Osteoporosis Management

Risk Factors

• Age (over 50)
• Family history
• Low calcium intake
• Sedentary lifestyle
• Smoking and alcohol use
• Hormonal changes (menopause)
• Long-term corticosteroid use

Our Approach

• Weight-bearing exercise programs
• Balance and fall prevention training
• Gentle manual therapy
• Posture improvement strategies
• Nutritional guidance
• Safe movement education

How Osteoporosis Is Diagnosed

Osteoporosis is diagnosed by your GP, usually with a DEXA scan that measures bone mineral density at the hip and spine. It is not something we diagnose at the clinic, and it is not something that can be identified by hands-on assessment alone.

If you have not been scanned but have risk factors — a fracture from a minor fall after age 50, a parent who fractured a hip, long-term corticosteroid use, or early menopause — that is a conversation worth having with your GP. Knowing your bone density changes how we program your exercise, so we will usually ask whether you have had a scan and what it showed.

Why Loading Matters

Bone adapts to the forces put through it. Light activity such as walking maintains general health but places relatively little stress on the skeleton, and on its own it is not a strong stimulus for bone.

The research on exercise and bone density points toward progressive resistance training and weight-bearing impact, supervised and built up gradually, as the more effective stimulus. That surprises people who expect to be told to be careful with everything — but appropriately loaded bone is stronger bone, and under-loading carries its own cost in muscle mass and balance.

• Progressive resistance training, increasing load over time rather than staying light
• Weight-bearing work matched to your bone density and fracture history
• Postural and back extensor strengthening to support the thoracic spine
• Hip and leg strength, which protects both bone and balance
• Supervision while technique is established, then a program you can continue

How We Adapt Treatment for Reduced Bone Density

Osteoporosis changes what is appropriate in the treatment room, and it is one of the clearest examples of why telling your practitioner about your medical history matters. Our practitioners modify hands-on technique where bone density is reduced.

• High-velocity spinal adjusting is avoided in favour of low-force techniques
• Loaded end-range spinal flexion and twisting are kept out of programs
• Sit-ups, toe-touches and similar flexion exercises are replaced with safer alternatives
• Manual pressure is graded to comfort, particularly over the ribs and thoracic spine
• Exercise is progressed gradually with technique established before load increases

Reducing Your Risk of Falls

For most people with osteoporosis, the fracture risk that matters day to day comes from falling. Balance, leg strength and reaction time are all trainable, and they are a substantial part of what we work on.

Alongside the exercise program, small changes at home make a measurable difference — securing loose rugs, improving lighting on stairs and hallways, keeping walkways clear, and reviewing footwear. If your balance has changed noticeably or you have had a fall, tell us and tell your GP, as some medications affect balance.

Working With Your GP

Exercise is one part of managing osteoporosis and it sits alongside medical care rather than replacing it. Decisions about bone density medication, calcium and vitamin D, and how often to rescan belong with your GP or endocrinologist.

What we contribute is the loading and balance side, programmed around your scan results and fracture history. If you have new or unexplained back pain, sudden height loss, or pain following even a minor fall, please see your GP promptly — these can indicate a vertebral fracture and need medical assessment before we continue.

How We Can Help