osteoporosis and balance

Who is at risk?

Can you answer YES to any of these question?

  1. Have your periods stopped?
  2. Does your diet lack Calcium or Vitamin D?
  3. Do you have an inactive lifestyle?
  4. Do you use steroids, thyroid or anti-seizure medications?
  5. Do you have a thin or small frame?
  6. Do you have a family history of osteoporosis?
  7. Are you of Caucasian or Asian descent?
  8. Do you smoke or drink alcohol excessively?

If you answered 'yes' to any of these questions, you may be at risk for developing osteoporosis or osteopenia (low bone density).

What is osteoporosis?

Osteoporosis is the most prevalent of the bone diseases that affect Americans. One out of every two women and one in eight men will have an osteoporotic fracture in their lifetime. 28 million Americans have either osteoporosis or osteopenia, which increases risk of fracture, pain and significant loss of function and quality of life. A woman's risk of hip fracture is greater than her risk of breast, uterine and ovarian cancer.

Osteoporosis is the thinning of bone tissue resulting in loss of bone density. Bone is living tissue that is continually being broken down as well as replaced with new bone. Osteoporosis occurs when bone is lost faster than it can be replaced.

As bones become more fragile, they are more likely to break. Osteoporosis is a silent disease because it can progress without symptoms or pain until a bone breaks. Severe compromise of bone density is found in younger populations due to poor nutrition, increased carbonated beverage intake, amenorrhea (absence of periods), eating disorders or excessive exercise. The simultaneous conditions of eating disorders, amenorrhea and excessive exercise are called The Female Triad and can result in profound risk in bone density in women throughout the lifespan.

The main factors which contribute to osteoporosis are:

  • Faster rate of bone loss after menopause or amenorrhea
  • Poor bone growth during childhood and adolescence resulting in lower peak bone mass
  • Bone loss due to eating disorders, medications or diseases.


Benefits of Exercise

Research has shown that specific weight bearing or resistance exercises can:

  • Improve bone density and lower risk of fracture
  • Decrease pain
  • Improve posture by decreasing or slowing the progression of thoracic kyphosis (rounding of upper spine giving a stooped appearance)
  • Improve balance and coordination
  • Decrease risk of falling
  • Increase mobility

Your Bone Health 

CorePhysio knowledgeable clinical staff assesses your individual needs and medical history to design a customized treatment program to optimize your bone health. Your therapist will evaluate:

  • Postural alignment
  • Overall musculoskeletal system
  • Body mechanics (the way you move in your daily tasks)
  • Balance

Based on evaluation findings, we will design an exercise program designed especially for you. You will learn how to safely perform your exercises and how to minimize your risk of fractures during daily activities.

Finally, if you participate in a gym or community exercise program such as Tai Chi or yoga, you will be given guidance that will help you avoid potential injury or risk of fracture. If you have difficulty with balance, you will be educated in methods to reduce your risk of falling as well as exercises to improve your balance.

Vertigo and Balance Rehabilitation

Dizziness and imbalance account for 5 to 10 percent of all doctors visits. Interpreting the term dizzy can be difficult because patients use this term to describe various sensations such as vertigo, lightheadedness and disequilibrium.

Vestibular pathology is one disorder that can be the source of dizziness and imbalance. Both central and peripheral disorders can produce decreased visual stabilization, gait dysfunction, and decreased postural and trunk stabilization.

Vestibular System Disorders:

  • Benign Paroxysmal Positional Vertigo
  • Vestibular Neuritis
  • Meniere's Disease
  • Endoymphatic Hydrops
  • Bilateral Vestibular Disorders
  • And more...

Vestibular disorder symptoms can result in functional impairments and increased risk for falls!

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo. Otoconia floating in the endoltmph create a pressure or suction resulting in symptoms of vertigo.

The patient's primary complaint is of brief periods of vertigo with rapid changes in head position. The episode lasts thirty seconds to two minutes. Recurrences can persist for years.

Physical therapy treatment is quick and effective for these patients. Treatment is dependent on the location of the loose otoconia and the patient's abilities.

Why Physical Therapy?

When a loss of paresis occurs in one vestibular nerve, the resting firing rate of the damaged ear does not match the normal ear. Although the vestibular system has little ability to repair itself, it can compensate for the mismatched signals being sent from the damaged and normal ears.

Physical therapy is designed to provide small, controlled movements and activities that promote dizziness and imbalance. Physical therapy is effective because treatment is customized to each patient based on their level of dysfunction. With symptom provocation, the patient develops compensatory strategies which resolve symptoms.

Vestibular Neuritis

This disorder is the second most common cause of vertigo. Symptoms manifest from a viral infection that can precede onset by two weeks. The infection results in unilateral vestibular paresis.
The patient's primary complaint is prolonged severe rotational vertigo which worsens with head movement. This symptom can be very disabling and may be accompanied by nausea, nystagmus and imbalance. Neuritis usually affects those from 30 to 60 years of age.

Symptoms can resolve in 2-3 days, however; two out of three patients do not resolve spontaneously and need vestibular rehabilitation to compensate for a unilateral weakness. A weakness of as little as 1-2 percent can cause symptoms in some individuals.

Groomer, G.L. (2002).
Vestibular Rehabilitation: A comprehensive clinical approach for positive functional outcomes. Kent, WA: North American Seminars, Inc.

Herdman, S.J. (2000).
Vestibular Rehabilitation (2nd ed.). Philadelphia: F.A. Davis Company.