Bone-safe exercise

Working out with osteoperosis comes with risks

By Tara Bannow / The Bulletin / @tarabannow


Published Dec 19, 2013 at 12:01AM / Updated Dec 19, 2013 at 03:17PM

Classes

What: Healthy Bone Series

When: 10 a.m. Tuesdays and Thursdays beginning Jan. 7 through Feb. 13

Where: Bend Pilates, 155 S.W. Century Drive

Cost: $139 for 12 session

Register: Call 541-647-0876 or visit www.bend pilates.net.

What: Yoga for Structural Alignment

When: 3:30-5 p.m. Tuesdays beginning Feb. 4 through Feb. 25.

Where: Pulse Alchemy of Movement at the Old Iron Works Art District, 50 S.E. Scott St., No. 2, Bend

Cost: $175 for four sessions.

Information: Call Laura Cooper at 541-350-1617.

When Debby Mandeville-Bowen’s mom was diagnosed with a severe case of osteoporosis at age 65, the Bend resident’s mind immediately flashed back to the time she joined her mom at one of her regular exercise classes.

“She just kept saying, ‘Gosh, I want to keep doing pilates; I want to keep doing it,’” Mandeville-Bowen said. “‘This whole time I thought I was doing it right.’”

In fact, Mandeville-Bowen, owner and instructor at Bend Pilates, said her mom’s exercises involved a lot of forward folding and twisting. For people with osteoporosis, a disease that causes bones to become progressively weak and brittle, bending the spine invites the risk of fractures because it compresses the vertebrae. Mandeville-Bowen said she suspects many women and men with osteoporosis regularly do these exercises without knowing they could cause injury.

“Somebody could do that five times, they could do that 500,000 times and it may not happen,” she said, “but it only takes once where they bend forward.”

The problem boils down to people not consulting their doctors about what exercises they should and should not do, as well as not letting their exercise instructors know about their osteoporosis, Mandeville-Bowen said. Sometimes, she said, instructors don’t know how to tend to people with osteoporosis.

The best exercises for building bone strength and maintaining bone density involve high-impact, weight-bearing movements that work against gravity — things like dancing, high-impact aerobics, hiking, running, tennis and jumping rope, according to the National Osteoporosis Foundation. That said, people with osteoporosis who have broken bones or are at risk of a break should focus on low-impact, weight-bearing exercises like using elliptical machines, low-impact aerobics, using stair-step machines and brisk walking.

Laura Cooper, director of physical therapy at Therapeutic Associates at the Athletic Club of Bend, has slightly different advice for her clients with osteoporosis than that of Mandeville-Bowen. While she agrees forward folding and spine twisting carry a higher risk of fractures, she thinks not everyone with osteoporosis should avoid them completely. Depending on her clients’ hamstring length and the tone of their abdominal muscles, Cooper teaches safe ways to enter these movements in a therapeutic yoga class she hosts for people with conditions like osteoporosis or those who are recovering from injuries.

The reason? It’s just more realistic, she said.

“People are putting their shoes on, they’re lifting up groceries, maybe picking up a grandchild off the ground,” Cooper said. “Very likely, during their day, they’re doing some type of forward flexion. It’s much better to have them — whether it be in the physical therapy setting or a therapeutic yoga class — learn how to do that safely so that they are minimizing the risk to their spine in a compression fracture by doing that.”

In a series of classes at Bend Pilates beginning in January, Mandeville-Bowen will teach people with osteoporosis safe exercises designed to strengthen their spines and upper backs while keeping their spines straight. Demonstrating some of the movements last week, she stepped on a piece of equipment with a lever that allows her to keep her back straight and hips stabilized while moving her legs one at a time from straight positions to bending at 90-degree angles.

Another simple movement Mandeville-Bowen demonstrated involved lying on her back and raising her arms over her head while making sure to keep her lower back pressed against the floor.

The exercises Mandeville-Bowen said she’ll highlight will work on strengthening the upper back while keeping the spine straight. She said she hopes the exercises will carry over into peoples’ daily lives.

“It’s just carrying themselves through their days with maybe better posture, alignment, balance, stability,” she said. “That’s an important part, actually. It’s not the hour they’re in here, it’s a way of life outside of here.”

Cooper said balance is one of the first things she monitors in her clients, even if their initial focus is on core strength and learning how much bending they can do.

“Then they’re surprised when I look at their balance and they say, ‘I didn’t realize my balance was so bad,’” she said.

Experts agree osteoporosis is an underdiagnosed and undertreated condition. In many cases, people don’t get diagnosed because they don’t recognize the risk factors, which include certain medications or other diseases — such as rheumatoid arthritis, lupus or multiple sclerosis — that can cause osteoporosis, said Andrea Singer, associate professor and chief of the Division of Women’s Primary Care at Georgetown University Hospital.

Bone density screenings called DEXA scans are recommended for women ages 65 and older and men ages 70 and older, said Singer, also the Clinical Director of the National Osteoporosis Foundation.

An estimated 80 percent of women over the age of 80 have osteoporosis, said Molly Omizo, a physician with the Deschutes Osteoporosis Center in Bend.

“It’s pretty much the average for an 80-year-old woman to have osteoporotic values,” she said. “That’s a lot of people.”

Aside from exercise, people with osteoporosis benefit from the same healthy habits that everyone else does, Omizo said: Eat a balanced diet, don’t smoke and drink in moderation.

Experts recommend getting 1,000 mg of calcium per day to maintain strong bones, primarily through one’s diet rather than through supplements. For women 50 and older and men 70 and older, that increases to about 1,200 mg per day, Singer said. Vitamin D, a nutrient known to help calcium absorb into the bones, is more difficult to take in through one’s diet, and is usually included in calcium supplements.

The National Osteoporosis Foundation estimates 20 percent of Caucasian women age 50 and older have osteoporosis. By 2020, the foundation estimates, half of Americans over age 50 will have low bone density or osteoporosis.

In the end, Cooper and Mandeville-Bowen agreed, no two bodies are the same. Just because people have osteoporosis doesn’t mean they can be lumped into a single category.

Cooper said she’s worked with young people with osteoporosis, people in their late 40s and the more typical ones in their 80s.

“What’s going to be appropriate for these two bodies is vastly different,” she said.

— Reporter: 541-383-0304, tbannow@bendbulletin.com