Skip to main content
SpringerLink
Log in

Exercise for Patients with Established Osteoporosis

  • Chapter
  • First Online:
Non-Pharmacological Management of Osteoporosis

Abstract

Musculoskeletal changes that are related to osteoporosis/osteopenia can be prevented or mitigated through implementation of proper osteoporosis rehabilitation programs. Osteoporosis can affect patients physically and psychologically. We need to treat the patient, not just the low bone and muscle mass. Being positive in our presentation is crucial for patients' compliance with the program. The physical activity (PA) and exercise interventions recommended here are evidence based and are the result of controlled trials and studies. In addition, the author has included a few caveats that are intended to emphasize avoidance of overstraining the spine beyond its biomechanical competence when interested in osteogenicity of exercise and PA. Effective back-strengthening exercises need to be devised according to the patient’s biomechanical competence.

Recreational exercises such as strenuous flexion in some yoga positions can increase torque pressure applied to the vertebral bodies and result in anterior wedging or, worse, compression fracture.

Bone, to be maintained, needs to be mechanically strained—within its biomechanical competence.

M. Sinaki [1]

To succeed we need to treat the patient— NOT the disease, NOT the BMD, NOT the musculoskeletal status.

M. Sinaki

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sinaki M. Prevention and treatment of osteoporosis. In: Cifu D (editor). Braddom’s Physical medicine and rehabilitation. Philadelphia: Elsevier; 2007. p. 929–949.

    Google Scholar 

  2. Wolff J. Das Gesetz der Transformation der Knochen. Berlin: Hirschwald; 1892.

    Google Scholar 

  3. Emslander HC, Sinaki M, Muhs JM, et al. Bone mass and muscle strength in female college athletes (runners and swimmers). Mayo Clin Proc. 1998;73(12):1151–60.

    Google Scholar 

  4. Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil. 1984;65(10):593–6.

    CAS  PubMed  Google Scholar 

  5. Sinaki M, Limburg PJ, Wollan PC, Rogers JW, Murtaugh PA. Correlation of trunk muscle strength with age in children 5 to 18 years old. Mayo Clin Proc. 1996;71(11):1047–54.

    Google Scholar 

  6. Newcomer K, Sinaki M. Low back pain and its relationship to back strength and physical activity in children. Acta Paediatr. 1996;85(12):1433–9.

    Article  CAS  PubMed  Google Scholar 

  7. Lexell J, Taylor C, Sjöström M. What is the cause of the aging atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men. J Neurol Sci. 1988;84(2–3):275–94.

    Google Scholar 

  8. Sinaki M, Nwaogwugwu NC, Phillips BE, Mokri MP. Effect of gender, age, and anthropometry on axial and appendicular muscle strength. Am J Phys Med Rehabil. 2001;80(5):330–8.

    Google Scholar 

  9. Riggs BL, Wahner HW, Melton LJ 3rd, Richelson LS, Judd HL, Offord KP. Rates of bone loss in the appendicular and axial skeletons of women. Evidence of substantial vertebral bone loss before menopause. J Clin Invest. 1986;77(5):1487–91.

    Google Scholar 

  10. Sinaki M. Musculoskeletal challenges of osteoporosis. Aging (Milano). 1998;10(3):249–62.

    CAS  Google Scholar 

  11. Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int. 2005;16(8):1004–10.

    Google Scholar 

  12. Sinaki M, Lynn SG. Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study. Am J Phys Med Rehabil. 2002;81(4):241–6.

    Article  PubMed  Google Scholar 

  13. Leidig-Bruckner G, Minne HW, Schlaich C, et al. Clinical grading of spinal osteoporosis: quality of life components and spinal deformity in women with chronic low back pain and women with vertebral osteoporosis. J Bone Miner Res. 1997;12(4):663–75.

    Google Scholar 

  14. World Health Organization—WHO criteria for diagnosis of osteoporosis; 1994.

    Google Scholar 

  15. Derynck R, Akhurst RJ. Differentiation plasticity regulated by TGF-beta family proteins in development and disease. Nat Cell Biol. 2007;9(9):1000–4.

    Article  CAS  PubMed  Google Scholar 

  16. Sinaki M, Itoi E, Wahner HW, et al. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30(6):836–41.

    Google Scholar 

  17. Sinaki M, McPhee MC, Hodgson SF, Merritt JM, Offord KP. Relationship between bone mineral density of spine and strength of back extensors in healthy postmenopausal women. Mayo Clin Proc. 1986;61(2):116–22.

    Google Scholar 

  18. Hongo M, Itoi E, Sinaki M, et al. Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(10):1389–95.

    Google Scholar 

  19. Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Itoi E. Back extensor strength and lumbar spinal mobility are predictors of quality of life in patients with postmenopausal osteoporosis. Osteoporos Int. 2007;18(10):1397–403.

    Google Scholar 

  20. Sinaki M. Spinal osteoporosis. In: Sinaki M, editor. Basic clinical rehabilitation medicine. Burlington: B.C. Decker; 1987.

    Google Scholar 

  21. Sinaki M. Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PM R. 2012;4(11):882–8.

    Article  PubMed  Google Scholar 

  22. Huntoon E, Schmidt CK, Sinaki M. Significantly fewer refractures after vertebroplasty in patients who engage in back extensor strengthening exercises. Mayo Clin Proc. 2008;83(1):54–7.

    Article  PubMed  Google Scholar 

  23. Rudins A, Sinaki M, Miller J, Piper S, Bergstrahl E. Significance of back extensors versus back flexors in trunkal support. Arch Phys Med Rehabil. 1991;72(10):824.

    Google Scholar 

  24. Sinaki M. Critical appraisal of physical rehabilitation measures after osteoporotic vertebral fracture. Osteoporos Int. 2003;14(9):773–9.

    Article  PubMed  Google Scholar 

  25. Sinaki M, Itoi E, Rogers JW, Bergstrahl EJ, Wahner HW. Correlation of back extensor strength with thoracic kyphosis and lumbar lordosis in estrogen-deficient women. Am J Phys Med Rehabil. 1996;75(5):370–4.

    Google Scholar 

  26. Sinaki M, Wahner HW, Offord KP, Hodgson SF. Efficacy of non-loading exercises in prevention of vertebral bone loss in postmenopausal women: a controlled trial. Mayo Clin Proc. 1989;64:763–9.

    Google Scholar 

  27. Hongo M, Itoi E, Sinaki M, Shimada Y, Miyakoshi N, Okada K. Effects of reducing resistance, repetitions, and frequency of back-strengthening exercise in healthy young women: a pilot study. Arch Phys Med Rehabil. 2005;86(7):1299–303.

    Google Scholar 

  28. Sinaki M, Borgo MJ, Itoi E. An effective progressive resistive exercise program from prone position for paravertebral muscles to reduce risk of vertebral fractures. J Bone Miner Res. 2008;23:S495.

    Google Scholar 

  29. Sinaki M, Pfeifer M, Preisinger E. The role of exercise in the treatment of osteoporosis. Curr Osteoporos Rep. 2010;8(3):138–44.

    Google Scholar 

  30. Sinaki M. Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: case series. Pain Pract. 2013;13(1):68–75.

    Article  PubMed  Google Scholar 

  31. Sinaki M. The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture. Phys Med Rehabil Clin N Am. 2007;18(3):593–608, xi-xii.

    Google Scholar 

  32. Borgo MJ, Sinaki M. Back progressive resistive exercise program to reduce risk of vertebral fractures. Sturzprävention. 2010;17(2):66–71.

    Google Scholar 

  33. Kurmen Figueroa DA, Sinaki M. Synergy between the rehabilitation of osteoporosis program-exercise and pharmacologic agents in the prevention of vertebral compression fractures. Am J Phys Med Rehabil. 2008;87(3):S9–10.

    Google Scholar 

  34. Sinaki M. Falls, fractures, and hip pads. Curr Osteoporos Rep. 2004 Dec;2(4):131–7.

    Google Scholar 

  35. Sinaki M, Brey R, Hughes C, Larson D, Kaufman K. Significant reduction in risk of falls and back pain in osteoporotic, kyphotic women through a spinal proprioceptive extension exercise dynamic (SPEED) program. Mayo Clin Proc. 2005;80(7):849–55.

    Google Scholar 

  36. Ekin JA, Sinaki M. Vertebral compression fractures sustained during golfing: report of three cases. Mayo Clin Proc. 1993;68(6):566–70.

    Article  CAS  PubMed  Google Scholar 

  37. Sinaki M, Khosla S, Limburg PJ, Rogers JW, Murtaugh PA. Muscle strength in osteoporotic versus normal women. Osteoporos Int. 1993;3(1):8–12.

    Google Scholar 

  38. Petrie RS, Sinaki M, Squires RW, Bergstrahl EJ. Physical activity, but not aerobic capacity, correlates with back strength in healthy premenopausal women from 29 to 40 years of age. Mayo Clin Proc. 1993;68:738–42.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA

    Mehrsheed Sinaki MD, MS (Consultant)

  2. Professor of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA

    Mehrsheed Sinaki MD, MS (Consultant)

  3. Director of Rehabilitation of Osteoporosis Program, Mayo Clinic, Rochester, Minnesota, USA

    Mehrsheed Sinaki MD, MS (Consultant)

Authors
  1. Mehrsheed Sinaki MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehrsheed Sinaki MD, MS .

Editor information

Editors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA

    Mehrsheed Sinaki

  2. Institute of Clinical Osteology and Clinic “DER FÜRSTENHOF”, German Osteology Foundation, Bad Pyrmont, Niedersachsen, Germany

    Michael Pfeifer

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Sinaki, M. (2017). Exercise for Patients with Established Osteoporosis. In: Sinaki, M., Pfeifer, M. (eds) Non-Pharmacological Management of Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54016-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54016-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54014-6

  • Online ISBN: 978-3-319-54016-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation