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This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2023. For the original video go to https://youtu.be/1wOuuvKG7r4
Brad: Greetings everyone. As physical therapists Mike and I have worked with hundreds of people with back pain as a result of compression fractures and they're always related to osteoporosis. It weakens the back and causes a compression fracture in the spine. It’s very painful, something you do not want to experience.
Mike: So if you are able to strengthen your core you can prevent this problem from happening. So we're going to show you three core exercises you can try if you have osteoporosis, to strengthen up that whole muscle group and prevent this from happening.
Brad: And we're going to show a few extra tips as well.
Mike: So if you have osteoporosis, oftentimes your bones become very weak in the vertebrae especially and they're at a higher risk of having a compression fracture.
Brad: That's right Mike, so things like flexing forward is probably the biggest stress put on the back and causing those compression fractures, so posture and body mechanics, how you work with your body makes a big difference, as well as the core. So we're going to touch on both of those things- strengthening as well as some posture and mechanical bending issues.
Mike: So the importance of strengthening your core when it comes to osteoporosis is it helps prevent the compression fractures from happening or even getting worse. When your muscles are strong it'll take stress off of the vertebrae itself, putting less stress on them, preventing these from happening. So the muscles we're talking about here are the abdominal muscles, the back muscles, and a little bit of the hip flexor muscles as well. If these all become strong they'll take pressure off of those problem areas.
Brad: And a really important thing that we're going to teach is how to do these in a non-aggressive or intimidating way. People think with core strengthening they're going to be doing sit-ups with all these gyrations. We're actually going to teach them in a very subtle manner that is being done in bed. They're isometrics and they're done by an expert, Sara Meeks, who is an expert in osteoporosis and strengthening of the core. Anybody can do these.
Mike: The first exercise Brad is going to demonstrate here is going to target the transverse abdominis which is a deep abdominal muscle group. It kind of wraps around your body and it's like a natural back belt for your body. So Brad, take it away.
Brad: All right so you do this in bed in the position I am here. I call this hook lying. You're going to take one hand and you're going to put it palm down and you're going to do that right underneath where your belt is, your lumbar spine, and you want to make sure that you have a natural arch in the spine so if you look here and I push down like this, we don't want that and we don't want to arch up really high, we just want a natural arch and it should feel comfortable.
Brad: Now this hand is going to monitor so the spine stays in that neutral position minimizing any stress on those vertebrae. The other hand is going to go on top of the stomach. Now this hand is going to stay stationary and as I breathe out, my stomach goes down. There's a space between the hand and the stomach. My back on the bottom has not moved and I tighten up as tight as I can for eight seconds doing an isometric working on that transverse muscle. So this part right here getting that down, hold, can you count to eight Mike?
Mike: One, two, three, four, five...
Brad: That's good enough. Actually do hold it for eight. Eight seconds and then relax. I'd like you to do that five times and then you're done with this first exercise. Again the transverse abdominis and really think about the belly button goes towards the spine keeping that gap but the spine stays stationary monitored by this hand. Good work.
Mike: The next exercise we're going to do is going to target the oblique muscles. What these do is help stabilize your spine when you're doing rotation-type exercises or even slight lateral bending like this. So Brad's going to show you what to do.
Brad: Okay now with this exercise again it's done lying on your back in your bed. I'm standing just to show you how to think about engaging those muscle fibers so that it works the way we want it to. So to think about your right rib cage right here and your left hip, the front part of your hip, that's called ASIS. We won't get into why we call it that but it's a long name and we're going to think about bringing these points together. And then the opposite points together and that's going to engage those fibers.
Brad: We'll show you how to do it right now. Again, lying on your back you can bring your knees up in hook lying. I'm going to take those diagonal points and I'm going to think about pulling it together and actually, you're pulling in and you're squeezing everything together. You can actually take your fingertips and feel those muscles in there. With your fingers just push in there. If you happen to have a little soft, you know, we'll call it fat, you push right through that and get in there and feel those muscles work. That'll be a really good indication that you're firing those and here I'm going to start it. And I'm squeezing in. I feel those muscles working and I'm going to count to eight seconds in my head or you can count out loud whatever really trips your trigger. Or you can have someone like Mike count.
Brad: Okay and relax, again eight seconds and relax. Do the same thing. Think about bringing those points together. Feel the muscle fibers work. Five repetitions on each and then you're done with a second set. Then we're going to go to the third.
Mike: So the last exercise is going to target the rectus abdominis. Those are the front six-pack muscles most people think of. They help slightly flex the spine forward in order to activate them and Brad's going to take it away.
Brad: Okay so with this exercise, again the same position. And I want you to think of bringing your belt line and your lower ribs and we're just going to squeeze straight together and compress but with this one, you do want to monitor with the hand behind the back so that your lower back does not push real hard into the bed. There will be a little movement but not a lot and you squeeze and I'm feeling that six-pack right there go and again eight seconds I'm going to count it out in my head. When you get to eight seconds relax and you know take 30 seconds, whatever you would like to do between each isometric. And go ahead and do it again.
Brad: Now if you have not done any exercises like this in the past, you may only want to do one or two sets. If you happen to feel any cramping in there you want to stop, give it a break, and probably start again the next day. Breathe deep and let those muscles relax. That usually doesn't happen with abdominal muscles but it could. So that are the three exercises for strengthening those core muscles. The next thing I do want to mention is really important to avoid this kind of bending where you're bending forward, even if you've got strong core muscles and you bend like this to pick something up, it compresses those vertebrae and that could cause a compression fracture. Also when you sit we want to go over that as well.
Mike: So with osteoporosis while sitting down it is important to avoid any flexion for prolonged periods of time when sitting or when standing up. So when sitting, most people will think of flexing like this leaning forward, maybe looking at your phone. This is a bad posture, you want to avoid. But a lot of people also lean back in their chair and if you look, I'm still flexing my spine, there's still a curve here.
Mike: So it is important to make sure your low back is touching the chair or couch, whatever you are sitting in. If it doesn't touch, maybe put a pillow there for some support and have a nice neutral spine, do not be flexed over. Now when standing up it is also important not to have a rounded back. So if I lean forward, my back is flexed and then I'm getting up, flexed the whole time and then I'm trying to extend. That's a lot of compression forces. So try to scoot to the edge. If you have armrests, certainly use them, but try to keep a nice neutral spine as you're standing up and pushing up through the arms and legs.
Mike: Try to keep it nice and straight and it goes with sitting down too. Don't sit down all bent over. Try to sit down nice and slow, reach back, and sit down.
Brad: Good, good points Mike. All about keeping the back in that neutral position. Armrests are a really good idea. Use chairs if possible with armrests because they're there to help and it's a good habit to work with. All right so we got three good isometric strengthening core exercises, you have your body mechanics to maintain and work with, and remember a healthy spine is a happy spine, as well as you being able to keep up moving and be active.
Mike: So if you want to check out more videos about osteoporosis, we do have a whole program done by Sarah Meeks on our website. You can pick which videos you think pertain to you. Some of them are the core exercises we demonstrated, some of them she goes a lot more in depth and is much more knowledgeable on the subject matter than we are. So if you have osteoporosis it'd be a good benefit to watch those.
Brad: She's the expert for sure.
Mike: Thanks for watching.
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