This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2018. For the original video go to https://www.youtube.com/watch?v=f4kTFDaN_Rw&t=596s
Bob: Today we're going to talk about three things you should never do if you have osteoporosis, and I think these are solid issues, in my opinion.
Brad: Right, unlike the solidness of the spine with osteoporosis.
Bob: Okay, so let's talk about number one. Your bones obviously don't have the density that they should have with osteoporosis, and you're going to be more susceptible to certain injuries. The one that we see quite often is a compression fracture.
Brad: Right so with osteoporosis, oftentimes everyone, not everyone but typically as you get older, in your 60s 70s more so with females but men have it too.
Bob: Very good point, and we’ll show you a common way to get a compression fracture which a lot of people don't realize. So here we have the spine. It's lined up. Brad is in the right position now. So, a common way to get a compression fracture is just to go ahead and bend forward and do one of two things. One is if you fell, that would put great compression on the spine.
Bob: Number two is if you just lift something heavy and your back is in that rounded-out position. You could develop a compression fracture just from that move. So, if you're going to lift something heavy, one you may want to rethink it, but two you want to make sure you're in really good posture so everything's all lined up. We're going to demonstrate in a second here why this bending forward like this can cause a compression fracture.
Brad: Another common one is, people when they sit down if they fall into the chair. In older people, it's relatively common for them to plop into the chair and that can really put some compression.
Bob: Yeah, they're in that rounded-out spot, and now watch this, this is what happens. And a lot of times the compression fractures happen right where we call the hinge. It’s on the thoracic area T11, and T12.
Bob: That's where we often see it, so let's go ahead. Let's say, that's T11 and T12 right there, the mid-back. So actually we could have T10, T11, and T12, so we have 3 vertebrae here. Brad's going to show you what happens when you go ahead and round out the back and you have weight on there.
Bob: That's what can happen, the bone can actually compress down.
Brad: So that's the rounding forward and then you sit down, and you plop or just because of the osteoporosis. Osteoporosis means that the vertebra is weak. It doesn't have the integrity and it's not going to accept this kind of force and they just crush.
Bob: And sometimes they actually inject cement in there now to try to rebuild it up again. You know once it's done, it's done.
Brad: It's not going to expand back out like our cushion here. It just must heal the way it is. It could take months. A lot of people are pretty uncomfortable for months, usually, after a few weeks they're getting better but then we're working at not bending forward, not plopping, because that just reinjures it, or reaggravates it.
Bob: Yeah, when we have somebody with a compression fracture, we really avoid any bending forward at all. We might even do a little bit of bending back but with osteoporosis in general, posture is very, very important. All right the second one is going to be obvious to everyone and I apologize for including it, but there are things to help prevent this from happening I thought we'd go over some of those. So the second thing is you have to try to avoid falling. If you're one of those prideful people that say” hey, I'm not going to use a cane or I'm not going to use a walker”, well, you know the saying Brad, pride happens before the fall. I see people all the time that should be using a walker or should be using a cane and they're not because they say, “I'm not old,” and then they fall. Then they really start acting old because now they’re dealing with pain. So, we're going to show you the next step. We're going to show you some exercises you should do which actually help prevent you from falling. That is the third thing that you should never do, you should never not exercise.
Bob: I think a lot of times people start getting older and they think, “I don't want to exercise because I might hurt my back” or “I might hurt the legs.” But your bone responds to exercise and it actually becomes a little thicker. It's called Wolff's Law.
Brad: We're going to show you how to exercise properly because sometimes people do exercise and they put their back in that compromised position.
Bob: Very good point, posture is so important with osteoporosis. In fact, let's talk about exercises to prevent falls and show some posture exercises too. So, the first one is just a sit-to-stand. What that does is it's getting weight through your legs, and even strengthening helps increase bone density too. And that's why Brad and I are not big fans of those lift chairs by the way unless you absolutely must have them. If you have the chair lifting for you all day, you're losing your strength and you're losing your density of the bone. So, all you're going to do is just scoot to the edge of the chair, and you're going to go ahead and use the arms if you need to start off with. I want you to do some repeated sit-to-stands.
Bob: Now the thing you must remember if you're having trouble getting out of a chair, your nose has got to get over your toes. If you try to stand straight up you might plop backward, and then you've got that problem with your back. The other thing I want you to keep in mind is to try to keep a good posture. Don't be rounded out and get up. Keep straight up just lead with the chest a little bit is what you'll want to do. And you can go ahead and every time you get out of the chair, if you don't want to pick a time of day to exercise, every time you get out of a chair you can do five sit-to-stands before you get out of your chair. People might start to talk about you but just tell them you've been watching Bob and Brad. So that one really helps the hip extensors which really helps you with your balance. The other one that really helps you with your balance is the hip abductors. That's the muscle that goes out to the side.
Brad: So usually it's nice to go in the back of a solid chair so you have something to balance with.
Bob: Or a countertop.
Brad: Yep, and we're just going to simply bring the leg out to the side. Notice I'm not leaning to the side, keep good and tall with shoulders back. Focus on everything that's right with posture and working that hip. These hip muscles are really important for your stability with walking just to keep your gait solid.
Bob: Look how he has good posture. He's trying to keep tall. Posture, posture, posture. All right, next, I'm going to show a couple of stretches. One is when you're just in your chair. Again, it's about posture. I hate to keep coming back to it. What happens quite often is your chest gets tight and it starts pulling you forward. You’re going to round out and so you're going to be more susceptible to that number one injury. So, you want to stretch your chest. You can do it in several ways. One you can bring your arms behind your head and bring your elbows back. That's stretching your chest. Another way is just to put your arms behind you and this stretches your chest. But another stretch you can do for your back and for your chest is to go ahead and use a ball.
Brad: Get a soft one. A nice soft squishy one.
Bob: You can get it as Brad says, you can steal it from one of the little neighborhood children and you'll get a reputation then.
Brad: Well give it back to them after you're done.
Bob: Okay, so you can just bend back over the ball and what's nice about this is you're stretching the chest, but you're also stretching the mid-back at that spot that tends to be vulnerable.
Brad: And if you've got shoulder problems where this is uncomfortable, you can do it with your hands down.
Bob: Yeah you can put your hands on your neck with your elbows down even. I like the ball because you can move it up and down and it can go into different spots. So, it works out well that way. All right a couple more stretches. The hamstring stretch, I think is always a good one to do, otherwise, it's going to be pulling on your back. All you have to do is you can bring your leg up to about 90 degrees and hold it behind the knee and then try to straighten your leg.
Brad: And this is nice because you're taking the stress off the back if you try to do some of these hamstring stretches in a chair, oftentimes they promote flexed posture and put pressure on your spine, whereas this doesn't.
Bob: The next one I like to do is to just get a little nutrition into the back and some movement in the back so when you get up, we're just going to do some twisties. We call them windshield wipers.
Brad: Yeah, because it reminds me of the old windshield wiper.
Bob: So, we're going back and forth and it just loosens up the back and gets it ready. The final one is when you get off the edge of the bed, or you can do this in a chair, I want you to just put one leg off the edge. On the end of it and the other one bring it back. You’re stretching that hip flexor right there.
Brad: So, he's getting that leg to come back. You'll feel the stretch right where that front pocket is hopefully. These should all just feel like stretches, they should not create any sharp pain if they do you need to stop.
Bob: Yeah, the reason we really like stretching the hip flexors is that muscle will pull down on your back and pull you into that rounded-out position. Be safe out there, we don't want to see you coming into our clinic with a compression fracture.
Brad: Did we mention anything about posture, Bob? How important it is? Just wondering.
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