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Osteoporosis

Physiotherapy and hydrotherapy for osteoporosis

Physiotherapists can help people with osteoporosis to reduce pain and improve mobility, improve posture and prevent falling and fractures. People generally receive physiotherapy after spinal, hip and wrist fractures and some people we talked with had physiotherapy after spinal surgery to help them recover strength and movement. Physiotherapy can be provided as an inpatient and outpatient. Hydrotherapy (gentle exercise in warm water), was received by several of those we interviewed with spinal fractures to help relax their muscles.
 
Physiotherapists were often described as ‘good’, ‘helpful’ and ‘encouraging’. Several of the people we talked to required regular physiotherapy sessions to help them cope with pain or immobility provoked by osteoporosis and/or other conditions such as arthritis or hemiplegia.
 

Robert learnt that some of the pain he was experiencing was the result of bad posture and being...

Robert learnt that some of the pain he was experiencing was the result of bad posture and being...

Age at interview: 49
Sex: Male
Age at diagnosis: 43
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And then she then sent me to a, the only, the first time ever that she actually said, ‘I think you’d benefit from seeing a physiotherapist at that hospital. And I, this was more to do with pain and how I, my posture. A lot of my pain was through the posture because I wasn’t sitting correctly and I wasn’t, wasn’t moving my neck around and I was tending. So I, I tend to suffer with a lot of bad neck pain and stiff neck but it’s because you’re constantly holding your head and you’re constantly, you know, so you’re, you’re doing this all the time. You’re not aware of it but you’re on guard all day. And your on guard like I’ve always got this pillow, I’ve always got this cushion here guarding my ribs so that I, you know, nobody’s going to hurt my ribs. I sleep with a pillow like that in the night. I’ve got the quilt there, you know, I’m, you know, I’ve got to have this guard. So you’re doing this, so your muscles are on alert so that causes stress. That causes pain because your muscles tense and that causes like I get neck pain because my muscles in my neck tighten and I get stiff. So a lot of the pain is avoidable if you know the right exercises or the right. If you know to get up and move around every now and again is not just sit in one position all the time and you’d be amazed at you know, that just by getting up and stretching your legs just how much difference it makes to your, you know, to the. And not sitting in one position all day because I ache if I sit in one position all night or all day, you know.
After their allocated physiotherapy sessions are over, people are expected to continue at home with the exercise routine learnt at hospital.
 

Iris had physiotherapy for 12 weeks and then she continued on a daily basis with the routine set...

Iris had physiotherapy for 12 weeks and then she continued on a daily basis with the routine set...

Age at interview: 60
Sex: Female
Age at diagnosis: 59
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Came back home, went to the fracture clinic and they said the same, “There is not a thing we can do for you, it is going to be painkillers. We can’t set it. We can’t do anything. Because it was broken here and it was broken here.”
 
So then I went just for six weeks I think it was, backwards and forwards to the fracture clinic and they x-rayed it regularly and everything and I then went into physiotherapy for about twelve weeks after that.
 
And it is fantastic. But the thing is, you see, because I was newly retired, I didn’t want any handicap at all. You know, that’s the wrong time of my life for me to sudden have a bad arm or anything else. So I was able to devote totally my time to physio and everything else, to get the use of it back. Which I did, so I used to have my hot wheat bags, and my paracetamol and codeine and I would take that. Then my hot wheat bags, then I would exercise. So I was just going all through these things. And it is fantastic. Sometimes I get a bit of pain in it, you know, which I am bound to get, I guess, but nothing else. So, you know, I was quite pleased with that. 
But not everyone who was sent home with a booklet of exercises managed to do them regularly. The one to one interaction with the physiotherapist was an important motivating and reassuring factor, especially for people who experienced pain on an ongoing basis. Sarah said that she is ‘lazy’ but when she does her exercises she still experiences pain. Many people explained that after a fracture they lost confidence and were fearful of falling and breaking another bone or doing a bad movement and going into spasm (see also Feelings and thoughts about osteoporosis).
 

It was very painful when Dennis first had physiotherapy after his fracture but now he has no pain...

It was very painful when Dennis first had physiotherapy after his fracture but now he has no pain...

Age at interview: 59
Sex: Male
Age at diagnosis: 55
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I get more pain now, than I did, because I was on total bed rest I did nothing until the physios came and then that was very painful. But on total bed rest I was fine. But the moment I got up the pain was horrendous.
 
So you were in bed rest for about six weeks?
 
Yes.
 
And then the physio came…?
 
Yes.
 
… and started you to walk around and …
 
Just putting my feet on the ground was horrendous. The pain. It really was painful. But the second day it wasn’t as bad and as the days went on they got me to do more, it got better.
 
What did they ask you to do?
 
Well I had to do a couple of exercises whilst I was in bed. They had me going up and down stairs which is quite painful, and still is. And doing exercises in their physiotherapy department. Very, very minor exercises quite easily done. And in the end it was literally taking me up and down stairs. And walking round the wards. And as I say it got better and better until the day I was discharged.
 
At home, yes. Walking on occasions I've been told I have got to walk every day. And I can’t walk far. I can only walk about fifty yards. And that's about my limit. I potter round the house. I need sticks to walk with. I try and do without them in the house but I can’t always especially going up and down stairs. I can’t go up and down without my sticks and just hopefully it's going to get better if my spine fuses.
 
Did they send you home with a list of exercises to do or not?
 
Just two exercises which I do lying flat on the bed. They're very easy. Just really to keep my mobility up I suppose.
 
And how often do you need to do them?
 
[laughs] I'm meant to do them every day, but I'm afraid I don’t.
 
So how often do you do them?
 
I would say it's probably once a week [laughs].
 
Why don’t you do them?
 
I forget about them. No. It doesn’t hurt at all. They're so simple. I just forget about them. And then when I think about them I do them. They're very gentle exercises, just lifting your buttocks off the bed and lowering it down and raising your legs up and that's all there is to it.

 

So they're not time consuming or …?
 
No. No. I only have to do about ten at a time. They're not time consuming at all. I should really get into a routine of doing it before I get up in the mornings.
 
A few people we talked to paid to see a private physiotherapist. People’s experience of private physiotherapy varied. Jane said that during her pregnancy before she was diagnosed she spent ‘an absolute fortune’ on private sessions because she couldn’t understand why she was having so much backache.
 

Elizabeth was disappointed with the private physiotherapist she saw.

Elizabeth was disappointed with the private physiotherapist she saw.

Age at interview: 85
Sex: Female
Age at diagnosis: 66
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Have you seen a physiotherapist?
 
A physiotherapist came. I rang the whatever it is, [city] physiotherapist when I first came back from France, because I had an excellent man in France. He got me on my feet. And he was really good. And I phoned up and said I need a physiotherapist and explained why.
 
And they sent one. She came. And at that time I was either lying down or walking about and not sitting up or anything. And she came and said, “Can you get out bed?” And I said, “Yes.” And so she says, “Let me see you get up.” So I did. And so she said, “Can you walk as far as your kitchen?” And I said, “Yes.” And so with the aid of a stick I walked to the kitchen. And I’ve got a microwave in there on the thing and she said, “Do you think you could work the microwave?” And I said, “Well if I lean on the counter I can.” And so she said, “Jolly good, I don’t think you need me.” And that was the end of that. And it cost me £70. In fact I think it was £74, which I really, really begrudged [laughs].
 
You said that the person you saw in France was very good, in which, can you tell me a little bit more about what he did?
 
Well he did make me do exercises, which I have done some of them here. Like making sure my leg muscles work by doing exercise, this sort of exercise.
 
Lifting your leg?
 
Hanging on a chair and you know put your leg out and all this sort of thing. And so he did all of that plus getting me walking. And he also massaged my back, which I found absolutely wonderful.
But she refused this girl that I had. She said she didn’t do it. And so I felt that I’d got hold of the wrong person.
 
But I mean he was absolutely brilliant. And I wished in many ways that I’d stayed there. But it wasn’t convenient really because my daughter is a schoolteacher and she was working. And rushing home to get me lunch and things like that and I thought it was far too much, for her. And that’s why I came back when I did.
 
And as I say I was disappointed when this woman didn’t want to… she. I didn’t understand it really. She didn’t, she just didn’t feel that she needed to do anything, I suppose. She wasn’t prepared to do any of the things that I thought she should’ve done. I mean I thought she should’ve been taking me for walks and things like that. But she… because I could get from there to there, she didn’t think I needed any more assistance.
 
Yes.
 
You didn’t go through your GP?
 
Well my GP said, “Look in yellow pages.” When I said, ”How about a physio?”. So that’s what I did.
 
And I don’t mind paying if they do their job. But I object to paying when they don’t.
 
And in this case you were not… particularly satisfied?
 
No. Not at all, she didn’t do a thing. Nothing. I mean, you could have said to me, “Get out of bed and walk to the kitchen.” I didn’t need a, a trained physio to say that to me at all. I think she was a complete wash out.
 

Jenny paid for private physiotherapy, which she says has been very helpful.

Jenny paid for private physiotherapy, which she says has been very helpful.

Age at interview: 62
Sex: Female
Age at diagnosis: 55
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Other questions I asked were really to do with my neck because I had just discovered that my neck was tilting over. And I thought, “Well I’m going to be looking at the pavement”. And I’ve got a horror of not being able to look up. So I asked him about that and he said, “Yes, you’ve got the start of the Dowagers hump,” which, you know, really pleased me. And I thought, the name of it alone was dreadful. So I thought, well I knew I'd got it but, and again I went and took myself to a physiotherapist privately. We have a good one in my area. And she’s given me exercises, she’s been brilliant. But the doctor hadn’t given me anything. Again I had to pay. So at the moment it looks to me as if anybody is having some sort of problems they might have to pay. But the physio’s been excellent. She’s measured height and she’s given me exercises for my neck, which has made a huge difference at night. You know, I can get comfortable and go to sleep, whereas before... And she sold me a pillow that would be right for me, to get my neck comfortable. So she’s been very good.  

 

 

(Text altered in accordance to Jenny's wishes.)

A few people thought that physiotherapy should be a long-term rather than a short-term treatment. They argued that in some cases help may be needed not just to help people to deal with the after effects of a fracture but to restore confidence as well.
 

After her spinal fractures Jane was allocated six twenty minute sessions of physiotherapy which...

After her spinal fractures Jane was allocated six twenty minute sessions of physiotherapy which...

Age at interview: 42
Sex: Female
Age at diagnosis: 36
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I’d always been quite physically fit and quite adventurous. And then found out that I could do nothing really. And then was quite scared of not being able to do anything. And terrified that if I did anything I’d probably end up fractured. Because at the time I still, I’ve still a low count on the osteoporosis. And so I did nothing really. And I did have a physio but physio lasted for six sessions or something and then it would be, and then it would be over. And so there was no long term and I was also introduced to the word chronic. Which puts me in a category of, I don’t know, I felt as soon as the word chronic was introduced it’s almost like not a quick fix person.

And so the physio came at six week spurts and because a few of my fractures were in my neck, because I’ve got, I’ve five crushed vertebrae, the one in my neck, because everything’s inter-related, just used to affect how I’d move. And so I could do something and get caught in a spasm and think I’d fractured and get into a panic. And then get six weeks’ physio, which is six sessions and then get a bit better and then put back on the street and then the same would happen. So there’s never a kind of if you do this, like if you did a regular Thai Chi or a regular low impact sport, although in my head I know I’ve got to do high impact in order to keep the osteoporosis, but there was never any kind of just very straight forward medical cleverness about how just to keep as well as you could, bearing in mind that everything you did was painful.

 

And the fear factor was, will I fracture? Or is this normal? Or is this, because all the pain’s quite new. And so I’ve probably lived for about two years in kind of terrified mode.

And then physio was, physio and stuff was really helpful but I think having to get to physio is quite traumatic really. And, so even here, now, if I get, if I do something to my, my back or my neck I’ll get physio but it takes me something like one hour and 20 minutes to get to physio for 20 minutes physio, and then I just weigh it up and it’s not worth going. And so I don’t know if you can do home physio, which I know sounds quite a bit, or, or group physio in doctor’s surgeries, or something. But, physio’s kind of quite hard to get actually to if you are physically not able. And so, I don’t bother with it anymore.
 
So it’s the time that takes and the distance …?

 

Well it’s the, it’s the distance, it’s getting on a bus and, and being jiggled along. By the time I get there it’s kind of already feel knackered. And then the physio kind of, if it had begun at the beginning of the process would have been all right, but, and then I’ve got to get home again. And I suppose the weirdest, I just look normal, I just look like a normal girl. So I hop up off a chair when anyone older than me needs a seat. Or, or you know, so you just, I like the fact that I look normal but inside of me I know I’m not normal. And I know I’m not as bad, you know, but it’s just, yeah.
 
So it the effort that it takes you in term of time, and like …..?
 
Just pain really, because it’s not the time. I’m quite willing to do the time, but I know that, I know that, like if there’s physio was along my high street, they’re not NHS I’ve got to pay for them. And they see physio as very long term whereas NHS physios, it’s only six weeks. So, I don’t know what the difference is other than money really.
&nbs

There may be times when someone with osteoporosis is advised not to have physiotherapy due to the fragility of the osteoporotic area or severity of pain, so it is always a good idea to tell your GP that you are having private physiotherapy or any other treatment such as osteopathy. The best person to seek advice from is the GP or the physiotherapist. But an individual’s knowledge of his/her own body should also help to make that decision. Several people were referred by their GP to see a physiotherapist that specialised in spinal injuries.
In several cases very gentle and minimal exercises were recommended. Heavy manual work can sometimes be seen as replacing the need for physiotherapy but it can also aggravate the level of pain experienced by the person.
 

Noreen’s physiotherapist gave her gentle massage and gentle exercises to do because her back was...

Noreen’s physiotherapist gave her gentle massage and gentle exercises to do because her back was...

Age at interview: 77
Sex: Female
Age at diagnosis: 75
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I couldn’t walk like I used to. I’d seen the physio at the surgery. You know, my GP but the physio is excellent, but she daren’t do much, my back was too fragile, she daren’t do the usual, you know, and gave me some, it wasn’t a TENS machine, but it was something like that, but that just aggravated it, and then, then I went back to the physio actually, after I’d had my operation and I saw Mr [name] [laughs] after six weeks or something like that. He said, “Now, it’s time for some gentle exercise.”
 
So my GP referred me to the physio at the surgery again and she said, “Now then, all I am going to do, is gentle massage and give you some gentle exercises to do at home.” Which I do, I can only, and she said, “You must only do them when you’re almost pain free.” You know, she said, “When you are having a bad spell you must not do them.”
 
So I do gentle exercises, on the chair, and on the bed, each day. But, you know, if I am going through a bad patch then I don’t.
 

Laurence would like advice from his GP about whether to have physiotherapy and how much exercise...

Laurence would like advice from his GP about whether to have physiotherapy and how much exercise...

Age at interview: 62
Sex: Male
Age at diagnosis: 54
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Well I when I had I had physiotherapy…. after I fell off the hay trailer about four years ago, told her what told this woman what job I do. She said, ‘Even though you’re going, you know, I take my hat off to you really doing what you’re doing with it with the situation what it is.’ She admired me in a way because what I do with the bending and all that I’m doing is doing me own physiotherapy really.
 
I could have physiotherapy, physiotherapy again because the first doctor I saw, this woman, another lady doctor who was a bit sharp she said to me about physiotherapy but I’ve been in contact with the physiotherapist from the [hospital] she wanted to know if I wanted it or not and I said. I don’t really know. I would rather the doctor say yes or no before I have any because I don’t want it to be detrimental, you know, to me basically.’
 
Like I say I mean I don’t want to seize up. I mean, perhaps why, you know, as I said in physiotherapy you’re bending a bit aren’t you, all over the place and I’m actually doing that now so really. In fact in 1987 when like I say hurt my back first of all I was on physiotherapy and it was hurting and I told the woman physiotherapist you know that I was working at the mill then chucking rubber at the mill. And she said, ‘But you’re doing your own physiotherapy. It’s a waste of time me giving you physiotherapy because you’re getting your own physiotherapy by doing what you’re doing.’ I suppose basically that’s what I’m doing now really. You know.
 
But you would like to find out whether you are doing too much.
 
Well yeah I suppose in a way, yeah. I mean if it’s. I’m sixty two now and I’m not sixty five for another three years. I suppose in a way yeah. Only if he (doctor) said to me advised you know, advised me to work part time then I would work part time. I suppose I you know. 
 

David had plenty of physiotherapy as a child but he chooses not to have any now because he...

David had plenty of physiotherapy as a child but he chooses not to have any now because he...

Age at interview: 25
Sex: Male
Age at diagnosis: 23
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I’m kind of against physiotherapy.
 
Tell me why?
 
[Laughs], I don’t want to upset anybody. I’m against physiotherapy. Well I mean, don’t get me wrong, I have had it in the past, I’ve had loads when I was growing up, but because I mean I’m against it now because like it’s bone damage and I’m seeing the manner, you know, and I think you know some physio can put a strain on the bones, and don’t matter how much physio you do, you’re not going to cure the bone damage are you? You know, I mean I mean fair enough you might help the muscles and you might help you know other aspects but you won’t help the bones, you won’t suddenly fix the bones so that my hips solid, my ankle goes straight, will you? You’re not gonna do that, you know, this I’ve got a splint for my ankle which I sometimes wear but it’s really big and bulky and stuff, and my hip you know what I mean, I mean I’ve been told by my consultant you know to try and not do as, you know you know if you just try do as little as you can, you know so don’t try and put excess pressure on it, so it’s really physio would do that, it wouldn’t. It would cause it more problems and...
 
No, it’s not so much rest or do as little, but just be careful and don’t be you know, you know just don’t do anything you don’t need to do. Do a few, if you know what I mean? Just, I mean I mean I walk around the house, I mean that’s fine but I wouldn’t want, well you know walk up the road or anything like that, you know, I’ll just use the wheelchair. Do you know what I mean? So don’t, just don’t take any risks. You know so, and whilst the physio I mean, I know the exercises, so, I’ve done them loads in the past, so if I wanted to do it I could do them I mean, I’m going swimming so that’s good exercise.  
 
I did have physio after I broke my leg, you know, the immediate weeks after, but that was because I was on bed rest for 8 weeks and my leg was straight, and I needed to be able to bend my leg to sit in the wheelchair. But you know so my leg was stuck out straight, you know, and I couldn’t sit in the wheelchair while it was like that. And I wanted to get back to Uni, you know, that was the big drive. So but again I knew, I mean I went, you know I did go to the physio and I did follow their instructions but I knew all what I had to been, I’m not being funny about that but because I’ve had knee replacements it’s the same sort of thing, you know, so I knew, about you know the putting the towel under your leg, and doing it slowly and progressively you know? And so from that aspect you know I do know the exercises, so if I want to do them I don’t necessarily have to go for physio, I can just do them myself.
 
 
 
 

Sarah describes her last physiotherapy as a more vigorous and painful session and she is unsure if it is the physiotherapy or the length of time that has passed since her fracture that have improved her symptoms.

 

Sarah enjoyed hydrotherapy. After her last physiotherapy session the back of her hand has been numb.

Sarah enjoyed hydrotherapy. After her last physiotherapy session the back of her hand has been numb.

Age at interview: 61
Sex: Female
Age at diagnosis: 61
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I have been having physiotherapy. And I was doing hydrotherapy, but of course you can only have so many sessions of hydrotherapy in the hospital. I had four sessions. That, it was lovely because, you know, just feel the water and no pressure on you. Great fun that was. And physio, oh, yes, he, one of, the last session I had I was on my stomach and he was really trying to get deeply into the root of where the fracture was. And I’ve ended up, well, our GP’s a bit suspicious, but the back of my hand here is numb and it still is. And that’s, you know, about three weeks now. And our GP thinks there’s a connection. But I haven’t seen my physio, he’s been on holiday, to ask him if there’s anything he did there that possibly could have affected my hand. I’m a bit suspicious. It was just suddenly after, the day after my last session, this numbness.
 
So will you go back to physiotherapy?
 
Yes, next week I’ve got an appointment. He’s just back from his holiday. I’ll ask him to explain what he did to me. That’s another time I had tears down my, streaming down my face, because he was going so deep, really pressing into my spine. And I, he asked me how I was and I said, “It’s just this side of bearable.” And he said, “Well, so long as it’s this side and not the other side.” But I really was crying. I don’t know if I’m a wimp or what.
 
Have you found that it’s helping?
 
I don’t know if it’s just coincidence, it’s, because it’s quite a while now anyway, it’s getting better. But the, it couldn’t have an ordin-, the GP said I couldn’t go to the physio at the GP surgery because he’s not used to fractures of the spine. You’ve got to be very careful. So at least I know I’m in, with the right people. The hydrotherapy really helped. Beautiful. Even if it’s just psychologically, you come out feeling gorgeous because you’ve had half an hour of, or, no, an hour of just being able to float and not have problems with your back.
 
So that’s nice.
 
Yes, I wish I could carry on with it.
 
What has he said, the physiotherapist - in terms of your treatment and what you’re aiming to?
 
Well, I’m trying to, I’m supposed to be, but not, because I’m very naughty about, I’m lazy about exercises, I’m supposed to be having, doing half an hour a day. I can do 15 minutes in the morning, 15 minutes in the evening. With me it’s more like 15 seconds because I’m too lazy. And I have, I’m supposed to twist myself like that, as far as I can like that. I’m supposed to actually have a rod between me, or something like that between to get in the right position. I’ve tried a rod but it’s too painful. But he said I could use a cushion and just keep doing that. Or there’s one on the floor and I look very inelegant. But that’s another one. And just several things. And I must try, I must be better at this, because he said it’s a lifelong thing as well to keep doing exercises. But I just, I’ve always been bad at doing it [showing some exercises].
 
You haven’t been doing them?
 
Well, when I remember and if there’s some music on, on the radio that’s rather nice, I won’t leave it go, I’ll just do exercises whilst the music is on. But that’s as long as the music lasts, two minutes. I won’
Having to travel to have physiotherapy or to go to a rehabilitation centre is not always easy particularly if you are disabled and/or unable to take public transport. Several of the people we talked to commented on how uncomfortable it was for them to travel on public transport. Jane said that being in pain during the journey to the hospital diminished the benefits of physiotherapy. Several would find it useful to have facilities nearer to home which they could walk to (see summary Osteoporosis, mobility, driving and transport).
 

Christine’s physiotherapist has been most willing to help and to look for alternative...

Christine’s physiotherapist has been most willing to help and to look for alternative...

Age at interview: 68
Sex: Female
Age at diagnosis: 61
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Weight bearing exercise, and since I am so incapable of doing real exercise I have been thinking about this a great deal and talking to various people. And weight bearing exercise can be as little as just standing up. So I do that as much as I possibly can.
 
Well I had advice to go to what I call the cripples gym [rehabilitation centre]. And I have been their quite a lot until I left that area because I was in [city area]. So it was very, very close to [rehabilitation centre]. But now it is too far. It would take me half a day to get there and back on my buggy. And the only way to get there is, as an alternative, is on what is called Dial-a-ride, which is a charity, which runs buses for disable people to go to places. But there are not enough buses and very often you cannot go when you need to go. So I ended up having to say, “No I can’t do this.”
 
So instead I am trying to do some other little form of exercise, and very recently I saw the special outreach physiotherapist, who suggested that maybe I could do some swimming. And I am about to start going once a week to have a little swim in the swimming pool in one of the hotels just down the [name] road here.
 
I was with the outreach physiotherapist because of my long term, very long-term chronic condition. And when I first came to [city] which is in 2000, I was put in touch with the outreach physiotherapist. She saw me then and it was she who recommended that I go to this special gym. And then I didn’t see her again. But fairly recently I met her at the gym at [rehabilitation centre], where she was supervising a small group of people with disabilities. And she said it was a good idea if she saw me again because it had been some years since she had seen me. And that was when she recommended that maybe I should try swimming. So, that is how I was in touch with her. 

 

I went there in person but with the physiotherapist. This is the outreach physiotherapist who said it would be such a good idea. And then she went, was in touch with the head of the leisure centre at the [name] Hotel, because I cannot afford to pay the normal subscription fee for that. And instead he suggested that they would be prepared for me just to go once a week for a swim there at six pounds per time. So that would be worthwhile.

 

 And how often are you planning to, to go swimming?
 
Once a week.
 
Well, [rehabilitation centre] has staff who are knowledgeable about a lot of different medical conditions, and so they are very good at recognising what things you cannot do. And then they say, ”Well, it looks as if you can do this one and this one. So let’s try those ones.” And that is worthwhile. And mostly they have been warm up on an exercise bike and then just the very few machines where I could do stretches and twists.
 
But it was good to know that nearly all the people who were there had some visible or obvious disability. And so you knew that you were not just with the super-fit young people but with people who needed to do this. So I felt very comfortable there. But I didn’t join groups.
  
Elderly patients are sometimes confused or forget relevant information regarding their treatment. Beryl is seventy-two years old and has restricted neck movement and following an x-ray her GP decided she would benefit from physiotherapy. But she forgot about the x-ray and therefore her session was postponed until the physiotherapist was able to confirm this information.
 

Beryl forgot she had had an x-ray and her physiotherapy session was postponed.

Beryl forgot she had had an x-ray and her physiotherapy session was postponed.

Age at interview: 72
Sex: Female
Age at diagnosis: 69
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Have they referred you to a physiotherapist or not?
 
Oh funnily enough I went to a physio. I waited quite a while, about two or three months but I made a silly mistake, yesterday when I had to go. She said, “Have you had an X-ray on your neck?” And I, not thinking I said, “No”. So anyway she discharged me but I phoned up this morning to physio. I said, “Can I speak to [name]”. I said, “Because I made a mistake yesterday. It wasn’t until I got home and I thought, “You silly thing that’s how they found out you’ve got it”. So I left it, she wasn’t there so I left a message and I think she’s going to phone me up this afternoon.
 
So what happened you had to go back, you came back home?
 
Well she, she massaged my neck and everything, massaged it with cream and for a long time. But then she, I could kick myself. But we often make little mistakes like that don’t we [laugh].
 
 
Exercise classes by physiotherapists
One thing that some of those we talked to would welcome is exercise classes designed/guided by physiotherapists. Some people would like more information and guidance regarding weight bearing exercises or any other type of exercise that is good for osteoporotic bones. Several said that ordinary gyms do not have the proper expertise to help them and so they are wary of doing weight bearing exercises in case they fracture (see also Osteoporosis and exercise).

Irene took part in a twelve week exercise programme specially designed by a physiotherapist for people with osteoporosis. The programmes aim was to measure the benefits of exercise for people with the condition. Her local hospital continues running this programme. According to Irene the exercise programme for people with the condition has expanded beyond the hospital premises as leisure centres in the city also became interested in implementing such a programme. Sports staff are trained by hospital physiotherapists.

 

Irene explains how the exercise programme for people with osteoporosis came about and how it has...

Irene explains how the exercise programme for people with osteoporosis came about and how it has...

Age at interview: 68
Sex: Female
Age at diagnosis: 49
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And do you know how the exercise group started, whose idea it was?
 
Well, yes, the then consultant, the surgeon in the Infirmary, had been down to the physiotherapy department and asked the physiotherapist in charge if they could make up some exercises for his osteoporosis patients. Because people suspected I think at the time, now we’re talking about 19-, when would it be now? the early 90s, knew that exercise would be good but they didn’t know what, when, how or why it was good. So there was a young physiotherapist there who was, wanted to do her Masters degree, and she asked whether this particular aspect of things would be a good project for her thesis. And it was accepted, and that’s how it started. And it was really thanks to this consultant in this Infirmary that it all started. And then after that all the physiotherapists became, it became city-wide in the hospitals in, at that time. And then the leisure centres and the instructors in the leisure centres thought that would be a good idea as well. And it became more widespread. And it came up to the Infirmary and they were instructed by the physiotherapist or the particular one that did the exercises, but all of them knew about the things, what was good and what was bad for people who had osteoporosis. And they were told what to emphasise, what not to emphasise. And then they went out and they started up, in a couple of leisure centres they had a couple of these classes for people with osteoporosis. Then the health board got in on the act and it became the thing, and it’s very heavily subsidised by the health board now. And they recommend people to go.
 
 

Irene said that the exercise programme was like a ‘drug trial’ study. The physiotherapist...

Irene said that the exercise programme was like a ‘drug trial’ study. The physiotherapist...

Age at interview: 68
Sex: Female
Age at diagnosis: 49
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In between times they were starting an exercise programme in another local hospital in the area. And it’s a, it was a young physiotherapist who was doing it as part of her studies and was accepted as the thing. And I was very fortunate to be taken on as part of the exercising group of the, the whole thing. Because the same as testing a drug and a placebo and the drug. The placebo in this case were the people that didn’t exercise and the people, the other people that got the drug were those who exercised. And the, we were measured at the start of our twelve weeks’ stint and measured at the end of the twelve weeks, of this time, as were the control group. Now those of us that had exercised had made some improvement, whether it was a bit more, a bit more brisk, a bit more confident maybe in some cases or we could stand up a bit easier or we could stretch even one centimetre more. And that’s really more or less what happened with the exercise thing. And at the end of the twelve weeks everyone became part of the exercises. Now it’s become part of the, our crowning glory in this area are the, is our exercise sessions.
 

Irene talks about the type of movements included in the exercise programme for people with...

Irene talks about the type of movements included in the exercise programme for people with...

Age at interview: 68
Sex: Female
Age at diagnosis: 49
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Well, it was mainly medium impact e-, exercise that we did. But this particular physiotherapist had also, she brought in another instructor from, well, another nurse in the, a junior nurse in the hospital was doing this, this sort of thing as well. A lot of it was, well, we did circuit training, that sort of thing we did, part of it. Now circuit training, we’re talking about specially designed for people with osteoporosis. So it was kind of gentle type stuff, although it was medium impact type of stuff. I’m trying hard to think of what else I’ve done this sort of thing. First of all there was a lot, you’d to walk around briskly to get heated up. Then there was quite a bit of jumping up and down, skipping along sideways. I can’t describe it. I can’t even show it to you because [laugh].
 
And then bending, well, stretching exercises. All the things that you would be doing in an aerobics class as, as, I mean there, there’s not really much difference except that this would be geared less impact stuff than you would do in a, in a normal sort of class. And the people that go to the, when they start doing exercising here, they go along first of all and they’re very very gentle exercises, which are actually more gentle than we did when we started off. But you’ve got to encourage people that haven’t exercised for a long time that they can do it and make them feel they can do it. And when I say to them when I talk to them at any time and tell them about the things I do, they’re looking at me as if to say, “Really?” “But, yes, really you can do it, but you’ve got to build up to it very, very gradually and make sure that you’re okay.” I’ve always got to tell people if they’re going to take up exercise at all, make sure you talk to your GP, you talk to a physiotherapist, any, you must do all of these sort of things for your own safeguard.
 
I mean do you think that the physio who ran the courses was reassuring to people that they wouldn’t break a bone by doing exercise?
 
Well, they, they normally this is the fact, they all go happy to the hospitals, to the physiotherapists. Possibly I think in the back of your mind is you feel, “If I fall, break a bone, I’m in the hospital, I’ll be taken straight away.” That’s never said, but I get that feeling.
 
 
Hydrotherapy
A few of those we interviewed had hydrotherapy sessions. Some had it when they were staying in hospital. Cressida, who over the years had many spells in hospital, said that physiotherapy and hydrotherapy was offered ‘automatically’. One support group organised its own sessions and regularly hired the pool at the local hospital under the supervision of a physiotherapist. Several people said that the experience of weightlessness allowed them to be pain-free and they found it very relaxing. Many people also see swimming as a good alternative and either swim lengths or do gentle exercises (see also Osteoporosis and exercise).
 

Rose went to weekly hydrotherapy classes where she was able to do exercises in the water which...

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Rose went to weekly hydrotherapy classes where she was able to do exercises in the water which...

Age at interview: 76
Sex: Female
Age at diagnosis: 57
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And the local group organises hydrotherapy classes at the hospital I attend. And until about a year ago I used to go once a week to those in the evening. We paid for it ourselves, you know, it wasn’t paid by the National Health Service. And hydrotherapy is absolutely wonderful. It just makes you feel good in the water. You can do things that you can’t do normally.
 
So you had one of the physiotherapists with you?
 
Yes, giving us the, the exercises to do. All of us do all sorts of things in the water, stretching, walking, doing everything you can think of. That’s, and I had a lot of that in the beginning when I was first diagnosed anyway.  
Physical activities and ‘weight bearing exercises’ such as walking, jogging, climbing stairs and push-ups, which improve bone strength are beneficial for people with osteoporosis. 

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Last reviewed June 2017.
Last updated June 2017.

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