Participate in Osteoporosis Support Groups

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3 Participate in Osteoporosis Support Groups NOF has support groups across the country to provide support and information for people affected by osteoporosis. NOF depends on volunteers like you to serve as support group leaders. To find out if there is a support group in your area or learn how you can start a support group, request@nof.org. 3

4 Join Steps for Strong Bones Walk, jog or run your way to healthier bones. Steps for Strong Bones is a fundraising and walking program. Join for free and ask your friends and family to support you in your quest for healthy bones with a donation to NOF. For more information visit or events@nof.org. 4

5 Join the Healthy Bones Advocacy Network NOF's Healthy Bones Advocacy Network is made up of volunteer advocates who reach out to policy makers to highlight the importance of osteoporosis and bone health and help advance NOF's public policy goals. To become an advocate or to learn more, visit 5

6 Attend A Gift from Mothers to Daughters On September 30, NOF will celebrate the gift of knowledge that generations pass onto future generations. This year s honorees are: Mother-Daughter Activists Marybeth and JC Bond Former First Lady of New York Matilda Cuomo Award-winning Broadcast Journalist Dr. Max Gomez For more information or to get involved, contact Kelly Austin at (202) or kelly.austin@nof.org. 6

8 Mission Statement The National Osteoporosis Foundation is the leading consumer and community-focused health organization dedicated to the prevention of osteoporosis and broken bones, the promotion of strong bones for life and the reduction of human suffering through programs of public and clinician awareness, education, advocacy and research. National Osteoporosis Foundation

9 Exercise For Your Bone Health September 22, 2010 National Osteoporosis Foundation

10 Today s Presenter Karen Kemmis, PT, DPT, MS, CDE Physical Therapist and Adjunct Professor SUNY Upstate Medical University Physical Medicine & Rehabilitation Department and Joslin Diabetes Center and University Endocrinologists 10

11 Physical Activity and Exercise Physical activity is any bodily movement, produced by your muscles. Exercise is a type of physical activity that is planned, structured, repetitive and purposeful to improve or maintain some component of your fitness or health. Both are important for your bone health. 11

12 What Types of Exercise Improve Bone Health? Several types of exercises are important for bone health, including those that: Make bones and muscles stronger Improve posture and body mechanics Improve balance to help prevent falls Help you function better during your day 12

13 Exercises That Make Bones Stronger Two types of exercises that improve or maintain bone density are: Weight-bearing exercises which make you work against gravity while being upright, such as brisk walking. Muscle-strengthening exercises which make you move your body, a weight or some other resistance against gravity, such as lifting weights. These are also called resistance exercises. 13

14 Weight-Bearing Exercise Examples High-impact exercises: Dancing High-impact aerobics Hiking Jogging/running Jumping rope Stair climbing Tennis Volleyball Low-impact exercises: Elliptical training machines Stair-step machines Low impact aerobics Walking on a treadmill Walking on level surfaces such as mall walking or walking outdoors 14

15 How Much Weight-bearing Exercise Should You Do? Children and adolescents: 60 minutes of moderate to vigorous activity every day, including high-impact activities Adults: 150 minutes per week of moderate or 75 minutes per week of vigorous activity, including impact activities; based on health and abilities Older adults: Follow adult guidelines, adapted as needed based on your health Always check with your healthcare provider before beginning a new exercise program. 15

16 Muscle-Strengthening Exercise Examples Muscle-strengthening exercises can be done: With weight machines With hand and ankle weights With elastic exercise bands By moving against gravity 16

17 How Much Muscle-Strengthening Exercise Should You Do? These exercises should be done two days per week. Try to do 1-3 sets for each exercise. Aim for a total of 8-12 exercises per week that work all major muscle groups. Weight should be heavy enough to cause fatigue after 8-10 repetitions or repetitions of a lighter weight if you re frail or at risk of a fracture. Maintaining proper form is very important! 17

18 Posture and Body Mechanics Good posture and proper body mechanics are important to decrease your risk of spine fractures. Good posture Poor posture 18

19 Posture and Body Mechanics Exercises should focus on reducing forward head posture and rounded or sloping shoulders. You may need to see a physical therapist to examine your posture and body mechanics; he/she can prescribe specific exercises for you. Posture exercises can be done for a few minutes each day. 19

20 Corner Stretch Exercise Stand facing corner in a lunge Place forearms on wall Keep elbows below shoulder level Slowly lean in toward corner Side view same exercise Keep spine in good alignment Lean from hips Should feel stretch in chest For complete instructions, see Exercise 2 in webinar handout Balance, Posture and Functional Exercises 20

21 Balance Exercises Most fractures of the hip, wrist and other bones occur after a fall. A complete balance assessment may include: review of your medications vision exam home safety check tests to check strength, flexibility, posture and balance 21

22 Balance Exercises Balance can be improved with leg strengthening and stretching exercises, challenging balance exercises and Tai Chi. Balance exercises can be done for a few minutes each day. Balance exercises are very important for older adults and anyone who has balance problems. 22

touching the inside edge of the back foot s big toe. 3.

23 Balance Progression Exercise 1. Feet together: Stand with feet tight next to each other. 2. Semi-tandem: Stand with one foot in front but slightly to the side of the other with the inside edge of the front heel touching the inside edge of the back foot s big toe. 3. Tandem: Stand with one foot directly in front of the other like being on a tight rope. 4. Single leg stance: Stand on one leg only. For complete instructions, see Exercise 1 in webinar handout Balance, Posture and Functional Exercises 23

24 Functional Exercises Exercises that improve how well you move can help you in everyday activities and decrease your risk of falls and fractures. If you have trouble getting up from a chair or climbing stairs, you should do functional exercises every day. You might practice getting up from a chair without your arms, climbing stairs, rising onto your toes or practice lifting packages correctly every day. 24

25 Chair Rise Exercise Sit on front edge of a chair and rise to standing position. Gently sit back down without using arms. Cross arms over the chest to prevent using them. Keep knees and feet hip-width apart at all times. Use the strength of the legs to stand and sit. If this can t be done without using your arms, place a pillow on the seat of the chair to make it a bit easier. For complete instructions, see Exercise 3 in handout Balance, Posture and Functional Exercises 25

26 Safe Movement Some movements and exercises may be unsafe if you have low bone density or osteoporosis, including: bending forward from the waist with straight legs (spine flexion) twisting at the torso (trunk) to an extreme (full spine rotation) strenuous overhead lifts or carrying packages that are too heavy activities that increase risk of a fall 26

27 Avoid Spine Flexion Spine flexion occurs when you bend forward from the waist with straight legs, such as: toe touches (see photo) any movement that involves bending to the floor Spine flexion also occurs when doing curl sit-ups (see photo) Wrong Wrong 27

28 Avoid Full Spine Rotation Avoid twisting or bending the torso (trunk) to a point of strain or full spine rotation, such as: the twist at the beginning and end of a golf swing or a full tennis swing 28

$Avoid Heavy Lifting and Lifting Overhead Avoid lifting or carrying heavy objects, packages or babies (e.g. 10 lbs or more). Lifting heavy objects overhead can cause a fracture.$

29 Avoid Heavy Lifting and Lifting Overhead Avoid lifting or carrying heavy objects, packages or babies (e.g. 10 lbs or more). Lifting heavy objects overhead can cause a fracture. For example: Lifting heavy weights Lifting babies or children overhead Lifting a heavy item into a top cabinet Work with a physical therapist or other healthcare professional to determine how much weight you can lift safely. 29

30 Avoid Activities That Increase Your Chance of Falling Reaching too far over your head can cause a loss of balance, increasing the risk of a fall onto the back or buttocks. Avoid any activity that could increase your chance of falling, such as: Rollerblading Downhill skiing Walking on wet or icy surfaces 30

31 What about Yoga and Pilates? Yoga and Pilates have many benefits including improved muscle strength, balance and flexibility. However, many movements in these exercises are not safe for people at risk of spine fractures. Learn proper modifications before doing yoga or Pilates. 31

32 The Exercise Prescription Weight-bearing exercises can be done for 30 minutes, 5 to 7 days per week; focus on impact. Muscle-strengthening exercises should be done 2 to 3 times per week. Balance exercises, posture exercises and functional exercises can be done for a few minutes each day. 32

33 Fitting Exercise In You may choose to do exercises that are most important to you. If you have balance problems, focus on balance exercises. If you have posture problems or poor body mechanics, practice improving those areas. If you struggle with daily activities, work on those. 33

34 Working with a Healthcare Professional Work with your healthcare professional (especially a physical therapist) if: You are not sure which exercise program is best for you You have had a fracture You have fallen recently or tend to fall often You have pain that prevents exercise 34

35 Question and Answer Time We will now answer questions submitted by the audience during this webinar. Please note: NOF is unable to provide you with medical advice. For questions about your specific condition, please talk to your healthcare provider. We are only able to answer questions related to exercise and the topics covered in today s presentation. 35

36 Contact NOF for More Information National Osteoporosis Foundation Phone: (800) Web:

37 Upcoming 2010 Webinar December 1 Update on Osteoporosis Treatment Options Felicia Cosman, MD Register at or call (866)

Safe & Effective Exercises for Osteoporosis

Safe & Effective Exercises for Osteoporosis Karen Kemmis, PT, DPT, MS, GCS, CDE, FAADE SUNY Upstate Medical University Physical Medicine & Rehabilitation Joslin Diabetes Center and University Endocrinologists