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Q: I have a client who was diagnosed with osteoporosis. How can I work out this client safely and effectively? Are there any resources to learn the exercises?
A: It is not uncommon to have a client who is diagnosed with osteoporosis or osteopenia – the precursor to osteoporosis. The tricky part about this disease is that clients generally don’t feel any pain or discomfort. Even if this is the case, it is very important to avoid certain movements and be cautious of the contraindications.
What to Avoid
During a workout, you are advised to avoid loaded spinal flexion as this may encourage compression fractures. Rotation and lateral flexion would also be contraindicated movements, however, research is inconclusive as to their long term effects on the spine. Inverted positions should also be avoided as they place stress on the upper quadrant and require that the cervical and upper thoracic and possibly the lumbar spines are brought into flexion.
Where to Focus
An osteoporotic client should partake in regular weight-bearing and strengthening exercise in neutral and extended positions of the spine, as these may help build the muscles around the bones, thereby strengthening them.
Further Information & Training
As with any medical concern, it is important to get as much information as possible from the client’s health care team preferably with an exercise prescription. General guidelines would be to include a long warm up, and progress the client slowly. Be sure to include a thorough cool-down as well. It is also advisable to do as much background research on this condition as possible.
Merrithew™ recently launched the STOTT PILATES® Flexion-Free Workshop, which will provide you with a variety of programming options ideal for this clientele. The workshop includes a variety of exercises and modifications all done in a neutral spinal position with slight extension of the spine. You can find more information about this workshop on our website. In addition to this workshop, additional programming options and guidelines can be found in the Programming for Osteoporosis workshop and in our Injury and Special Populations course.