Pilates and Osteoporosis

Pilates and Osteoporosis

How’s your week been?

Last week I attended a workshop on Pilates for Osteoporosis to keep myself updated on any new information regarding this condition.

It was an interesting workshop that reconfirmed many things I already knew about this condition, and just in case you haven’t let me know if you have osteoporosis which is if you have a DEXA (Dual Energy X-ray Absorptiometry) T score of greater than -2.5, then there are actions you need to reconsider particularly through our pilates sessions which I will go through below.

If you have been diagnosed and have not told me, please let me know so that we can modify your exercises accordingly.

So firstly, having osteoporosis does not mean you should not move for fear of fracturing everything. Your body loves movement and movement generates force on bones that helps try to either maintain or in some cases improve bone density. What may need to happen is you reconsider the way you move.

If you have a diagnosis of osteoporosis this basically means you have a higher risk of fracture – a compression/wedge fracture where the vertebral body collapses at the front.

Moves that should be avoided are forward flexion moves so therefore moves like:-

Ab curl/ Roll up/ Rolling like a ball / Spine stretch forward / Saw / Jacknife / Teaser / Side Bend – you get the gist.

The action of flexing over increases the chances of the vertebral body collapsing forward so as mentioned above, if you have a T score of greater than -2.5, we must avoid flexion.

There are however other ways to move to still create strength in your centre and benefit your body and arguably nowadays the original pilates content/exercises for matwork, are not really useful to a society that is being taken over by technology so that we are moving less, we are spending more time slumped on the couch, over the ipad, PC, iphone, etc already creating a deeper flexion in our upper back, more commonly known as kyphosis.

I love using equipment to assist a flexion free workouts because it enables you to connect into your centre in most instances more strongly than if you were flexing up.

As we age, if you are more kyphotic, shoulders hunched forward, struggle with neck or shoulder pain, why would you want to increase your hunched shoulders by flexing forward all the time. Abdominal curls do not make flat abs.

For those who do find their shoulders are a bit hunched over and don’t touch the floor when laying on your back, I would strongly recommend you use the head pads to help open the shoulders and to help you resist the temptation of lifting the head in certain exercises.

Balance and coordination movement should be a vital component of your exercise focus whether you have osteoporosis or not. Strength training using body weight or dumbbells is also very important. Just because you shouldn’t flex doesn’t mean you can’t move.

When doing pilates, we have been talking this month about positioning of the shoulders and the neck which is vital to reducing any aches and pains in this area but also so that muscles fire in the right pattern because your joints are in a better start position before you move.

I often mention the disassociation of hip to back movement as in squatting with a straighter back or moving back and forth on your hands and knees avoiding altering the position of the spine as we tried in some classes this week.

I’ve also been suggesting people work on their sit to stand as in sitting without falling down and without using your arms both sitting down and getting up. Use your legs, find your gluts (bum) and make them work to avoid too much strain on the spine.

Working on extension is a great exercise for osteoporotic clients but this will be subject to posture. If you are very kyphotic you may need a towel under your hips to avoid too much lumbar lordosis. You may also need a head pad to rest your forehead on to lengthen the back of the neck and your extension range may be minimal but can still be attempted gently.

Please keep in mind just how you use your neck in extension. I am seeing a lot of chins lifting when really the eyes should stay to the front of the mat and the floor so that there is no crick in your neck so to speak.

To recap in our pilates classes, if you have osteoporosis, head should stay down for all flexion style exercises and a modification is always provided that avoids doing the roll up or head lift. Please take the modification, it is for your own benefit.

Any questions, feel free to ask and drop me a message. I will be doing a fairly flexion free class on the Mondays through October to reinforce what I have mentioned in today’s news letter.

​​​​​​Have an amazing weekend and see you all next week!