Hi folks, I'm Bob Schrupp physical therapist. Bob Heineck physical therapist.
We are the most famous physical therapist Together we are the most famous physical therapists on the internet,
Well in our opinion of course Bob.--Today Bob, we're gonna talk about three things you should never do if you have osteoporosis, and I think these are pretty solid issues
In my opinion --right, unlike the solidness of the spine with osteoporosis.--Wow what a segment.
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Okay, so let's talk about number one Brad
Your bones obviously don't have the density that they should have with osteoporosis, and you're going to be more susceptible to certain injuries
And the one that we see quite often is a compression fracture. Right so with osteoporosis
Oftentimes everyone not everyone but typically as you get older,
in your 60s 70s more so with females but men have it too--yep very good point and
A common way to get a compression fracture which a lot of people don't realize, so here we got the spine
It's lined up you want to show how it's lined up Brad? It's lined up. You're in in the right position now.
So a common way to get a compression fracture actually is just to go ahead and bend forward like this and
Do one of two things one if you fell
You know that would put a great compression on the spine or two actually if you just lift something heavy and
Your back is in that rounded out position
Yep, just like that. You could develop a compression fracture just from that move. So if you're gonna lift something heavy
One you may want to rethink it, but two you want to make sure you're in really good posture
So everything's all lined up. So we're gonna demonstrate in a second here
Why this bending forward like this can cause the compression fracture. I also, another
Common one is people when they sit down if they fall into the chair--oh sure--in older people it's relatively common
They'll kind of plop into the chair and that can really put some compression.--Yeah they're in that rounded out spot, and now watch this, this is what happens
And a lot of times the compression fractures happen right here where we call the hinge.
Sure--and it's on the thoracic area here where they- T11, T12
That's where we often see it, so let's go ahead. Let's say, that's T11 and T12 right there Brad,
That's thoracic 11 and thoracic 12, the mid-back.
So actually we could have T 10 11 and 12, so we got 3 vertebrae here and Brad's gonna show you what happens
When you go ahead and round out the back and you have weight on there now yep
That's what can happen, the bone can actually compress down, so that's that rounding forward
And then you sit down, and you plop or just because the osteoporosis means that vertebra is weak
It doesn't have the integrity and it's not going to accept this kind of force and they just crush
And sometimes they actually inject cement in there now they try to rebuild it up again but it's-
You know once it's done, it's done. It's not gonna expand back out like our cushion here.
It just has to heal the way it is
They could take you know months a lot of people are pretty uncomfortable for months, usually a few weeks they're getting better
But then we're working at not bending forward not plopping because that just reinjures it, reaggrevates it
Yeah so when we have somebody with a compression fracture we really avoid any bending forward at all
We might even do a little bit of bending back
But you know with osteoporosis in general posture is very very important. Alright the second one is gonna be obvious to everyone
I apologize for including it, but there are things to help prevent this from happening
I thought we'd go over some of those--sure--so the second thing is you got to try to avoid falling
I mean you've gotta, more than anybody else
If you have-if you're one of those prideful people that say hey, I'm not going to use a cane or I'm not gonna use a walker
Well, you know the saying Brad. Pride happens before the fall, and you know
I see people all the time that should be using a walker should be using a cane and they're not because you know they say
I'm not old, and then they fall, and they really start acting old because now you're dealing with pain
And you can't walk and stuff like that--right
So we're going to show you the next step. We're gonna show you some exercises
You should do which actually help prevent you from falling, and that is the third thing that you should never do
You should never not exercise
Right--I think a lot of times people start getting older and they think
I don't want to exercise cuz you know I might hurt my back or I might hurt the legs
But your bone responds to exercise and it actually becomes a little thick and it's called Wolff's Law
You caught me off guard there Bob. I was thinking about some exercises as well as when you exercise
We're going to show you how to exercise properly because sometimes people do exercise and they put their back in that compromised position
Very good point, posture is so important with osteoporosis in fact
Let's talk about, let's to help prevent falls
Let's show a couple exercises and that but we'll show some posture exercises too.--Sure okay--so the first one
Which is a great one to do Brad
Is just a sit to stand because what that does is it's getting weight through your legs and even strengthening helps increase the bone density too
What we'd like you to do is to go ahead and you know when you're sitting in the chair
And that's why Brad and I are not big fan of those lift chairs by the way
Unless you absolutely have to have them because if you have the chair lifting up for you all day, you're losing your strength
And you're losing your density of the bone
So all you're gonna do is you just scoot to the edge here
And you're gonna go ahead and use the arms if you need to to start off with and I want you to do some repeated sit to stands
Now the whole thing you got to remember about this if you're having trouble getting out of a chair your nose has got to get over your toes.
I mean if you try to stand straight up like this
You might plop backwards, and then you've got that problem with your back
The other thing I want you to keep in mind is to try to keep good posture
Don't be rounded out like this and getting up. Keep straight up just lead with the chest a little bit is what you'll want to do.
And you can go ahead and you know every time you get out of a chair if you don't want to exercise
You know pick a time of day to exercise every time you get out of a chair
You can do five sit to stands before you get out your chair and people start to talk about you--right
You say I've been watching Bob and Brad and this is what they say, you'll be okay then.
I've been watching that Heineck kid, every time he tries to get out of a chair he takes five tries and it's like no he's not taking five tries
He's just getting strengthening. So that one really helps the hip extensors
Which really helps you with your balance, the other one that really helps you with your balance are the hip abductors
That's the muscle that goes out to the side, you want to show that Brad on here?
So usually it's nice to go in the back of a solid chair you got something to balance--or a countertop
Yep, and we're just gonna simply do this
Notice I'm not doing this keep tall good shoulders back
Focus on everything that's right with posture working that hip right there
These hip muscles are really important for your stability with walking just to keep your gait solid which is
Also gonna help you--and look how he's got good posture
He's trying to keep really a tall posture posture posture. All right next one Brad, I'm going to show a couple stretches
One is when you're just in your chair, you wanna go ahead and
Again, it's about the posture Brad. Hate to keep coming back to it
You're gonna want to make sure because what happens quite often is your chest it gets tight
And it starts pulling you like this yeah, and you're gonna round out
And so you're gonna be more susceptible to that number one injury where you know you lift stuff
And you're in this bad posture, so you want to chest, I was going to say chest your stretch
Stretch your chest so you can do it in a number of ways
One you can bring your arms back like this you can put your arms behind your head and bring your elbows back
That's stretching your chest another way is just to put your arms behind you like this and this stretches your chest
But another stretch you can do for your back and for your chest is to go ahead and use a ball like this--get a soft one
A nice soft squishy one--yeah, you can get it like Brad says you can steal it from one of the little neighborhood children and
You'll get a reputation then. Well give it back to them after you're done. Well when they kick it in your yard it's yours right?
Well of course.--Okay, so you can just bend over like this and what's nice about this Brad
You're stretching the chest, but you're also stretching the mid-back at that spot that tends to be vulnerable
And if you've got shoulder problems where this is uncomfortable, you can do it with your hands down
Yeah you can go like this even and I like the ball because you can move it up and down Brad it can go into different spots
So it works out really well that way. All right a couple more stretches, how about one in bed Brad
The hamstring stretch, I think is always a good one to do
Otherwise it's gonna be pulling on your back
All you have to do is you can bring your leg up like this bring it forward and then
Stretch your leg up like this--yep
And this is nice because you're taking the stress off the back if you try to do some of these hamstring stretches in a chair
Oftentimes they promote flex posture and put pressure on your spine where this doesn't--and I'd like, the next one
I like to do is to actually just get a little nutrition into the back
And some movement in the back so when you get up
We're just gonna do some twisties we call them or you call them windshield wipers, don't you Brad?
Yeah, because it reminds me of the old windshield wiper, so we're going back and forth like this
And it just loosens up the back gets it ready, and then the final one
You know when you get off the edge of the bed, or you can do this in a chair
I want you to just to put one leg off the edge like this
On the end of it and the other one bring it back like this and you're stretching that hip flexor right there
So he's getting that leg to come back. You'll feel right where that front pocket is hopefully
These should all just feel like stretches, they should not create any sharp pain if they do you need to
Not do them, avoid them.--Yeah the reason we really like stretching the hip flexors
Is that muscle will pull down on your back and pull you in that rounded out position so
So you know hey everybody out there be safe
We don't want to see you, you know, coming into our clinic with a compression fracture
Did we mention anything about posture Bob, how important it is
Just wondering.--Nag nag nag. It's all we do.