Osteoporosis is often referred to as a silent disease because people don’t know they have it until fractures in bones start to appear and investigation into the strength of the bones goes underway.
The most common places for fractures to appear are in the wrists, hips, spine and ribs.
A bone scan can reveal the health of your bones but it is important that more than one site of the body is scanned, as the bone density in your hips may differ to that of your spine or wrists. Typically, your GP will only ask for these three sites to be scanned, as they are more likely to be affected than the rest of the body.
The bone density result will be given as a ‘T score’ some Pilates teachers like to know this score so they can create classes using appropriate exercises.
Osteoporosis is the name given to describe low bone density.
The inside of healthy bone looks a little like honeycomb. When bone density lowers, these honeycomb-like structures show large spaces which can result in reduced strength of the bone.
What is the difference between osteoporosis and osteopenia?
Osteopenia is the precursor to osteoporosis and shows a reduced bone density, but not as much as osteoporosis.
Who can get Osteoporosis?
Changes in hormone levels due to the menopause can cause the growth rate of bone to decline, which is the main reason why women are most likely to be effected by Osteoporosis. However, men do also suffer from Osteoporosis, as testosterone is required in men to build bone, so when this starts to decline (usually around the age of 60) the regrowth of bone can be slower.
The other factors that can impact bone health include:
- Being diagnosed with certain diseases such as rheumatoid arthritus
- Smoking and/or drinking alcohol for a prolonged period of time
- Genetics can play a part, people with smaller frames have less bone mass
- Light body weight
- History of anorexia or other eating dissorders
- The prolonged use of some drugs such as steroids or chemotherapy
“Weak bones can cause the spine to collapse”
-The National Institute of Health
The good news is that Osteoporosis and Osteopenia can be reversed!
Bone is considered ‘living tissue’ and all living tissue is under a constant cycle of breakdown and regeneration. Osteopenia and Osteoporosis occur when the natural breakdown of the bone tissue is either faster or more efficient than the bodies ability to rebuild bone.
Just like a muscle, the bone can be strengthened. There are certain things we can do to encourage our bodies to build bone.
Can Pilates really make a difference?
- Exercise that includes balance work, alignment focus and functional movement will help to lower the risk of falls, which can result in fracture. Pilates can teach you to be very aware of your body and how your body moves through space, giving you more confidence in every tasks and lowering any stress or worry related to potential falls.
- Pilates also aims to strengthen the deep intrinsic muscles that support the spine and skeleton. By strengthening the muscles around a site of bone weakness, there is a lesser chance of fall or fracture.
- Pilates exercises can lengthen the spine. Through breath work and targeted exercises, we can strengthen the muscles in the spine to hold the spine in a way that reduces compression of the vertebral discs.
- Adding load bearing exercises can encourage the body to build more bone. When the bone is put under force, it sends signals to the body to build more bone so that it can better cope with the forces put upon it (adaptive training). In Pilates classes, we use the bodies weight and other small and large pieces of equipment to safely add load to the body in movements that aren’t contraindicated. Your teacher will also be aware of your alignment so that the load is added to the correct parts of the body.
- When we stretch the body, we not only stretch muscles, but we also stretch tendons that connect muscles to bones and we stretch ligaments that connect bone to bone. Stretching pulls on these tendons and ligaments, which then pull on the bone they are attached to. This process encourages bone growth. So safe stretching in class, especially with added resistance from the many pieces of small and large equipment we use is hugely beneficial for bone growth.
What else can I do outside of Pilates class to help increase my bone strength and density?
- Creating regular increase in blood flow to the bone is very important. Blood carries nutrients that feeds the bones to help them grow. Cardiovascular exercises increase the flow of blood to the bones. Walking is enough of a cardiovascular exercise to encourage this blood flow.
- As mentioned before, load bearing exercises are important to encourage bone growth. Including hill climbing to your exercise programme is enough to encourage bone growth in the hips, as you ‘load’ the hips with your body weight as you step forward and pull yourself to a higher level. Hill climbing will also strengthen the glutes and muscles surrounding the hips to further support this area.
- Your food is your fuel. Bones require a diet rich in alkaline based foods in order to grow. If your diet is rich is acidic foods, such as dairy (there is evidence now, to show that milk and dairy isn’t as good as we thought in encouraging bone growth), coffee, alcohol, sugar, white bread and white pasta, then I would suggest switching it up to include as many fresh vegetables as possible (particularly leafy dark greens), nuts, fruits, healthy fats and oils.
- Stretch! You can stretch at home too. There are no contraindications for stretching with osteoporosis or osteopenia, as long as you aren’t adding load to the body at the same time (for example, a roll down would not be a suggested exercise for you). For people with very low bone density, I would not encourage you to bend the spine forward (c-curve or roll down) or bring your knees into towards your chest. And do not make this shape of your spine (flexion) whilst also rotating the spine. If you want to rotate the spine for a stretch, I would suggest doing this gently, while you are lying down until your bone score has improved.
- Vitamin D. Get out in the sunshine or include a vitamin D supplement to your diet. The body needs vitamin D to absorb calcium which is then turned into bone.
If you find you are already doing all of these things but are not getting the results you feel you should have, then it would be a good idea to speak to someone to see if there is anything else going on in the body.
As always, if you have any concerns or questions regarding your current Pilates class or would like help to create a plan to increase your bone density outside of class, to include meal planning and other guidance, please contact me directly, I am always happy to help.