And here is the last part of the article on osteoporosis. If you do have osteoporosis – and you MUST take your doctor’s advice before doing any exercises – here are a few “do’s” and “don’t’s”:

1. DON’T bend forward from the upper back, causing your shoulders to round.
2. DO lean forward from the hip keeping your back flat. Push your bottom backwards as if looking over a cliff.
3. DON’T do bends to the side.
4. DON’T rotate or twist the spine around.
5. DO exercises like standing knee lifts holding onto a chair.
6. DO bend your knees to pick things up…again, keep that back flat. Pretend you have a book on your head. It works surprisingly well.
7. DON’T lift your head when doing abdominal exercises lying on your back.
8. DO exercise your abdominals lying on your back! A strong core is essential to minimise risk of fracture. This is where an expert Pilates instructor who is aware of your condition can really help you. But you MUST obey them….if they tell you to do one version of an exercise while those around you are doing a different version, do as you’re told. Are you listening, Mum??
9. DO eat properly and regularly.
10. DO take regular gentle exercise most days of the week. Beware of ice and very rough ground in case of falls.
11. DO strengthen your leg and hip muscles. So as not to fall. If the muscles on the side of your hip (Gluteus Medius) are strong, then if you do stumble you are much less likely to fall.
12. DO exercise on your front to extend and “lengthen” the muscles in your spine.

Being diagnosed with osteoporosis is not the end of the world. You just have to start taking a lot more care of yourself. You just can’t say that you don’t have the time! I know people with osteoporosis who have broken a rib just by sneezing, or a small bone in their hand just by turning over in the night. They are constantly at the Fracture Clinic or trying to struggle along with a limb in pot, and fractured bones are miserably painful.

So take steps to avoid hazardous activities or situations, but at the same time work to strengthen your bones and the muscles holding them together as much as possible.One of my ladies does have osteoporosis; she comes to circuits and Pilates classes twice a week, rain or shine and has done since the day it was spotted on the bone scan. She recently stumbled over an uneven paving stone and fell, hurting her ankle.

The paramedics were sure it was broken, especially when she revealed she had osteoporosis, but at the hospital they were all amazed when the x-rays came back clear…a bad sprain but no fracture. That happy outcome was directly credited to the fact she exercised with such diligence!

And that’s about it. The important thing with having osteoporosis is being constantly aware of your posture and your surroundings and doing your utmost to protect your weak bones with strong muscles and a switched-on brain!

And here come the Do’s regarding osteoporosis.

Try not to get it in the first place! We rarely think about the future when we’re young too busy living. But, like our pension, our bones are something we should invest in before we start having problems with them. When you are eighteen, you can’t be bothered thinking about your pension. When you are fifty-eight you wish you had!

With osteoporosis, sometimes the scales are balanced against you, unfortunately. Being female, having a family history of osteoporosis, having a sedentary lifestyle and conversely, overtraining physically or being underweight, excessive smoking and drinking and poor diet (as in lack of calcium) all contribute. Well there’s not a lot you can do about the genetic side of it. I blame the parents! The other unchangeable factor is advancing age and going through the menopause, and I sure as hell wish I could find someone to blame for those.

So what can you do to guard against osteoporosis? Here are my 10 Commandments:

1. Thou Shalt Walk. Every day. Weight bearing exercise is ESSENTIAL.
2. Thou Shalt Strength Train. No, Ladies. You won’t develop muscles like Popeye!
3. Thou Shalt Get Thyself outside into the Fresh Air. Sunlight is essential for producing Vitamin D, which helps calcium absorption. Even on a grey, lousy, rainy day Mr Sunshine gets a ray or two through.
4. Thou Shalt Walk Some More!
5. Thou Shalt Do Exercises for Thy Balance and Coordination. Stand on 1 leg. Perfect.
6. Thou Shalt Come to Thy Pilates Class. Well I had to get that one in somewhere. Bob and I have to eat.
7. Thou Shalt Eat Dairy Products. Unless you have been diagnosed by a qualified dietician as being allergic to them. Far too many companies out there with far too few relevant qualifications will analyse your diet and recommend cutting out complete food groups DON’T DO IT!
8. Thou Shalt Eat Thy Spinach. And watercress, and every other dark coloured vegetable you come across. No, don’t say Bleah!. Bung watercress in your sarnies, spinach in your vindaloos and you’ll never know. Until your bowel gets out and goes home!
9. Thou Shalt Exercise on All Fours. Only way to build bone in wrists and arms.
10. Did I mention the walking??

Don’t tell yourself that getting osteoporosis is inevitable because it’s in your family, though. That’s an excuse to do nowt! There’s no direct genetic link, just a tendency. So do something. Join an exercise class or two, preferably one that uses little weights.

Ok, so what about Pilates and osteoporosis? It’s more a series of “Don’ts” from the look of it. If there’s any osteoporosis in the thoracic spine – the bit between the shoulderblades – over time the spine will crumple in on itself to form what is known as “Dowager’s Hump”. And at this point it gets nasty…seems like just about ANYTHING (including sneezing) can cause the vertebrae to fracture. Don’t like the sound of that!

Everybody’s heard of Dowager’s Hump. My grandmother had it….she NEVER got any exercise and spent her days reading and watching telly surrounded by a cloud of cigarette smoke with a glass of brandy beside her. Although she did live to be 81, God bless her. Heart like a swinging brick….
Looks like my mother is starting with the thoracic osteoporosis as well…but it won’t develop into the Hump From Hell. Not on my watch.

It seems to be quite a modern scourge, this osteoporosis….seems like our lives are too physically easy these days. Not enough weight – bearing work. Lack of calcium in the bones. Men can get it too, but women are much more likely to because of factors such as menopause and the reduction of the hormone oestrogen that it brings with it.

The inside of the bones is destroyed faster than it is being rebuilt, resulting in the bones themselves becoming almost “spongey”. Add weak muscles from a physically inactive lifestyle and what do you get?
That’s right. Fractures. And they don’t heal well.
Not something to look forward to, is it?

Smoking doesn’t help either (oh surprise, surprise!) and neither does excessive alcohol consumption (rats!!). Add a “modern” junk-and –convenience food diet and is it any wonder that close to half of all women in the USA over the age of 50 will suffer from osteoporosis? And where the USA goes….

Unfortunately, that’s true. There is little goodness or calcium in modern pre-packaged foods. Take packaged white bread, for example. The fibre and husk is removed, all the goodness ground out by machine. Then preservatives are added, then chemical forms of calcium and vitamins, sometimes even brown food dye are put back in! I wouldn’t even feed it to my dog. Spongy, tasteless….Bleah. (That’s the bread, not the dog!). At the very least, buy stoneground wholemeal or granary bread. Preferably organic. Ideally we should all make our own. Before you ask, no I don’t. But I should…

We’ve gone a bit off subject here, so I’ll return to the “Don’ts” of exercise and osteoporosis.
First of all, go for your bone scans regularly! They can spot the “prequel” to full-blown osteoporosis, which is called osteopenia…certain bones are beginning to thin, usually lower back (lumbar spine).
Next, take note of any height loss, or if your arms seem longer. No, I am NOT kidding! Also, if you have waist, rib or mid-back pain for no apparent reason, go see the doc or physiotherapist.

If you have osteopenia or osteoporosis of the spine:

• DON’T bend your back forward and round your shoulders…hinge from the hip.
• DON’T do side bends.
• DON’T do Abdominal crunches with your head raised.
• ESPECIALLY DON’T bend forward and twist your spine.
• PLEASE DON’T do high impact exercise, like fast aerobics. Yes, some impact is necessary for your bones, but the accident risk of what I call the “headbanging” classes is unacceptable. Remember, you’re not just going backwards and forwards in these classes, but sideways and round in circles, with quick changes of direction. (High impact is both feet off the floor at the same time, as in skipping or jogging).

And don’t do the ironing. Seriously, the position most of us iron in is lethal. Get your board to the right height and put 1 foot on a box. Or even better, keep a local cottage industry going by sending your ironing out to someone else…I do!I really cannot persuade my mum to do the same….trying to prevent her ironing is like trying to stop a freight train with a tube of toothpaste. She’s going to throw that iron at me one of these days… And she has a mighty good aim. Now that would count as high impact!!

More on the “Do’s” next time…