Bone Health

Learn about bone health, what it is, what it is effected by, and how to maintain and promote it. This article gives great insight to the importance of bone health published on moveforwardpt.com, a site created by the American Physical Therapy Association. For more questions call us at 619-756-7500!

 

Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

  • Age: More common in older individuals
  • Sex: More common in women
  • Family History: Heredity
  • Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
  • Weight: Low body weight (small and thin)
  • Diet, especially one low in calcium and vitamin D
  • History of broken bones
  • Menopause
  • Inactive lifestyle
  • Smoking
  • Alcohol abuse
  • Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.

Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.

Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.

Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

  • Keep your back, stomach, and leg muscles strong and flexible.
  • Keep your body in alignment, so it can be more efficient when you move.
  • Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
  • Use good body positioning at work, home, or during leisure activities.
  • When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
  • Ask for help or use an assistive device to lift heavy objects.
  • Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

9 Things You Should Know About Pain

Most individuals experience and deal with physical pain differently. It helps to better understand the reason why we feel pain to know what it means or could be signaling. This article helps explain the reasons behind feeling pain written by Joseph Brence and published on MoveForwardPT.com. MoveFowardPT.com is an editorial board compromised of physical therapists members from the American Physical Therapy Association. For more questions call us at 619-756-7500!

 

1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.

2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, others experience minor injuries with a lot of pain (think of a paper cut).

3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding may not be the cause of your pain. A study performed on individuals 60 years or older who had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated or bulging disc, upon diagnostic imaging.

4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.

5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.

6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts.

7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).

8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a “roadmap” within the brain that details a path to each part of the body may be a bit “smudged.” (This is a term we use to describe a part of the brain’s virtual roadmap that isn’t clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)

9. There is no way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”

Progress or Plateaus

Most people will encounter plateaus at some point during a consistent training program. Learn more about what plateaus are and what to do when they arise in this article written by Jeff Gilliam, PhD, PT and published on physicaltherapist.com. For more questions call us 619-756-7500!

 

So often we see such great progress as we begin our weight loss program, pushing onward to our goal at a jackrabbit pace, only to be met with a discouraging plateau. When plateaus are experienced, our first response should be, “Am I doing everything possible to encourage my progress? Am I following through with the program as it’s been designed”??? If our answer is “Yes!” then our next question should be, what has happened to slow my progress, and what can I do to ensure continued progress toward my goal?

During weight loss programs, momentary plateaus are an absolute. Plateaus occur as the body loses weight and no longer requires the same amount of calories to run its basic bodily functions and daily activities. No longer are you carrying around 10, 20, or 30 extra pounds during daily activities, which means fewer calories are being expended now, than when you started the program. Also, whenever you go on a caloric restricted diet, your body becomes very efficient in running its basic bodily functions, and requires fewer calories for the Resting Metabolic Rate (RMR). Lastly, during weight loss programs, typically 25% of the weight loss is from lean body mass, while approximately 75% is from fat. The likelihood of muscle loss is increased when resistance training does not accompany a weight loss program. Maintaining muscle is a key to ensuring that the RMR continues to expend energy at a high rate, subsequently burning calories at a level that will allow for continued weight loss.

When plateaus arise, modifications in your program will be necessary to ensure ongoing progress. Increases in your exercise intensity/time are often required, and a close examination of your food choices may be necessary. In order to offset this trend, it may be necessary to increase your exercise output (an increase in exercise time and/or intensity) making sure resistance training is a part of your routine. Additionally, making sure your protein intakes are optimal will spare lean body mass loss during caloric restriction. The importance of protein in a weight loss program is highlighted by a recent study which found when subjects on an ad lib diet increased their protein intake to 30%, they ate 441 fewer calories each day, lost more weight, and experienced greater feelings of satiety than the lower protein group. Remember at your current weight you’re expending fewer calories at rest than when you started your weight loss journey, which means you must continue to make better food choices to encourage your body to continue to lose excess body fat.

These changes should cause your body to increase its fat burning capacity and is often affective in “recharging” the system and renewing weight loss at an acceptable level. During times in which you experience a plateau in your weight loss, strategic shifts toward better food choices and avoiding those occasional food temptations will allow you to realize ongoing progress. The use of daily exercise to boost your metabolism has been shown to be helpful in offsetting a depression in the RMR.

Remember: Plateaus are only momentary pauses in our progress that will soon be relinquished by making the appropriate adjustments in our dietary and exercise regimens.