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Ask an Exercise Physiologist: Early-onset osteoporosis and spinal pain

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Interesting questions this week about early-onset osteoporosis and best sitting posture.

Thank you to the Her Canberra community for being so engaging and asking the tough questions. Addressing your concerns is the first step in finding answers.

I’ll get to the other questions on mountain running, periodisation in the gym and the benefits of exercising with depression over the next month.

New here? Ask an EP is here to help with all your health and wellness questions and challenges—lifestyle, wellness, pain and health.

Do you have a burning health and wellness question? Now is your chance to ask.

Each week we will pick a couple of questions, and help you solve your burning query. If we share our problems, we are more likely to solve them.

Let’s get started.

I’ve recently been diagnosed with early stages of osteoporosis. I feel like I’m very fit and healthy, so I was quite surprised to hear my bone density is poor (although my Mum did get osteo early). 

I manage well with prescription medication and a vegan diet, however, I feel like I could be doing more on the exercise front (I currently swim, walk and do beginners mat Pilates 3-4 days a week). 

I do have a knee recovering from surgery, so I need to monitor my load. What are your top tips for maintaining bone health?

–Monica, 55

Osteo is largely a preventable disease, and you’re absolutely right Monica, the right form of exercise most certainly can increase the strength of your bones.

Osteoporosis occurs when the creation of new bone doesn’t equal the loss of old bone. Did you know that it’s estimated that just under a million Australian’s have Osteoporosis? That’s approx. 3.8% of the population.

Research has proved that physical activity can help to prevent, treat and manage Osteoporosis.

Good on you for doing your research—please do continue to consult your doctor. Do you have a women’s health doctor who specialises in bone health and menopause?

Dr Kelly Teagle from WellFemme is a great place to start. Seeing a Nutritionist or Dietitian who specialises in bone health should be on your radar too. I recommend the Healthy Eating Hub (Clare or Kate), or Stacy from Hive Nutrition.

The type of exercise that is “bone-building” (osteogenic) is the type of exercise you require—weight-bearing exercises that force you to work against gravity and resistance exercises are the best for your bones.

Here are six movement choices to consider if you want to improve your bone health:

  • Aim for a minimum of 30 minutes of exercise most days. Sorry—3-4 days a week isn’t enough! You could break it up into three x 10 minute walks to get started (but monitor that knee rehabilitation).
  • Outside (Vitamin D) hiking/walking/jogging (once your knee has recovered) are fabulous options (make sure you have a plan through a specialist, so you don’t increase your km’s too quickly!).
  • Take the stairs at work—great for bone building.
  • Resistance training with Therabands/dumbbells (3+ days a week). Chair and corner wall exercises can be a safe alternative if you’re new to resistance training or working on your balance post knee operation.
  • If you have the option, choose the explosive dynamic Pilates reformer classes (generally speaking, your beginner Pilates mat exercises often aren’t designed with bone health in mind).
  • Be consistent with which body part you do the resistance movements—be aware that the area of the skeleton that is stressed (eg: bicep curl exercises) and this improved density (upper body) will be lost if the loading exercises aren’t continued.

Best of luck! Be consistent, have a plan and adhere to the plan. Let me know your progress.

I get SIJ (Sacroiliac Joint Dysfunction) pain and general lumbar spine pain. My job requires me to sit 7-8 hours a day (minimum) on a good day.

What are your top tips for maintaining a safe seated position? By the end of my shift (starts around 5-6 hours) my backaches.

– Kerry-Anne, 48

So many points to address here!

  • Firstly, do you have a lumbo-sacral and spinal strengthening rehabilitation program?  It’s essential to have spinal fitness and strength endurance if you are required to sit for long periods of time.
  • Have you had a workplace desk assessment (or considered a standing desk)?
  • Do you have scheduled breaks during the day (eg: a walk at lunch or fitness class?)? I’d recommend not sitting in the same position for any longer than 30 minutes. Try changing the position of your spine by using a rolled-up towel or lumbar roll.

Top tips for a seated position:

  • Sit up, with your spine tall and shoulders back and down. Once you are as tall as possible, release by 10%. This is more sustainable for a longer period of time.
  • A lumbar roll (or rolled-up towel) can help to maintain the normal curves in your spine, if you struggle to support yourself.
  • Distribute your weight evenly into both sit bones.
  • Bend your knees at 90 degrees, or slightly higher than your hips.
  • Feet should be flat on the floor, with weight distributed evenly.
  • My favourite saying when it comes to posture: “your next posture, is your best posture”.

What is ONE THING you can change tomorrow?

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