to suffering from depression.
Exercise can help relieve the pain and some of the symptoms
of this condition. By strengthening the muscles in the back, the spine can be
brought more upright. This has been shown to increase mobility and reduce pain.
This type of therapy can greatly improve the quality of life of the patient.
Exercise can also be an important part of a treatment
regimen designed to prevent future fractures. Patients with kyphosis often
suffer from multiple vertebral fractures over time. It has been shown that the
“time since last fracture” is a major determinant of the quality of life of
these patients. The physiotherapist therefore has a big role to play in the
rehabilitation of patients with known vertebral fractures. It does seem as if
posture and muscle strengthening exercises help with pain management
Aid hip fractures
Hip fractures may be the most serious complication that can
arise from osteoporosis. In addition to the incapacitation, mortality rates in
those who have suffered a hip fracture are up to 20 percent higher than in
subjects of the same age and sex.
More than 95 percent of patients require surgery to repair
their hip fracture, and of these, less than one-third will regain normal
functioning and more than half of the rest will never be able to function
independently with many needing institutionalisation and nursing care. This
puts a considerable burden on patients, family members and health care systems.
Less than one out of three patients who have surgery to
repair a hip fracture will function independently.
Recent studies have shown that intensive exercise training
can lead to improvements in strength and function in elderly patients who have
had hip replacement surgery. Patients who received the exercise therapy were
significantly better at a variety of daily living fundamentals, such as getting
up, walking, climbing stairs and maintaining posture.
For example, they walked on average 50% faster and climbed
stairs about 30 % faster than patients who did not receive the exercise regimen.
Exercise after fracture aims to relieve pain and to help patients regain range
of motion and independence. Supervision from a physiotherapist is vital to
ensure that an exercise programme is best suited to individual needs, and to
help reduce the risk of further injury through falling. Often exercise in warm
water is the first step before other exercises are attempted.
Maintain a balanced, healthy diet and lifestyle, as exercise
alone cannot prevent osteoporosis. Calcium and vitamin D are also required for
building and maintaining bone mass, and smoking and excessive alcohol intake
can contribute to bone loss. For some individuals, where appropriate,
prescription drugs may also be required to keep bone loss in check.