Osteoporosis & Pilates

Learn about osteoporosis and how it affects your Pilates practice!

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Transcript

0:09

Hello. Hello everybody. Welcome and welcome back to Pilates Students' Manual, helping you get the most out of your Pilates classes. I'm Olivia. You get the latest updates about everything I'm working on by joining the community at buymeacoffee.com/OliviaPodcasts and on Instagram at @PilatesStudentsManual.

Pilates Teachers' Manual: 0:28

The Book is now available for purchase as both an EPUB and PDF file and also on Kindle, available on Amazon. You can purchase it and other podcast merch at shop.OliviaBioni.com and you can convert the EPUB or PDF version of my book into a Kindle friendly file by visiting amazon.com/sendtoKindle. Today's episode is all about doing Pilates when you have osteoporosis, so I'll share a little bit about what that condition is, as well as what you want to avoid in your Pilates practice, as well as how Pilates can potentially help reverse the effects of osteoporosis in your body. Okay. So first let's talk about what bone is, like I feel like we know what bones are in our bodies, but we actually have two different types of bone tissue, something called cortical bone. Which makes up about 80% of the bones in our bodies. It's really strong. It's really dense. It's found in all of our long bones. It forms the outer shell of our bones. And then there's something called trabecular bone, which is a bit spongier. It has space in it and gaps in it. It's found in the vertebral bodies, which are the, um, we, you know, we have our discs in our spine. These are kind of the sandwiches for those discs. That round bit of vertebral body, not the pointy bit on the back that you can feel when you run your fingers along your spine. Um, but the, the kind of sandwich for the discs, that's called the vertebral body. Also, it's found in the neck of our femurs, so where our thigh bone articulates at our hip socket, that's called the neck of the femur. It's this like little bit of a neck shaped portion of the bone where the ball fits into our socket, the ball head of the femur, but then the neck that attaches the ball to the rest of the femur bone and also the joint surfaces of our bones. It's more spongy. It has more space in it. Now, osteoporosis is defined as a disease that is characterized by 20% or more of bone loss. It predominantly affects our trabecular bone, so it's affecting the vertebral bodies of our spine. It affects the neck of the femur at our hips and also our wrists, which is, um, just a place where there's a lot of bones articulating against each other. So wrists are also susceptible to this bone loss. Osteoporosis is not an inevitable part of aging. You don't just get older and then suddenly you have osteoporosis. What is a natural part of aging is about 0.5% of bone loss per year, and that's if you're not doing anything to correct it, between like 0.5% and 1%, but 20% is significant. Like that is a large jump in terms of loss of bone density and remembering that that trabecular bone is that spongy bone. There already is space in that bone tissue and to lose bone in there is going to really make those areas susceptible to fracture. So even if you have a minor fall or an injury, there's research done with people opening windows that get stuck causing a fracture in their neck. Other symptoms include loss of height. If you think of people as they get older and they start shrinking, some of that is that compression of the bones in our spine and we're losing height as a result. That hyper kyphosis, sometimes called a dowagers hump, but that bump that some people can get in their upper back as their head continues to jut forward and their body starts making bone at the upper back and attempt to hold the head up. We've got two kind of actors when we're thinking about osteoporosis. There's cells that build bones called osteoblasts. Blasts are the builders. And osteoclasts are the cells that break down bone and cause our bones to be reabsorbed. So what is a natural part of aging is that when we are young and we are growing, we have an excessive number of osteoblasts, and the way I remember it is blasts are builders. Clasts are crunchers. That may or may not work for you, but that's how I think about it. So osteoblasts are building bone as we're growing in our youth, they're building that bone as we get bigger. As we kind of stabilize in terms of height, we aren't building a ton of bone unless we're exercising and challenging our bones to be stronger. And then we start to have more osteoclasts, which are the cells that are crunching up our bones and responsible for reabsorbing our bone tissue. We talk a lot in exercise about if you don't use it, you lose it. And that's not meant to be scary, but like our bodies are designed to be super duper efficient. And if we aren't using muscle tissue, our body's like, well, I'm not gonna maintain this. It's expensive to maintain muscle tissue. I'm going to reallocate those resources to other places. And our bones are the exact same way. If we're not putting. Pressure on our bones to reinforce them. Our body will absorb those tissues and again, reallocate them to other ways. And that's kind of how Wolf's law comes into play. And Wolf's law is bones that are subjected to resistance and impact, stress, pressure, all of those things. They get stronger. Your body will build bone in the places that have stress on them. So if you exercise and you put your bones under stress in a healthy way, your body will build bone in those areas, and we're gonna talk about how Pilates can really positively affect us in that way that when we put stress on our bones, our body builds more bones. But in the case of that dowager's hump, that's a negative application of Wolf's law that as the head juts forward and it's heavy and our body's trying to hold it up, our body will build more bone at that upper back space and attempt to reinforce where the stress of holding the head up is. And then it's not as simple as, we'll just stand up straight, like your body has really reinforced that position with bone. Osteoporosis is not inevitable, but it is common. One in every two women and one in every four men aged 50 or older will suffer an osteoporosis related hip, spine, or wrist fracture during their lives. I want to equip you as students to know, okay, if I have osteoporosis or osteopenia, which puts you in that like 10 to 20% of bone density loss, thinking, what would I do if I was at risk for osteoporosis or if I had osteoporosis? Like what would I do differently in my classes? I want you to know. Not all types of exercise help us build bone, because thinking back to Wolf's law, we need that impact. We need that stress on our bones to reinforce them and help them get stronger. So types of exercise like running or tennis or weight training where we are putting load and impact on our bones will help us get stronger. Things like a dance class or a step aerobics class where we're vertical, and again, that impact is what is helping our bones get stronger. Lower impact forms of exercise, like being on an elliptical, like walking where there is some, at least we're vertical while we're exercising, that can help protect against further bone loss. But if you think about exercises like cycling or swimming, the appeal is that there isn't any impact on the joints, which can be great for a cardiovascular benefit, but in terms of building bone, those are not going to help us build bone because we need that impact on our bones. So you might be wondering, how does Pilates fit into this? Well, especially equipment Pilates, where we're on the reformer, we're on the chair, we're using the springboard, we're doing things with spring resistance. We can definitely build strength and build our bone density. And in addition to building our bone density, we can also work on things that friends with osteoporosis, really benefit from, so strengthening those spinal extensors, right? We're working against gravity to strengthen that back line of our muscles. Whether we're doing exercises like swan or swimming, we're working in that extension to kind of resist that head forward posture that you might get slumped over your desk for, you know, 20, 30, 40, 50 years. Right. We can. Work on balance to help prevent falls. So we can do coordination exercises, we can do things standing, we can do things in a safe way that will help us, uh, minimize our risk of falling in our daily life. And by doing things on maybe heavier springs or getting vertical and doing some exercise, we can be part of the reversing the loss of bone density puzzle here. Pilates also promotes flexibility, which can help our bones be happier and move better. Happier is not a technical term, but like we'll be able to move a little bit easier through a range of movement when we're a bit more flexible. We can increase our body awareness. We've talked about the power of proprioception on the podcast. That's so important, knowing where you are in space. And while Pilates is not the highest impact form of exercise going for a jog or, you know, going to a dance class, something like Zumba, is definitely gonna be more impact than a Pilates class. There are ways that Pilates can definitely fit in to reverse the effects of osteoporosis. There is one thing that the research really clearly shows that I wanna share with you, and that's, that our friends with osteoporosis should avoid some positions that happen in a Pilates class really frequently, but they are just not the right choice for your body if you suffer from osteoporosis. The main positions are spinal flexion, so any rounded shape in the spine. Something like a roll up, maybe it's a roll up on the reformer, A teaser that rounded shape. A chest lift in your hands in strap series. Any spinal flexion you are already at risk for a spinal fracture. And putting yourself in a loaded position in flexion is where you're the most susceptible to having a spinal fracture. So we're gonna avoid spinal flexion. We wanna do exercises with a long spine. We wanna work in extension. We also wanna avoid any end range or forced side bending. Thinking about doing something like mermaid and then putting a weight in your hand. So we're really loading that side bend. Also really loading a twist. So something like a twist where you're cranking yourself deeper, again, more likely to have a fracture. This doesn't mean that you can't twist or that you can't do a side bend, but we are trying to work in a more moderate range here. Again, just to be super conservative and avoid that risk of fracture. Any of that frontline work that's putting excessive pressure on the rib cage. Think of things like rocking, or for some people, things like swan. Goodness gracious. Certainly swan dive. There's just the potential for a fracture on the rib, and we're putting a lot of pressure in one spot on one bone, so we can find either less aggressive forms of extension possibly. So that could be like minus the rocking motion of swan dive or rocking, or maybe putting something with a little bit of cushion underneath the front ribs like a blanket. Yeah. And then as far as that forced like extreme external hip rotation, that doesn't happen a ton in Pilates. It does happen more in like yoga and things like pigeon pose, things like that, where you're just putting all of your body weight on that neck of the femur, which is again, made of trabecular bone, which is more susceptible to having lower bone density if you have osteoporosis. The research has just shown that these are the positions and the shapes to avoid because the likelihood for a fracture is the greatest. And I am not saying that to scare you, but I do want you to be informed about something called the fracture cascade that can happen in the spine. And that is once you have a spinal fracture, you are more likely to have additional spinal fractures below the fracture that you just had. As each fracture occurs, the bones of the spine get a little bit more wedge shaped, which contributes to that, uh, dowager's hump or that rounded back, that hyper kyphosis that becomes structural instead of positional, where that is the shape that your body is in. That's not ideal. So for flexion especially, we are avoiding that shape. One of the best things about Pilates is that there are so many versions of an exercise. Take short box series on the reformer, where there is a round spine or a round back version, but there's also a long spine version. Same thing with knee stretches. There are ways to focus on a hip hinge instead of a spinal flexion shape. And in things like hands and straps, or if you're doing the series of five on the mat, that that chest lift is optional. If we have osteoporosis, you might chat with your instructor if they're offering a round back option. Is there also a long spine option? Is there something else you can do? And then enjoying all of the benefits that Pilates offers, that work for flexibility, that strengthening of the back line of the body, working on coordination and balance, minimizing those fall risks, gaining strength. I mentioned doing things on heavier springs, so for exercises like footwork, doing things on the heaviest springs that you can maintain proper alignment as you're doing the exercise. Like all of those things are fantastic. I want you to keep doing them, but if you have osteoporosis we're avoiding spinal flexion, avoiding extreme twisting, extreme side bending, and uh, extreme external hip rotation as well. When in doubt, you always wanna check with your doctor. You might get a DXA scan to see what your bone density is, and then share your diagnosis if you do have osteoporosis with your instructors so that you can make better choices for yourself, that instead of, you know, rolling up on the mat or on the reformer, you're finding long spine ways of moving through class and also long spine ways of moving through life. So you can just be the healthiest version of yourself. And finding ways to do that higher impact exercise and using your Pilates practice to support you if you have osteoporosis. Huge thank you to all my supporters on Buy Me a Coffee. I can't wait for this month's Coffee Chats as an opportunity to connect and see what's going on with you. It is a new year. We're back with new episodes. I'm so excited to be here. I hope you have a great couple of weeks and we'll talk again soon.