Pilates and osteoporosis
By: Paul Schembri | 21/01/2014
PILATES AND OSTEOPOROSIS
One of the most potentially devastating conditions that can develop during one’s life – and that may present itself within a client attending a Pilates Studio – is that of Osteoporosis. It is believed that over 2 million Australians have developed this disease and it is becoming another ‘silent killer’ (similar to Hypertension) in the sense that the condition can develop without any initial tell-tale symptoms. Two-in-three women and one-in-three men over the age of 60 will develop an osteoporotic fracture in their remaining lifetime.
What is it? How does it develop?
Throughout our life span, the specialised cells that create bone in our body are constantly being renewed, broken down and replaced again. In our early years, more bone is being laid down – hence our bone growth – and by our late teen years, we have reached peak bone mass. As we move and exercise and build muscle, this assists in building and strengthening bone: Muscles pull on tendons attached to the bone, more cells are laid down and the bone is then ‘strengthened’ to cope with the stress of movement and exercise. As we age bones lose minerals, such as calcium, much quicker than can be replaced and can become porous (full of holes) losing their strength and become fragile and brittle.
As the bones become thinner and weaker, even a minor bump or fall can cause serious fractures (a partial or complete break in a bone) with the most commonly affected areas being the wrist, hip, upper arm or forearm and spine.
One of the most visual signs of advanced Osteoporosis affecting the spinal column is the classic ‘Dowager’s hump’. If you can imagine a stack of vanilla slices as the spinal column and then replace the custard with meringue, you can begin to appreciate the fragility created by this condition. As small fractures occur within the bodies of the vertebra, they start to collapse, become wedge-like and alter the natural curves of the spine.
As the spine deteriorates and we lose height, the ribcage becomes shortened and compromises our ability to use our lungs effectively and places further compression onto our internal organs.
There are many factors that can contribute to the development of Osteoporosis. One of the leading causes in women is that of menopause (whether early or usual onset) when oestrogen rapidly declines and calcium/other bone minerals are reduced. It is said that within the first 5 years during the onset of menopause, a woman can lose up to 10% of her bone density! Low testosterone in men can also contribute to the development of Osteoporosis although, generally, the decline is much more gradual and bone mass can remain adequate until later in life.
Other contributing factors can be: Age; low levels of physical activity; Genetics (i.e. a direct family member is diagnosed); Smoking; a low dietary intake of calcium (Adults require 1000mg of calcium per day – 1300mg once over the age of 50); weight levels i.e. excessive weight gain/loss can affect hormone levels; excessive alcohol intake; delayed onset of puberty & menstruation (the menstrual cycle can be disrupted following excessive exercise and/or dieting) and Low vitamin D dietary intake/levels (Vitamin D helps with calcium absorption). Vitamin D is also absorbed into our body through sun exposure. Strong anti skin cancer messages, such as the ‘slip, slop, slap, seek, slide’ campaigns have also indirectly assisted the rise of this condition as sunscreens can prevent the skin form absorbing vitamin D.
Some conditions such as Asthma and Rheumatoid Arthritis and their associated medications can also increase risk factors for Osteoporosis. Long term use of corticosteroids, used to treat such conditions, can prevent calcium from being absorbed. Other conditions such as Thyroid disease, Chronic Liver &/or Kidney disease, Crohn’s disease and Coeliac disease (which affects the body’s ability to absorb nutrients) can also contribute to the development of Osteoporosis.
As mentioned earlier, often a fracture is the first alert that there is something wrong when bones are X-Rayed and the condition of the bones is then seen. One of the more reliable scans to do is a painless DXA scan which specifically measures the density of the bones. In Australia, Medicare rebates are often available for such scans especially if one or more of the above ‘causes’ are met by the individual.
Treatments and Prevention
Men and women can take steps from a young age to prevent the development of osteoporosis such as maintaining a healthy diet with plenty of vegetables, fruits and whole grains; eat calcium-rich foods and increase Vitamin D absorption/consumption – sardines, spinach and almonds are quite high in calcium, and fatty fish, liver and eggs are high in Vitamin D. One should also avoid smoking, limit alcohol and caffeine intake and undertake regular strength training and weight bearing activities. It is never too late for Osteoporosis prevention or, if diagnosed, treatment! If this condition has been diagnosed, your doctor may recommend you take medications to assist in minimising bone loss and to increase bone building. Hormone therapy may also assist in maintaining the strength of bone tissue, however it is now generally not recommended to remain on long term hormone therapy due to the potential side effects of breast cancer, heart attack and stroke.
How can Pilates assist?
As mentioned earlier, modified strength training and weight bearing exercises can assist in preventing osteoporosis and/or delay its’ progression. Exercises and movements that promote muscle strength, balance and coordination are important as they promote muscular endurance and muscular mass and therefore increase bone density. Such muscle work – especially within the Pilates studio setting – will also assist in maintaining and improving posture and muscular balance. Pilates will also develop proprioception (sensing the body in space in response to weight loading, weight shifts and gravity) and therefore improves balance and helps with the prevention of falls. A fully trained Pilates Instructor or registered studio will be able to consider and program safer exercise options for each individual/affected client (Infinity Pilates is a registered studio with the Pilates Alliance of Australasia – PAA – and all its’ instructors are fully trained Diploma graduates). It is recommended that a combination of strength training and weight bearing exercises, done 4 – 6 times per week, is important as exercising for bone growth needs to be regular, varied and last 30 – 40 minutes per session.