Exercise and Osteoporosis

Strong, steady and straight:

UK consensus statement on physical activity and exercise for osteoporosis

https://bjsm.bmj.com/content/early/2022/04/24/bjsports-2021-104634

Key recommendations from the consensus were three-fold:

1. Resistance training and impact exercises should be utilized to maximize bone strength.

2. Resistance training and balance activities should be utilized to decrease fall risk.

3. Spinal extension exercises should be utilized to reduce the risk of progressive kyphotic posture development, which may reduce the risk of vertebral fracture in this population.

The authors also emphasized that the benefits of physical activity in this population outweigh the risks, and that the risk of significant harm is limited.

"specific and highly challenging balance and muscle-strengthening exercises, supervised by a trained health or exercise professional, are recommended,"

interventions should be

"tailored to suit the individual to ensure that they challenge balance without increasing fall risk"

"Strong"

The recommendation for maximizing bone strength, consists of muscle strengthening activities 2-3x/week with loads that allow 8-12 repetitions per set. They advocated training all major muscle groups of the body for 1-3 sets, per exercise.

Specific Recommendations

For individuals without vertebral fractures or multiple low-trauma fractures,

50+ impacts per session accrued through moderate impact exercises like stamps, hops, and jumps.

For individuals with vertebral fractures or multiple low-trauma fractures,

impact activities that build to the level of brisk walking.

For individuals who are frail or otherwise less able to exercise,

physical activity and exercise according to individual ability, with an emphasis of reducing fall risk.

"Steady"

the authors’ recommendation for reducing fall risk, is based around integration of muscle strengthening activities that include balance and/or balance specific task practice.

"Straight"

the recommendation related to reducing the risk of vertebral fracture and progressive kyphotic posturing, is summed up nicely by the authors. "A positive and reassuring approach is recommended to reduce fear, enhance confidence and control - ‘how to’ rather than ‘don’t do’, especially as most people with osteoporosis are unlikely to experience a vertebral fracture during these activities." The list of recommendations in this section was vast, but primarily distilled down to training the spinal extensor musculature and avoiding sustained, loaded, end-range spinal flexion during daily activities and exercise. In individuals with diagnosed vertebral fracture, advice and exercise is encouraged in a holistic treatment model to reduce fear and maintain mobility/function.

We hope these guidelines empower rehabilitation providers and fitness professionals to challenge their clients with progressive strengthening, impact, and balance activities that reflect their individual status; versus the diagnosis they carry.

Adapted from: Brooke-Wavell K, Skelton DA, Barker KL, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med. Published online May 16, 2022:bjsports-2021-104634

Somatic Moves for tight hip flexors

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Hip flexors can become tense from overuse, especially in summer pursuits —and they can be inactive, with to much sitting and driving.In this video Martha Peterson shows moves to relieve the flexors.

You can also do the Arch and Curl with Psoas Release at the beginning and end of your day.

If you’ve been seated for an extended period of time

Walk backwards, then forwards.

Notice the difference not only in your hip flexors, but the front and back of your body, and the movement of your shoulders and hips.

The Effects of Yogic Breathing

Yogic Breathing Affects Cerebrospinal Fluid Dynamics During Breathing Practice

Practicing yogic breathing may have an effect on an individual’s cerebrospinal fluid (CSF) dynamics—the movement, flow, and circulation of the CSF—and on the health of the central nervous system, according to a new study published in the journal Scientific Reports.

CSF is a type of fluid compartment around the brain and spinal cord that serves as a cushion for these organs. CSF distributes nutrients and hormones, and along with interstitial fluid (ISF, the fluid found in the spaces around cells), helps the central nervous system to remove metabolic waste from its environment.

Like most fluids in our body, the CSF also moves. In fact, the study of CSF dynamics has become a recent focus in the field of neuropathology. Understanding how the CSF moves and exchanges with ISF is of high importance for Alzheimer’s and other diseases of the nervous system. CSF movement is driven primarily by pressure changes, usually from the pulsations of the heart and sometimes respiration.

Findings from this study suggest that respiration can potentially be the primary driver of CSF dynamics, depending on the form of breathing an individual is practicing. The researchers noted that the next step is to see how long-term yogic breathing training could affect the CSF dynamics, and therefore, central nervous system health.