Osteoporosis: Preventing Falls and Fractures

By Jilian Binuya, DPT Student
May is Osteoporosis Awareness Month!

According to the National Osteoporosis Foundation, osteoporosis is a disease associated with low bone mass and the deterioration of bone tissue. This can lead to fragile bones as well as an increased risk of osteoporotic fractures; these are fractures that result from situations that would not typically result in a fracture such as a fall from standing height. Osteoporosis can be a result of hormonal changes, vitamin or mineral deficiencies, and lack of exercise.
Osteoporosis Statistics:

  • In the US, more than 53 million people either already have osteoporosis or are at high risk of bone fractures because of low bone mass.

  • There is a 50% risk of osteoporosis for postmenopausal women.

  • Osteoporosis can develop a year or two before menopause

  • Once menopause occurs, there is a yearly decrease bone mineral density of 0.5-1% which can double to 2% per year during a 5 year period

  • While anyone can develop osteoporosis, the most at-risk population is non-Hispanic white women and Asian women.
How Do I Know if I Have Osteoporosis?  

If you are (1) a woman over the age of 65 or (2) a women of any age who has factors that increase the chance of developing osteoporosis (such as post-menopause or having a family history of osteoporosis), then you should already be getting regularly screened for osteoporosis.

However, any person regardless of sex, should speak to their primary doctor if they are experiencing:

  • Height or weight loss

  • Changes in posture

  • Changes in your balance and the way you walk

  • Changes in muscle strength

It is important to report to your doctor if you have had any previous falls or fractures

For those who menstruate, it's important to report your menstrual history, as hormone changes can have an effect on bone growth.

When getting screened for osteoporosis, your doctor will likely order a bone mineral density test such as a dual-energy x-ray absorptiometry (DXA) test.

For more information on how to know if you have osteoporosis, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases and speak with your primary care physician.
How Can Physical Therapy Help?

Physical therapists are movement specialists! We can perform regular fall risk screenings to test your strength and balance. Additionally, we can help develop exercise plans that are both efficient and SAFE to help maintain bone density, prevent future injury, and improve your independence! 

Strength training is crucial for building bone mass as well as reducing risk of falls. Weight bearing exercises (such as jogging, walking, or doing squats) and resistance training (such as lifting weights or using resistance bands or cables) involve exercises that allow forces, including gravity, through your joints.

These forces stimulate our bodies and tell us that we need to build bone mass! High-impact exercises such as running, jumping rope, dancing, and tennis are great ways to build strong bones to prevent bone density loss. However, for those who have osteoporosis or who already have low bone density, a low impact exercise such as walking, elliptical training, or low-impact aerobics can be a safer alternative, especially if you have already experienced a broken bone due to osteoporosis. Resistance training is also necessary to build core and leg strength as it contributes to our ability to balance and stay upright. Core and posture exercises are helpful for preventing postural changes associated with osteoporosis as well as injuries to your back.

FUN FACT: Hip strength and pelvic strength go hand in hand.

Weaknesses with either muscle group can have an impact on the other which in turn can impact your back and core. Physical therapy can help assess your strength and create an exercise plan for you so that not one muscle group is causing a weak link. 

Leg strength is also so important for balance. Challenging your balance in a safe way is an excellent way to prevent falls! Balance can be affected by muscle imbalances or weakness, vestibular issues, or changes in sensation or vision.

Balance training involves exercises and activities that challenge all of these systems in a functional way. We do this by first assessing your balance. Can you stand on one leg for 10 seconds? Can you stand with your eyes closed for 30 seconds? Can you reach for an object greater than an arms length away from you without holding on to anything? If these tasks seem very difficult for you, you may consider training your balance to decrease your risk of falls.
How to Fall!

Having osteoporosis can mean that any misstep or loss of balance could turn into a potentially bone-breaking fall, therefore we always want to prevent falls from occurring in the first place! However, sometimes falls are inevitable or unavoidable. No matter how much we try to prepare, accidents happen. Because of this, it is just as important to know that there are safer ways to fall that will decrease your risk of injury.

Remember these tips:

  • Avoid Straight Lines! Falling on an outstretched hand can lead to greater injuries. If possible, disperse the force throughout a greater surface area (your hands and forearms) by bending your elbows. This allows muscles to absorb impact. 

  • Get Low! If you are losing your balance and anticipating you are going to fall, bend your knees to get your trunk (your center of mass) lower to the ground. This will help your body roll to the ground which has less impact on the body.

  • Protect Your Head and Neck! Head injuries are a common secondary injury. Protect your head and neck by nodding your head and tucking your chin in the opposite direction of the fall. For example, if you are falling backwards, nod your head forward and tuck your chin into your chest. If you are falling forward, look up so your head goes back away from the direction you are falling in. This helps keep your head from hitting the ground.

  • Practice Falling… Safely! Seeing a physical therapist for fall prevention and recovery is the best way to prepare yourself in case of a fall.
Don't Forget Fall Recovery!

What happens if you fall and you cannot get up off the ground? Persons who fall resulting in a long lie (a long lie is when a person who falls spends a prolonged period of greater than 1 hour on the ground because they are unable to get up) are at risk of delayed medical treatment, dehydration, pressure wounds, hypothermia, pneumonia, and an increased fear of falling. This increased fear of falling can result in folks being afraid to move about independently in their communities and even their own homes. With fall recovery training, we aim to get you comfortable with being on the ground by helping you develop a plan to get up off of the floor and onto a safe surface such as a chair or bed.

Consider this: If you were to fall in the middle of your home and could not get up, could you crawl to a sturdy piece of furniture such as a bed, couch, or arm chair? By having a plan set in place and practicing these movements of crawling and lifting yourself off of the ground, you can reduce your risk of long lies and need of emergency medical treatment.

Be proactive! If you are interested in fall prevention or fall recovery training to maintain your independence and confidence, the therapists at CTS can help!
Jilian Binuya, DPT Student
Do you suffer from chronic pelvic pain? Pain with intercourse?
Interstitial Cystitis (IC)? Pelvic floor dysfunction?

Join our Women's Pelvic Pain Support Group
Saturday, May 14th from 10-11am
This support group will be held monthly on the third Saturday of each month from 10-11am. We will meet in person with masks and social distancing at CTS Sorrento Valley - 5677 Oberlin Drive, Suite 106.

Each meeting will start with a brief 15 minute educational discussion. 📚

Our May topic is YOGA FOR PELVIC PAIN! 🧘‍♀️

The purpose of this group is to build community and co-create a safe space where we can share our experiences with pelvic pain in a supportive and affirming environment. This could include brainstorming treatment ideas and/or sharing the evolution of our personal journeys. 🗣

We welcome all who identify as women 💃 to be part of this discussion.
We understand that this isn't always possible, but to help with the flow of the meetings, we'd encourage you to join at the beginning. This will allow us to introduce ourselves and get to know each other before we delve deeper into our personal journeys. This is especially helpful in creating the sense of community that we'd like to build since we will be discussing topics of a personal nature.
Join Elizabeth for a Stress Prevention Workshop
Saturday, May 14th from 11am-12:15pm at
the Mission Valley YMCA Community Room

This workshop is intended to increase public awareness about the causes and cures of our modern stress epidemic.

$10 from YMCA members, or $13 for participants. Questions? Contact Barb Madsen at 619-298-3576 or bmadsen@ymcasd.org
CTS Move of the Month - May 2022:
Finding Your Balance
In this two-part video series, Jilian Binuya, DPT student, discusses different ways to test and find your balance using Base of Support, Visual Feedback and Dynamic Movement.
Part 1: Base of Support & Visual Feedback

In terms of balance, the wider your feet are from each other, the more stable you are.

🔹 Start with your feet greater than hip width apart and hold that position for 30 seconds.

🔹 Once you feel stable in that position, bring your feet closer together to hip width apart and hold for 30 seconds. Then bring your feet together to a narrow stance and hold for 30 seconds.

🔹 From a narrow stance, bring one foot forward into a step stance and hold for 30 seconds. Next, bring your heel to your toe for a tandem stance and hold for 30 seconds.

🔹 Shift your weight on to one foot, bring your other leg back into a single leg toe touch and hold for 30 seconds. When you're ready, pull that leg off the ground to go into a single leg stance, and try to hold for 30 seconds.

🔹 Find a position above that's challenging but safe, and use visual feedback by closing your eyes. Hold that position for 30 seconds with your eyes closed.
Part 2: Implementing Dynamic Movement

For more of a challenge, implement dynamic movement by reaching outside of your base of support and changing your visual feedback.

🔹 Choose a foot position that feels stable for you. Bring one hand out and reach to the side as far as you can without losing your balance. Repeat on the other side. Use a counter to hold on to if you feel unsteady, and repeat 10 reaches on each side.

🔹 Go to the next level of foot position, with feet closer together or a step stance, and repeat 10 reaches on each side.

🔹 Try to reach in front of you, shifting your weight on to your toes. Then shift your weight on to your heels. Repeat 10 times.

🔹 Challenge yourself further by changing your visual feedback and adjusting your head position. Find a foot position that feels stable and look left and right, 10 times in each direction. Then, look up and down, 10 times in each direction.

🔹 Once this feels stable, close your eyes and repeat these head turns, 10 times in each direction.

comprehensivetherapy.com / (858) 457-8419 / Open Monday-Friday 7am-7pm