Margaret Martin: Can you exercise after a vertebral compression fracture?
That's the question we're going to answer today.
So my name is Margaret Martin, I'm a registered physiotherapist, my site is MelioGuide, and
welcome to my YouTube channel.
This channel is devoted to aging well with exercise, with a special focus on stronger
bones to create a stronger body.
Let's go back to the question.
Should you exercise after a vertebral compression fracture?
Absolutely.
And don't just take my word for it, studies have been coming out over the last decade,
and especially over the last year three or four years, showing that individuals don't
just do better after exercising, but they recover faster, they regain a better quality
of life.
Each day and every one of you that have vertebral compression fracture will experience it very
differently.
Just like two individuals with arthritis, they could have the exact same x-ray, one
could be pain-free, and the other one can barely walk.
So same with individuals with vertebral compression fractures.
Your x-ray can look like your neighbors and you might have severe pain whereas your neighbor
doesn't even realize that they actually have a vertebral compression fracture, that is
very possible.
So the vertebral compression fractures I'm speaking about are those caused by osteoporosis,
where there's a diminished quality of bone as well as density of bone.
So I'm not speaking about the type of vertebral compression fractures that somebody would
get in the spine cord unit where I've worked for years, but in the spinal cord unit you'll
see much younger people, you'll see young men, women, those who were in serious car
accidents, people who might have fallen from a roof, jumped into an empty pool, things
that will cause a lot of trauma to the spine in which sometimes the pieces of the spine
are disrupted, they have to go in and do surgery.
There's a lot of intervention after those kinds of compressions or fractures to the
vertebrae.
When it comes to an osteoporosis compression fracture, some of them are silent, people
don't even know they have them.
And yet, another 55 or so percent will have pain.
The osteoporosis compression fractures occur with things like repeated forward bending,
it's just sort of a gradual insult to the spine, or it could happen from something as
simple as a slip or trip just from standing height.
So these are the compression fractures that we're talking about in terms of gradually
reintroducing exercise.
So whether your vertebral compression fracture is in your thoracic spine, so thoracic spine
starts just at the base of your neck and it goes down to where your ribs finish, or if
it's in your lumbar spine, either way, it's very important that you get the okay from
your doctor, the green light, to start exercising, you want to make sure that your compression
fracture is stable.
Most compression factors simply compress either in a wedge or a biconcave shape, sometimes
there are pieces that actually break off.
So that's why it's important that if you're in significant pain, and this is why you'd
probably know you have a vertebral compression fracture because someone does an x-ray, but
that your doctor, or your surgeon, your endocrinologist, whoever's following you says, "Things are
stable.
Things are healing.
You can progress to exercise."
Now many of you, as I say, will be experiencing pain after vertebral compression fracture
so I really strongly encourage you to find a manual therapist, a physiotherapist in your
area who can put their hands on you, whether it's with some myofascial release, some taping,
some acupuncture, but some means of giving you some pain relief.
As well, you'll probably be taking some pharmaceuticals, but we want some intervention so you can feel
comfortable to start exercising.
And even if you're still experiencing pain, it's okay to exercise.
As I say, if you've been given that green light to go, then gradually progressing an
exercise program is so very important because that's what's going to make you stronger.
As you get stronger, your spine gets more support and your pain will hopefully diminish
with time.
So I don't want you to just take my word for it in terms of advice and how to get going
because I've never personally experienced a vertebral fracture, although I've worked
with hundreds of women who have.
But fortunately, I have a special guest today, and many of you might know Brenda already
from a blog post that we did five years ago on the treatment and management of osteoporosis,
and I highly recommend that you listen to this blog post if you haven't yet already.
So I've asked Brenda if she would share some of the key insights that she has faced over
the last five, six years on overcoming so many of the barriers that she has had to overcome
in order to keep moving and stay fit.
So Brenda, I'll turn it over to you to dive deeper into how you make exercise a habit
for yourself.
Brenda: Well, I've been exercising since I've been 30 so I have had sort of had a good habit
of that from way back.
I'm a morning person so I try to do it when I have the most energy.
I keep my equipment all in one room.
There's a TV there and there's music there if I want it.
I find the treadmill a bit boring at times so I've taken your advice and sort of divided
the treadmill time between the morning when I'm energetic, and then later in the day when
I'm not, which actually gives me a bit more energy.
I prefer to walk in the neighborhood, I call it my nosy neighborhood walks so that's a
lot more interesting to keep what's on tabs, and I go farther, much farther, than I would
on the treadmill so it's actually more beneficial.
So in terms of habits, life happens, routines get disrupted, you can't sort of beat yourself
up about that.
All you can do is just try to say, "Okay, back to go, let's just get back into the habit
of things."
And you can do spot exercises.
So for example, if I'm waiting for the kettle to boil I can do tricep pushups against the
counter there, or if I'm waiting for the cable TV guy to finally take me off hold, I can
do all kinds of butt squeezes, and you name it, you've got lots of time in that regard.
At bed time, because then I'm horizontal, that's when I tend to do my stretches, and
that's a nice transition from day to night so that works for me.
But getting into a habit and getting into a routine is the best because then your exercises
really come back to help you.
Margaret Martin: So as a physiotherapists, we always tell our clients to build gradually
to really progress your exercises.
So these are terms we use, but sometimes people don't quite understand the meaning of them
and the consequences of that.
So over the five years we've been working together, you've had many times where you've
had to rebuild gradually and I hope you could maybe share a little bit on how you've progressed
or re-progressed over those years.
Brenda: Well, I think way back when we first did an interview, I mentioned that the first
physiotherapist [inaudible 00:08:25] she wasn't so and she gave me exercises that were just
too fast and too progressive for my stage that I was at, and I got more pain than less
and so I stopped, which was actually not a good thing to do because had I had little
tiny, progressive exercises, I think it would have helped me.
But I found you, and then you targeted my exercises and you gave me small numbers of
them so I didn't feel overwhelmed.
And even though it took me forever to do them at the very beginning, what it did was it
eased me back into the routine of exercises again, and it made my muscles remember that,
"Hey, they really were there, still living underneath all of that."
So that worked, the small numbers of exercises and then gradually repeating, or increasing
them because over time the exercises I would find maybe too easy, or I wasn't maybe doing
them right so you would correct me in my positioning of them, and then I was targeting the muscles
that I was working on better.
I've had setbacks, as you very well know, and there's nothing like pain to make you
stop.
But what I do is I just go back, I've kept all my sheets, I go back to the beginning
and just say, "Okay, start over."
So I may not be back up to where I used to be, but I'm edging my way back up as high
as I possibly can.
Baby steps, just baby steps.
You can't feel overwhelmed, and even a friend of mine who hasn't done, because of this COVID,
she hasn't done her REM yoga for quite some time, she's really out of shape.
And her yoga teacher said, "Just do it as you feel more comfortable and just gradually
increase."
So that's what I try to do.
The setbacks make you think, "Oh, I just don't want to do this."
But really, by not doing anything, it makes it worse.
So gradually doing little bits of exercises, you get positive feedback, and you go from
there.
And the other thing too is, if I understand what the exercise is for, what muscle that's
targeting or how it will help me, I'm a lot more motivated to do that exercise as well.
Margaret Martin: So you touched upon documentation and that's how we started it and to keep track
of each exercise, the name of the exercise, how many reps, how many sets.
And in our first interview, as you commented, how meticulous you are with your documentation.
Now, knowing what you did and what might've flared you up is one thing, but could you
share how documentation has helped you?
Brenda: Well, I'm a list person by nature.
I make my daily lists, I have my list by the computer for those jobs.
I have a list in the kitchen for other jobs and so on.
So making a list and tracking things sort of comes more naturally to me.
Some people it might not, but I find the list for my exercises, it tracks my progress, and
I can see that progress.
So that progress then gives me positive feedback.
The list keeps me motivated because I can see, "Ah-ha, I was doing 10 this week, and
now next week I'm doing 15."
And so on.
And it keeps you honest, if you think, "Oh yeah, I've been exercising all week."
And then you look at your chart and you think, "Liar, liar."
So really, it does keep you honest.
And again, by having that sheet, I have taken it to you and said, "Okay, this exercise isn't
working, I don't know what I'm doing wrong."
You modify it or correct maybe just the position that I'm in.
So again, that documentation really helps keeping me on track because I could be doing
more harm maybe to the muscle than good, or just not making it as good as it possibly
could be.
And I told a friend of mine who was saying she'd exercise all the time, I said, "Keep
a chart, make a chart."
So then she realized that she wasn't exercising all the time so it really helped her too.
So document, best thing ever.
Margaret Martin: Yes.
So really good point.
Thank you.
Especially when it comes to osteoporosis because we know our little mesenchymal stem cells
that are in our bone marrow, they need daily stimulation.
So you're right, it keeps us honest.
And really, really helpful for therapists because when you come back and we can see
how you've been progressing and have that dialogue with you in terms of which exercise
might be problematic or not, or which one you've actually identified, which makes our
life so much easier when you already have that figured out for me, Brenda, thank you.
And Brenda, you're always so positive and you always manage to make me laugh every time
I see you.
So do you mind sharing how you keep so positive and how positivity has helped you through,
I wouldn't say your darkest days, because you've had some pretty dark days since I've
seen you.
Brenda: Yes.
I've had some dark days in the last five years.
Some of it back related, and others just life related.
But in life, you just can't go back, you can only go forward.
And I used to be able to do Jane Fonda's workout exercise as well.
Even Jane Fonda might not be able to do her work exercises now so put it all in perspective.
So my philosophy is sort of three.
If you bitch, or gripe, or complain about something three times, then find three solutions
to it.
Analyze it, get three solutions, try one.
If the first one doesn't work, try the second, if the second one doesn't work, try the third,
and if that doesn't work, go back to go reanalyze, but try to find a solution to the problem.
There's no point in whining, nobody likes to hear a whiner, and you don't like the sound
of your whiny voice either.
So it serves no purpose because you have to just get on with it.
So you may as well have a good laugh while you're getting on with it.
And then you have to listen to suggestions from other people, so that's not always easy,
sometimes you want to go, "Yeah, but..."
But who wants a yeah-butter?
You want to be able to actually find a solution to the problem.
And martyrs are boring so you have to be open to possibilities and you have to be able to
accept help, that's not always easy.
I didn't think five years ago that I would be using walkers and canes, but I do use walkers
periodically now, well, first thing in the morning, and I use canes.
I have a hot pink one that I use for specific purposes if I want more pity, and it works.
But accepting help and suggestions is a big step towards sort of liberating yourself.
I don't talk about my back issues or my bone issues.
I have two friends that I can talk to about them and we can have good laughs over things,
but after that, I don't talk about it.
People ask, I say, "Thanks."
And I give them a brief answer, then I switch the subject, politicians, COVID, whatever,
because my back dominates my life, I don't want it to dominate my social interactions
so that keeps your mind away from things.
I had a funny thing the other day where a friend was telling me someone had referred
to my health situation as my crippling destiny.
Wow!
My crippling destiny, I thought, "Well, that's a downer if I ever heard one."
So I thought, "Okay, I know I'm disabled."
I'm officially disabled because I can get tax rebates on products and so on because
of that, but crippling seemed to really go over the top, and then the word destiny.
So I really thought about that and I thought, "Okay, if bad bones are my destiny, what control
do I have over my destiny?"
I have control over the exercises that I do.
I have control over my diet and the various pills or vitamins I have to take.
And I have control over my brain, that I can go into dark corners or I can try to find
the lighter side of things.
So what I did was I wrote crippling destiny on a post-it and then I stuck it on my kitchen
cupboard so when I'm feeling that I maybe need to do an exercise or whatever, it's there
to remind me.
But not to underestimate that you can have setbacks and it can be really brutal, you've
seen me in actual physical situations when it's been really, really tough, and you just
want to sit down and cry.
And you know what, sometimes that works, put on some sad music and wallow a bit, and then,
as my older sister would say, get on with it.
And you just have to laugh sometimes at things, you just put on some lipstick, put on some
earrings, and don't look in the mirror too often, but keep on going.
So I'm not sure if that was helpful or not.
Margaret Martin: I hope that the words that are shared today by myself and by Brenda give
you the encouragement to start exercising and regain confidence in your body.
I'm Margaret from MelioGuide, thanks so much for tuning in and have a lovely day.