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What is it like to live with a compression fracture? Are there effective ways to treat a compression fracture with Physical Therapy? Do I recommend specific exercises for my clients with compression fractures? Is there a best way to sleep with a compression fracture? I answer each of these questions in this blog post.
In the video (left) you will meet Brenda — one of my clients with compression fractures — and hear her story of how her compression fractures happened, how they affected her quality of life, and what she has done to return to living an active life.
The first video (left) is 25 minutes long. There are two more videos later in the blog. One is 5 minutes in duration and the other is 10 minutes. If you are at risk of a compression fracture, already have one or know someone suffering from a compression fracture, you should read this blog post and view the videos — the time you invest will be well worth your while. I promise.
Introduction
My patient, Brenda, is here to share with you how her life has been impacted by compression fractures.
Of all the individuals that I’ve worked with who have compression fractures, Brenda is the most positive and persistent client. She does every single compression fracture exercise I ask her to do. Each time we meet she arrives with her completed checklist and asks me questions specific to compression fractures.
When Brenda prepared for today’s talk, she realized how frustrated she was with her situation. She felt despair and anger because of her compression fractures. I asked her not to emphasize her frustration but, instead, share the tactics that have helped her deal with her compression fractures. Brenda’s story is meant to help all of those individuals, men and women, with compression fractures who are suffering in silence.
Brenda’s Thoracic Compression Fracture
Brenda is a retired teacher. She has always enjoyed gardening, bi-weekly exercise classes, and daily walks.
In her thirties Brenda realized that she needed to look after her bones. Her mom had fractured both of her hips as well as her pelvis. Brenda’s genetics and family history of osteoporosis were red flags indicating that she might have some issues with her bones sometime in the future.
A routine DEXA (Dual-Energy X-ray Absorptiometry) test and FRAX score, in 2011, showed that Brenda had some bone loss. She was diagnosed with osteopenia. She became more careful, watched the calcium in her diet, her vitamin D levels, and continued her exercise classes.
Her General Practitioner recommended bisphosphonates, but she couldn’t tolerate them. He switched her to Prolia. She was on Prolia for four years. A repeat DEXA showed that she had improved, so she discontinued her Prolia injections in the spring of 2015. She was excited because she felt she had turned the corner. Brenda concluded that her bones were healthy because of her exercises, diet and Prolia injections. It turned out that Brenda came to this conclusion prematurely.
T9 Compression Fracture
Once she got the clean bill of health, Brenda planned a dream holiday for her and her husband — a five week trip to Africa.
Unfortunately, that dream holiday became a nightmare. On the first day of the trip she experienced severe back pain (to learn more about the relationship between compression fractures and back pain, please read the section later in this blog post) when she moved some heavy bags. She was able to manage the pain because she had some over-the-counter pain medication with her. However, by the time the trip ended, she was in severe pain. Too severe for her pain medications to suppress. The more potholes she hit as they drove across Africa, the worse her pain got.
As soon as she returned to Canada, she went to see her doctor. He diagnosed her with a strained back. Unfortunately, a series of x-rays showed that Brenda had a 70% T9 compression fracture. It was a thoracic compression fracture and four other vertebrae had some level of compression.
Physical Therapy Treatment for a Thoracic Compression Fracture
I asked Brenda to discuss the treatment she received after the diagnosis of her compression fractures.
After the diagnosis of compression fractures, Brenda was given strong painkillers that helped manage the pain and allowed her to sleep. The physiotherapist (the one she saw before she came to see me) helped with the pain. The physiotherapist used hot pads, electrical pulses that stimulate the muscles, acupuncture, and a minimal amount of ultrasound. That initially helped with the general pain.
Can You Make a Compression Fracture Worse?
I wish more people asked me this question because so many people don’t realize that yes, your vertebral fracture can get worse.
It is so very important to remind yourself that this can happen.
How you get up in the morning, how you choose to move a certain way, how you dress, how you tie your shoes, how you garden – all of those things allow you to be in control and avoid your compression fracture to become more compressed.
If you currently have a 30% compression of your vertebral body, it can become 40% or even 50% compressed.
Some people can compress their vertebral body so much that they can’t see it on an x-ray anymore. It is not something I wish on any of you.
However, since you’re watching this, this is likely not to occur because you’re taking things in hand and you’re empowering yourself to be able to move well.
I asked Brenda if either the physician that gave her the diagnosis or the initial physiotherapist who treated her told her that the compression fractures could get worse by how she moved.
Brenda said she was not informed about this. In fact, she did not even know that one of her compression fractures, a T9 compression fracture, was compressed 70% and could not be fixed.
I find that many people do not understand the importance of good posture, good movement and the potential repercussions on the health of their spine. I encourage readers to read my blog post on Osteoporosis Posture Explained where I discuss, in detail, key concepts related to postural alignment and how good posture practices can fend off compression fractures.
How to Move When You Have a Compression Fracture
Compression fractures are not static. How you move throughout the day, the exercises you do, how you lift, how you bend, how you get in and out of bed — all of these things can either keep the vertebra from becoming more compressed or cause further collapse. This is not meant to scare you. Rather, it is meant to inform you that it is in your control to help yourself reduce the further risk of a compression fracture.
Vertebral Kyphoplasty and Compression Fracture
A surgical technique called vertebral kyphoplasty would be the only way to fix her T9 compression fracture. This intervention would have to happen within the first six to eight weeks after a T9 compression fracture. During a a vertebral kyphopasty surgery, the surgeon re-inflates the vertebra with kyphoplasty and then injects a form of cement into the vertebral body.
Although a vertebral kyphoplasty can give you pain relief, it doesn’t actually stop the progression of further compression fractures. The importance of good body mechanics and diligence during your exercises is really important — despite having that type of intervention.
Further, the vertebral kyphoplasty could be detrimental because it could make one strong section with weaker bones around it.
Exercise Recommendations for Osteoporosis
Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.
But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop — how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — why is core strength important if you have osteoporosis?
Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.
Brenda’s Life Before Her Vertebral Compression Fractures
Brenda’s vertebral compression fractures changed her lifestyle. She states that her life went from “white to black” — a 100% change in her life. Here she details each of the parts of her life that have been affected by her compression fracture and how she has had to accommodate the pain from the compression fracture.
Community and Family Activities
Before the compression fracture, Brenda was the “Energizer bunny”. She was involved in the community association, university women’s group; did things at home like refinishing furniture for her daughter; and was engaged in lots of activities.
But all that changed 100% because of the pain.
Gardening
Brenda has had to hire young women to help her with the garden because gardening involves hauling, lifting, heaving, and shovelling. These activities can be bad for your back when done incorrectly. All she can do now is deadhead plants. Gardening was a stress reliever before, now it’s a source of stress.
Cleaning
Brenda considers herself to be one of those “odd people” that likes to clean. Again, it’s sort of a feel good thing, but she has had to hire a cleaning lady to help her with the heavy stuff, the vacuuming, the washing of floors, the toilets — all those things that put extra strain on her back.
Laundry
Brenda can do a little laundry, but ironing is very difficult, so she has embraced the “rumpled linen look”.
Driving
When she first had her T9 compression fracture, Brenda could not drive. She could hardly get into the car when she had to go to various appointments. It has only been of late that she feels comfortable enough to drive, but she is much lower now in the seat of the car — three inches lower. It took nine months from the time of the initial severe pain to get to the point where she can drive again.
Food Preparation
Brenda’s husband has health issues of his own and he is very limited in what he can do. In the beginning, shortly after the compression fracture food preparation was limited to semi-prepared or prepared foods.
Brenda is limited in what she can do in the kitchen. For example, in order to peel a potato or a carrot, she had to put both my forearms on the counter. She could not lift a dish in or out of the oven.
Grocery Shopping
Brenda is unable to do the grocery shopping and has left that task to her husband.
General Mobility Around the House
Brenda had to use a walker for the first time ever in her life after the compression fracture. She used it to get out of bed and to the bathroom in the morning. She has not had to use a walker for about the last three weeks.
Clothing
Brenda has had to “embrace the crumpled look” because everything hurts around her middle. She finds that she cannot wear tight clothing that might press on the bone that is protruding in her back.
Physical Therapy Treatment for Vertebral Compression Fractures
The following are the compression fracture Physical Therapy treatment modalities that helped her with her compression fracture.
Myofascial Release Therapy for Compression Fracture
Brenda indicated that the best compression fracture Physical Therapy treatment option for her has been myofascial release. It has helped with the initial spasms. She experienced really bad vice-like grips around her right hip after an episode with the spasms. These have been taken that away completely.
Also, because the tightness in her chest has been reduced, she feels a little bit more erect. She does not have that same pulling forward sensation that she experienced before.
Targeted Compression Fracture Stretching Exercises
Brenda never lets a day go by without doing her targeted stretches. She finds them to be really helpful. They relieve her pain or her aches. They help her with fighting this gravitational pull that she experiences from morning till night.
Brenda does stretches from the Exercise for Better Bones program but I have advised her to hold them a lot longer (as long as 10 minutes) than I have recommended in the book. They are more like a fascial stretch.
Brenda finds that it takes the 10 minutes for her body to release and relax into the stretch. She finds that the prolonged fascial stretches make her feel good.
Dynamic Taping for Compression Fracture
Brenda finds the dynamic tape to be another kind of little miracle worker. She could not believe that it actually works. When it’s not there, she can really feel the difference. It has really helped with that long muscle in her back that is strained.
Strengthening Exercises for Compression Fracture
Brenda finds the strengthening exercises to be very beneficial. Because she was physically fit before the compression fracture, her muscle memory is coming back. Every time she improves in her exercises, her muscles are activated; and every time those muscles are activated, she is stronger in whatever she does, whether it’s getting off the toilet, getting out of a chair, getting out of bed in one smooth motion. This is a big, big step and improvement for Brenda.
Be Fit Before Your Compression Fracture
There are considerable benefits to being fit before the compression fracture. Unfortunately, a lot of women and men do not exercise until something happens and their body does not have a positive association with exercise. Brenda did.
As a result, Brenda was used to muscle soreness from vigorous exercise. Women and men who have not exercised before think that something has gone wrong. Brenda has always had a positive association with exercise. I think that is very important. I encourage listeners to exercise in a regular basis.
Strengthening Exercises
Brenda found the strengthening exercises that I have given her to be initially were very hard to do even though she was fit. She could hardly lift my head up off the floor. But, to her credit she did one rep, and then she did three reps, and then she did 5 reps, and then, eventually, she did 10 reps.
Brenda considers it “baby steps” progress. She is fastidious about her chart and can see her progress. She finds this motivating. If you understand intellectually what the exercise will do, then she really motivated in terms of her everyday life. So that really, really has helped.
Nordic Walking with Weighted Kypho Orthosis Vest
Brenda uses activator poles (Nordic walking poles) with a weighted kypho-orthosis vest. She used to walk five kilometres plus a day. After the compression fracture the most she could walk was five houses and back — and that exhausted her.
Today she is up to three kilometres walk at a snail’s pace. She can do it with the poles and the vest because it keeps her in the proper position.
The weighted kypho-orthosis vest helps her walk more upright because it counterbalances the weight of her head and allows her to control where her posture is taking her. She is also wearing the weighted kypho-orthosis vest when she prepares her meals.
Brenda says the vest helps her stay more upright because her body naturally wants to go forward. That’s the go-to position and she has to fight that all the time.
Advice for Your Younger Self
I asked Brenda knowing what you know now, what would you tell your younger self? Here are Brenda’s thoughts on that question.
Choose the Right Health Professional
The first thing she would tell her younger self (in fact, what she has told her daughters) is that you have to be really fastidious, as much as you can be, about choosing your general practitioner, or your family doctor.
He or she should be your strongest advocate in the medical system. They should listen carefully, they should be able to communicate well to you, so that if you don’t understand the medical jargon that they break it down for you. They should be able to answer the questions you have and anticipate the questions that you don’t have — the things that you should know.
Be Assertive and Own Your Health
You may have to be assertive to get your needs met. For Brenda that’s not such an easy thing to do. But one has to stand up for one’s rights and it’s their professional duty to find out if they don’t know. And they won’t know everything. Often your physician is a generalist. But they do have a professional obligation to find out and to send you on to a specialist who does know.
Keep a Copy of All Tests
You should keep a hard copy of all tests that you have even in this day and age of electronic copies. Have a file so that you can trace back your health history. It will save a lot of time.
Take Someone With Your When You Are in Severe Pain
When you are in really severe pain, you need to take somebody with you to the doctor because the brain is fuzzy under pain and you just are not fully aware of what is happening.
Get a Second Opinion
Brenda says you should not be afraid to get a second opinion. It doesn’t hurt. The world is not going to fall apart. If it doesn’t feel right, it probably isn’t right. You know your own body, and that is important to follow through.
Pay Attention to Your Diet
Be bone health aware in terms of not just milk, but other sources of calcium as well. Especially after you have left home. You have to be your own calcium conscience.
Exercise
Get fit and exercise. But, Brenda was not aware of the kinds of exercises that were detrimental to her spine. Many fitness professionals are not trained to deal with a person with osteoporosis. Brenda did the wrong exercises with gusto. She is now paying the price.
Nutrition and Support Devices
In this section we will cover the nutrition advice Brenda follows and the devices she uses to reduce the pain associated with her compression fracture.
Nutrition and Protein
Earlier Brenda recommended that people make sure calcium be part of their diet. While calcium is important, you should make sure you have adequate amounts of nutrients including vitamin D, magnesium and vitamin K.
Prunes have been shown to play an important role in bone health.
I find that many of my clients do not have enough protein in their diet. Protein is one of the main building blocks. If you have the protein, which is acidic, make sure you increase you intake of fresh fruits and vegetables which are alkaline and help balance the acidity in protein.
Support Devices and Braces
I asked Brenda about the devices, and braces, and cushions that helped her get through the first eight months after the compression fracture.
Back Support Cushion
Brenda has a pillow that she takes where ever she goes. She puts it on her spine because it absorbs shocks from the potholes in all the roads that we have in Canada. She uses it for support when sitting in a chair because it helps cushion the lumbar area.
Lumbar Support Brace for Lighter Work
Brenda has a smaller lumbar brace that she wears for household things like dusting or doing the laundry.
It is not so much as a support, as a reminder: “Don’t do bad moves.” (Brenda uses the Obusforme Brace in the illustration.)
Lumbar Support Brace for Lighter Work
Brenda has a smaller lumbar brace that she wears for household things like dusting or doing the laundry.
It is not so much as a support, as a reminder: “Don’t do bad moves.” (Brenda uses the Obusforme Brace in the illustration.)
Weighted Kypho Orthosis Vest
Brenda uses a Weighted Kypho Orthosis Vest for walking, while preparing her food and any activity anything where she is standing around a long time.
The other day, while her house cleaner does all the challenging stuff, Brenda wore the vest to dust. It’s a reminder to keep upright.
Heat Pad
Brenda uses a heating pad a lot. When she starts to feel achy, she sits down for 15 minutes and puts it on. It helps take the ache away. When she does her stretching exercises, she has it underneath her as well.
Reacher
The reacher is a terrific little device. It was very handy in the initial stages because everything seems to drop when you don’t want it to drop. You can use one for the garden for picking up things like sticks.
Shopping Cart
When Brenda goes to the large shopping stores, she will lean on the cart handle to take some of the pressure off her back. Sometimes she will put her purse in her back and adjust it so it is in the small of her back. It operates like the weighted kypho orthosis vest mentioned earlier in this blog post.
Over Reliance on Orthotic Braces
In regards to orthotic back braces, sometimes we get used to the braces and then we almost don’t want to take them off. They are braces, and so if you wear them or use them all the time, from the time you get up till the time you go to bed, they actually make you weaker.
My suggestion is to use them appropriately for tasks that you actually need that extra support — such as when you work in your garden. For further information, please read my blog on orthotic braces.
Recommended Products
Many of my clients and readers of this blog have asked me to assemble a list of Recommended Products that I think should be a part of their therapy, strength training, and pain relief program. I have created a page of Recommended Products you can consult.
Lumbar Compression Fracture Exercises
Before we begin, I have a video that addresses many people’s concerns about starting an exercise program after a compression fracture.
The following are 15 the lumbar compression fracture exercises I recommend for my Physical Therapy clients with osteoporosis:
- Chest stretch
- Chin tuck
- Arm lengthening or reach back
- Arm pull back
- Shoulder Stabilization
- Abdominal activation
- Wall push-ups
- Bridging
- Prone leg lift
- Squats
- Step ups
- Bicep curls
- Horse Stance
- Floor M
- Reverse Fly
These exercise choices are based on a study published in BMC Musculoskeletal Disorders by Bennell. These can be broken into two major groups: one set of exercises for posture and flexibility and the other for strengthening. I explain these in more detail below.
I do not recommend that every one with a compression fracture do all of these exercises. Everyone is different and the exercises will need to be broken into groups and delivered at apace that works for you.
The best thing you could do is to work closely with a Physical Therapist who is knowledgeable in the treatment of compression fractures.
If that person is not accessible, then I recommend you start with the Posture Exercises outlined in my book, Exercise for Better Bones.
The Bennell study (2) looked at the effects of compression fracture exercises and manual therapy on physical impairments, function and quality-of-life in persons with osteoporotic compression fractures. The study concluded that there are positive benefits of physical therapy prescribed compression fracture exercises for patients with compression fractures.
Spine Fracture Treatment Exercises and Thoracic Compression Fracture Exercises
The exercises I have listed are appropriate as spine fracture treatment exercises and thoracic compression fracture exercises.
Physical Therapy Compression Fracture Treatment Guidelines
The following is the treatment protocol I use (based on the Bennell study) for clients with compression fractures.
Once your muscles have started adapting to the change in height caused by the spinal compression fracture and the compression fracture has had time to heal (usually 8 to 12 weeks after the episode of increased pain) you should start a compression fracture exercise program.
The goals of compression fracture exercise program are to:
- Decrease your pain at rest and with movement.
- Increase your standing tolerance and overall strength.
- Reduce your risk of falling.
I recommend that you invest time and understand how compression fractures occur and learn how to avoid all activities and postures that can make your compression fracture worse. Both of these items are covered in this blog post and in the Exercise for Better Bones program.
Physical Therapy Compression Fracture Treatment Guidelines
The following is the treatment protocol I use (based on the Bennell study) for clients with compression fractures.
Once your muscles have started adapting to the change in height caused by the spinal compression fracture and the compression fracture has had time to heal (usually 8 to 12 weeks after the episode of increased pain) you should start a compression fracture exercise program.
The goals of compression fracture exercise program are to:
- Decrease your pain at rest and with movement.
- Increase your standing tolerance and overall strength.
- Reduce your risk of falling.
I recommend that you invest time and understand how compression fractures occur and learn how to avoid all activities and postures that can make your compression fracture worse. Both of these items are covered in this blog post and in the Exercise for Better Bones program.
Physical Therapy Exercises for Compression Fracture
I recommend a compression fracture exercise program that includes a combination of postural, flexibility, strength and trunk control exercises. The specific exercise mix is dependent on the individual needs of my clients and I choose what is appropriate after an assessment.
Daily Postural and Flexibility Lumbar Compression Fracture Exercises
Each of these compression fracture exercises can be found in Exercise for Better Bones. I decide the appropriate mix of postural and flexibility exercises based on my assessment of the individual.
- Chest stretch
- Chin tuck
- Arm lengthening or reach back
- Arm pull back
- Shoulder Stabilization
With time I encourage you to progress the chest stretch by lying on your back over a rolled-up blanket. Place the blanket lengthways.
Straighten your arms out at the height of your shoulders (shown in Stronger Bones Stronger Body workout video) to open up your chest wall and reduce the constant forward pull into gravity.
Strength and Trunk Control Lumbar Compression Fracture Exercises
A selection of these compression fracture exercises can be done up to three times per week. I decide the appropriate mix of strength and trunk control exercises based on my assessment of the individual.
- Abdominal activation
- Wall push-ups
- Bridging
- Prone leg lift
- Squats
- Step ups
- Bicep curls
- Horse Stance
- Floor M
- Reverse Fly
Finally, I encourage you to work with a health care professional who can provide soft tissue massage, postural taping, or taping and gentle spinal mobilization.
Physical Therapy Exercises for Compression Fracture
I recommend a compression fracture exercise program that includes a combination of postural, flexibility, strength and trunk control exercises. The specific exercise mix is dependent on the individual needs of my clients and I choose what is appropriate after an assessment.
Daily Postural and Flexibility Lumbar Compression Fracture Exercises
Each of these compression fracture exercises can be found in Exercise for Better Bones. I decide the appropriate mix of postural and flexibility exercises based on my assessment of the individual.
- Chest stretch
- Chin tuck
- Arm lengthening or reach back
- Arm pull back
- Shoulder Stabilization
With time I encourage you to progress the chest stretch by lying on your back over a rolled-up blanket. Place the blanket lengthways.
Straighten your arms out at the height of your shoulders (shown in Stronger Bones Stronger Body workout video) to open up your chest wall and reduce the constant forward pull into gravity.
Strength and Trunk Control Lumbar Compression Fracture Exercises
A selection of these compression fracture exercises can be done up to three times per week. I decide the appropriate mix of strength and trunk control exercises based on my assessment of the individual.
- Abdominal activation
- Wall push-ups
- Bridging
- Prone leg lift
- Squats
- Step ups
- Bicep curls
- Horse Stance
- Floor M
- Reverse Fly
Finally, I encourage you to work with a health care professional who can provide soft tissue massage, postural taping, or taping and gentle spinal mobilization.
Exercise Recommendations for Osteoporosis
Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.
But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop — how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — why is core strength important if you have osteoporosis?
Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.
Sex With Compression Fractures
My first piece of advice regarding sex with compression fractures is to consult with your physician before engaging I a physical activity such as sex with your partner.
Second, I cover this topic in more detail in my online course, Guide to Living with Compression Fractures.
When Can You Have Sex After a Lumbar Compression Fracture?
There is no need to give up an enjoyable sex life because of a compression fracture. Vertebral compression fractures (VCF) may alter your sex life, but they should certainly not eliminate it.
A compression fracture may make you feel fragile and vulnerable. That is natural.
Have open and honest conversations about these feelings with your partner. It can help you both feel more comfortable with the situation.
Let your partner know how you feel and discuss the support you need. These conversations provide you both with the opportunity to demonstrate love and care for each other.
A vertebral compression fracture can create stress in your relationship. It is important that you keep this in mind and I recommend that many people consider couples therapy during times of stress. You can find a good therapist in your area. For example this is a good source of couples therapy in Toronto.
During the First 8 to 12 weeks of Recovery (May be Longer for Some People)
When you’re in the recovery stage, physical intimacy is best expressed in alternative ways than intercourse. Consider exploring each other through gentle, sensual touch.
After the Healing Phase
Once you have been given the green light by your physician or surgeon to exercise, you can also start exploring intercourse again.
For some with minimal compression(s) in the mid thoracic spine, little may change for you. Lumbar compression fractures will certainly create a bigger impact on the positions you choose and how aggressive you are comfortable being.
Discuss positions you both enjoy as long as you both keep in mind that the partner with a compression fracture has a heightened awareness of their safety.
Symptoms of Compression Fracture
The following are six symptoms of a compression fracture:
- Over the age of 60.
- History of a previous fracture, whether that is a wrist fracture, a toe fracture.
- Have a shorter duration of back pain. Don’t disregard back pain that only lasts a couple of weeks.
- Find that your back pain might not be sharp but a lot of people with vertebral fractures will describe their back pain as crushing in nature.
- Your back pain actually gets better when you lie down.
- Unlike people with sciatica, your back pain most likely will not be, if it’s from a vertebral fracture, will not be going into the leg.
If you have any of these symptoms, especially a combination of these symptoms, you should ask your doctor to assess you for a vertebral fracture.
Many people are not aware that they have a compression fracture. In fact, a recent study (3) states that about 12% of post-menopausal women will have a vertebral fracture but only one third of those will get the attention of a medical professional.
In the video below I identify the symptoms of compression fracture and what you should do if you have a fracture.
Post Menopausal Women and Symptoms of Compression Fracture
A recent study looked at how 12% of people that are post menopausal are going to have a vertebral fracture in their lifetime.
But only one-third — less than 4% of those fractures — are brought to the attention of the doctor and therefore are brought to the attention of the individual.
This is striking, not only am I seeing people with one vertebral fracture or two vertebral fractures, but by the time they come to see me, by the time they’re first diagnosed, they actually have five vertebral fractures.
This is really terrible because it affects their quality of life. Then they become fearful of moving and it’s a vicious circle.
Compression Fractures Can Get Worse
My clients come to see me after they have been diagnosed and no one has told them that their vertebral fractures can get worse (until they meet me). Just because your spine has compressed 70%, it doesn’t mean that it can’t keep compressing.
If you have a compression fracture, it is so important for you to be really meticulous about your alignment because those fractures will get worse. Not only will the actual fractures themselves get worse but you are at a higher risk of fracturing more and more levels. But all is not lost.
Impact of Exercise on Compression Fractures
A recent study (4) shows that a 12 month duration of exercise had a very positive effect for people who had experienced vertebral fractures. The outcome was that after 12 months they had a significant improvement in quality of life. They had an easier outcome of doing their tasks of daily living, their functional mobility was improved and their balance was improved.
If you have been diagnosed with a vertebral fracture do intelligent exercises, avoid all forward flexion, follow the guidelines that I have on my blogs and in Exercise for Better Bones and play it safe and know that you can still improve your quality of life and you can still be stronger.
If you are not sure whether you have a compression fracture but have any of the six symptoms listed above have it investigated.
What is Compression Fracture
I want to talk about a topic that is especially close to my heart: movements that increase your risk for spinal fractures or compression fractures. During this discussion of the movements that cause a fracture we will get into detail on what is a compression fracture.
Compression Fracture Movements
Many new clients come to me for Physical Therapy compression fracture treatment because they receive advice from fitness trainers or books that does not take into account the fact that they have osteoporosis, osteopenia or low bone density. The clients think that they are doing things that are sound and right for them given the fragility of their bones. They are trying their very best.
Unfortunately, there are a lot of movements that they are doing (under the guidance of a fitness instructor or book that is not familiar with osteoporosis) that might be good for the general public but not for individuals with low bone density, osteopenia or osteoporosis. These movements are putting them at risk of a compression fracture.
By the end of this tutorial, you’ll have a good understanding of what movements, be it in yoga, pilates, in an exercise class or movements around the house, that you should modify.
Spine Anatomy: Compression Fracture in Back
In this tutorial, we’re going to look at why the lumbar and thoracic spine is more at risk than other bones in the body of a compression fracture. This would be a good time to review, if you haven’t yet done, the tutorial on understanding bone.
(To follow this tutorial you will have to play the embedded video because I will refer to images and diagrams as I speak through the talk.)
The illustration shows the normal curves in our spine. We have a normal inward curve in our lumbar spine, or our low back, which is referred to as a lordosis. A normal inward curve in our upper spine, which is the cervical lordosis, is at our neck. We have a normal small outer curve in our upper back, referred to as the thoracic spine.
These curves look really pronounced in our illustration. But if you look at somebody with good alignment, you’ll usually see a nice shape to the spine.
We know from previous tutorials that the vertebral body is composed of a hard outer coating. This hard coating is referred to as cortical bone.
The cortical bone surrounds the trabecular bone in the inside — the softer bone. The trabecular bone is commonly referred to as cancellous or spongy bone.
The illustration to the right shows the cross section of a vertebra of the spine. The cortical bone is the thick non-porous bone at the rim on the cross section of the spine. The trabecular bone is the porous bone in the center of the cross section.
Thoracic Compression Fracture Versus Lumbar Compression Fracture
A compression fracture can happen anywhere along the spine. The incidence of thoracic compression fracture is the highest among all parts of the spine because this area is the one where the postural stoop (or kyphosis) will occur. You could experience a lumbar compression fracture when you have an impact. I had a client who went tobogganing with her grandchildren. As they were going down the snow run they hit a few bumps — enough to cause a lumbar compression fracture and considerable pain.
Flexion Exercise Versus Extension Exercise
In the 1980’s, we weren’t sure whether flexion or extension exercises were a safe thing to give to a woman with osteoporosis or people with back pain. Fortunately there were physicians who studied this issue.
If you who are not familiar with flexion and extension exercises, I have two photos showing each type of exercise.
The first photograph on shows a flexion exercise. Note how our model Pat is rounding her back in order to complete the sit up or crunch exercise. Unfortunately, this exercise is still very popular in exercise classes and used by many personal trainers.
The second photo shows an extension exercise.
Note how our model Aline, in the photo, is performing the Prone M (also referred to as Floor M) exercise by elevating her torso upwards and creating an extension of her back.
I also prepared a video explaining flexion and extension.
In 1984, Dr. Mehrsheed Sinaki at the Mayo Clinic did a study (5) on postmenopausal osteoporotic women that looked at the effects of flexion exercises versus extension exercises.
The mean age or the average age for the women in this study were 49 to 60 years of age.
She broke the study set into four exercise groups:
- First group did extension exercises.
- Second group did flexion exercises.
- Third group did a combination of flexion and extension exercises.
- Fourth group did no exercise at all.
Within a year and a half, if they had back pain or if they were due for a follow-up, members of the study set would report back in. Dr. Sinaki did spinal x-rays and would see whether or not they had sustained fractures of the spine. These were the findings.
Flexion Compression Fracture
Compression fractures occurred at the following rates by group:
| Group | Exercise Class | Fracture Rate |
| 1 | Extension Exercises | 16% |
| 2 | Flexion Exercises | 89% |
| 3 | Extension & Flexion | 59% |
| 4 | No Exercise | 67% |
The study found that fractures occurred at a very high rate, 89%, in the group that had done flexion exercises (group #2), such as sit ups and toe touch exercises.
The group that did no exercise at all (group #4) still had a very high rate of fracturing. The thought behind that is that for a lot of things that we do in life such as picking out the laundry, reaching forward, coughing, sneezing, involves a lot of flexion.
Further, unless we counteract that with some extension exercise, as you see in group #3 where they did some extension and some flexion, you will not reduce your rate of compression fracture.
The group that did just extension exercises (group #1) had a very low rate of fracturing. Sixteen percent in comparison to 90%. This is a substantial difference.
Why Flexion Causes Compression Fractures
Let’s take a closer look at what happens to your spine when you do flexion exercises or perform activities that cause a flexion motion. The image provides a closer look at the actual trabeculae or the cross-bridges within the vertebral body. When we do a lot of flexion motions of the spine, as well as side flexion and extremes of rotation, those motions have been implicated with high forces and can cause excessive stress on the vertebral body.
The weakened trabeculae in osteoporotic bone can’t withstand those excessive forces. As a result, they start to fracture. You can see in this vertebral body that there are large pits. The weakened areas are unable to bear the stress caused by the flexion (wether through exercise, activities of daily living or other sources) with the result being a compression fracture.
The x-ray image of the spine below shows a compression fracture. The white vertebra is compressed. This can cause a loss of height of the vertebrae.
What has happened is that there’s been so many forces that the disc is actually starting to push through the vertebrae. The vertebrae itself is actually quite a bit shorter in stature than the vertebrae above and below it. It has just compressed in on itself.
How to Reduce Kyphosis
If we want to stop the progression of forward flexing of the spine (kyphosis) that occurs because of the repeated wedge fracturing like we see in the image to the right, we need to do this at a stage ideally where the individual has not yet fractured. This is also known as a Dowager’s Hump, buffalo hump, or neck hump.
We prefer to work with them when they are still able to hold their ear over their shoulder and their shoulder over their hip in nice alignment.
Exercise and movements during the day that put our spine in flexion are implicated. We need to make sure that when you are moving, that you have the best alignment possible.
In the video, you will see Pat, one of my clients, demonstrating how to garden safely.
In the photo, Pat is bending forward in an unsafe manner. She is putting a lot of force on her spine, especially in her mid back, through this position. She is lifting a heavy bag in a flexed position. This movement could cause a compression fracture.
If she took the time to get down and kneel, as she is demonstrating in the second photo, she will maintain a nice postural alignment.
The bending is happening in the knee and hip as opposed to the spine. That’s much safer on the spine. The loading through trabeculae and the whole vertebral body is much more even and safe.
Exercises and Movements That Increase Risk of Compression Fracture
Studies have shown that exercises that involve flexion increase your chance of spinal fracture. They have also demonstrated that exercises that involve the combination of flexion and rotation increase fracture risk even more than flexion exercises only.
Daily activities can be problematic. I will often see women carry heavy purses and they go to sit down and they’ll rotate and drop their purse to the side. Movements like create a very compressive load and put your spine at risk of a compression fracture.
Movement Strategies to Avoid a Compression Fracture
Here are several movement strategies that will reduce your risk of a compression fracture.
Follow an exercise program designed for people with osteoporosis. Exercise for Better Bones is an osteoporosis exercise program that provides exercise programs for people at different fracture risk and activity levels.
Make sure you follow good movement patterns during your activities of daily living (ADL). There is a comprehensive guide on safe movement included with Exercise for Better Bones.
Yoga and pilate moves need to be practiced with caution and should be practiced under the supervision of instructors who are well trained in the precautions that need to be carried out for individuals with osteoporosis and low-bone density. If you want more information or have an instructor who wants more information, consider Yoga for Better Bones. It provides details on Yoga poses you should modify or avoid.
Avoid exercises that put you in flexion. Stay clear of exercises that involve flexion and rotation. I wrote a detailed post on osteoporosis exercises to avoid.
Types of Vertebral Compression Fractures
Not every vertebral compression fracture is alike. Just as we are all unique in our makeup, the same applies to compressions that can occur in the spine. The most significant risk factor for obtaining a vertebral compression fracture is having osteoporosis.
Compression fractures may be classified based on the portion of the vertebral body that is affected. (1) They are generally classified when at least 20% of the height of the affected portion is lost.
Wedge Vertebral Compression Fracture
The wedge vertebral compression fracture takes its name from the shape that is created as the front or anterior of the vertebral body is affected.
Wedge compressions are most commonly seen in the mid back, around the level of the lower angle of the shoulder blades.
Biconcave Vertebral Compression Fracture
The biconcave vertebral compression fracture, like the wedge fracture can have different levels of compression. With a biconcave vertebral compression fracture the middle of the vertebra collapses.
With biconcave fractures the top of the vertebral body takes on what looks like a smile while the bottom of the vertebral body takes on a grin.
In the next lessons I cover in more detail what types of movements have been shown to increase the risk of both wedge and biconcave vertebral compression fractures.
Crush Vertebral Compression Fracture
A crush vertebral compression fracture is the least common type of vertebral compression fracture. In crush fracture the posterior portion of the vertebral body collapses.
The last type of compression fracture is classified as complex.
How Do I Strengthen my Back After a Compression Fracture?
In order to strengthen your back (and improve your posture) after a vertebral compression fracture, I highly recommend that you start with the postural exercises in Exercise for Better Bones and then build from there to the Beginner strength exercises. After that, continue through to the Active strength exercises.
All of those exercises are incredibly safe and progressive.
Take it one day at a time, one exercise at a time, and progress at a pace that works for you.
Weight Lifting After Compression Fracture?
Yes, absolutely.
How much weight can you safely lift?
I don’t know.
It depends on your body, how strong you were, the quality of your bone, and your form when you exercise.
It is always best to start slowly and gradually with baby steps. Start at the beginner level, gradually work your way up, see what your body allows you to do, and maximize the weight that you can lift safely.
Can I Wear or Use a Weighted Vest After a Compression Fracture?
Weighted vesta are a popular exercise device for many people with osteoporosis but should you wear one if you have a compression fracture? I answer that question in this video:
Can You Drive with a Compression Fracture?
If you find that you have no pain sitting or doing shoulder checks, then there’s no reason that you can’t drive.
However, I have a number of clients who took several months, even some as long as nine months, to be comfortable driving. This was due to the fact that they would place their hands down by their side to brace themselves when the car went over a little pothole or bumpy spaces in the road.
If they were driving, they didn’t feel they had the control of both their body and the car at the same time.
So it’s a personal decision that you’re going to have to make to keep you safe and feeling well.
Is a Heating Pad Good for a Compression Fracture?
Yes, it is.
In the early phases of your vertebral fracture, there will be some inflammation around the vertebral body itself, but the heat pad can be applied away from the vertebral bodies and to all the back muscles on either side of the vertebrae. The heat helps the muscles to relax.
As time goes on, your spine has to work a little harder if you have compressions because the forces in the spine have changed.
The heating pad is nice when you’re taking your break before bed or taking siesta in the afternoon, for example, to bring some blood flow to the muscles and give them a little break throughout the day.
As mentioned earlier in this post, Brenda uses a heating pad a lot. When she starts to feel achy, she sits down for 15 minutes and puts it on. It helps take the ache away. When she does her stretching exercises, she has it underneath her as well.
Sleeping Position with Osteoporosis Compression Fracture
Here is my recommended osteoporosis sleeping position for people with compression fractures. This is likely the best sleeping position for osteoporosis of the spine:
- If you wear pyjamas to bed, choose silky material to help reduce friction and make moving in your bed easier.
- ‘Log roll’ when turning in bed. Keep your knees bent, roll your shoulders and knees simultaneously.
- Use extra pillows to ensure a supportive sleeping position.
- Use a heating pad to help your muscles relax.
- Consider wearing a waist belt to support the space between your lower ribs and pelvis.
- Use a pillow under your knees/legs when sleeping on your back.
- Keep your head pillow as low as you comfortably can when on your back.
- Use a pillow between your knees and ankles when sleeping on your side.
- If you are a side sleeper, make your head pillow wide enough that it supports your head in a neutral position (i.e. that your chin is in at the level of the middle of your breastbone).
- Consider sleeping in your own bed so that you do not have the worry of your partner’s movements jarring your back.
- Avoid sleeping in a recliner. Get as flat as you comfortably can so as to take weight off your compressed vertebra.
- Avoid a water bed.
- Avoid a memory foam mattress if you keep your room cooler than 65 degrees Fahrenheit at night (because they get too stiff).
- Medium-firm mattress is often recommended but you have to find the one that is right for you. Make sure you spend at least 10 minutes lying on one at the shop. Wear the same thickness of clothes you would at night.
To learn more about how to get a good night’s sleep if you have a compression fracture, visit my page dedicated to better sleep.
How to Get Out of Bed With a Compression Fracture
Here are my recommendations for patients with compression fractures who want to know how to get out of bed with a compression fracture:
- Use your pelvic floor and deep abdominal muscles to brace your back when getting in and out of bed.
- To get out of bed, ‘log roll’ onto your shoulder and then push yourself up with your hands until you are in a sitting position.
- To get in bed, get in a sitting position. Carefully tilt down, lower yourself with your hands and roll onto your shoulder until you are lying flat on your side.
Compression Fracture and Back Pain
A comprehensive study published in the Journal of Bone and Mineral Density in September 2017 (7) identified a relationship between the incidence of compression fracture and back pain.
The research team examined data from 4,396 men over the age of 65. The men had enrolled in the Osteoporotic Fractures in Men study between 2000 and 2002. The key findings and conclusions were:
- Only 25% of new vertebral fractures are diagnosed by their physician.
- Approximately 60% of older men with small osteoporosis-related compression fractures reported new or worsening back pain.
- The percentage of men in the study reporting back pain with undiagnosed compression fractures (70%) exceeded those without compression fractures by 11 percentage points (59%).
- 93% of the men who had their fractures diagnosed during the study reported back pain.
- Prevention the compression fractures could have reduced the onset of back pain and further disability in the study group.
The study’s main author, Dr. Howard Fink, concluded: “Back pain is the most common symptom (of compression fractures).” The study results are similar to findings in elderly women.
Recall that Brenda experienced severe back pain during her trip to Africa — likely brought on by a compression fracture. If you experience back pain, consult your physician and specifically ask if she can determine if the cause is a compression fracture.
Exercise Recommendations for Osteoporosis
Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.
But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop — how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — why is core strength important if you have osteoporosis?
Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.
Conclusion: How to Treat a Compression Fracture
We have covered a wide range of issues related to compression fractures. We learned why your spine is at risk of a compression fracture and about physical therapy compression fracture treatment. Brenda’s story shows that every person’s experience with compression fracture is going to be different.
We identified six symptoms that you might have a compression fracture. I have quite a few clients that have compression fractures and do not even know they ever had them. I’ll ask them to get x-rays because I’m trying to convince them to move safer. Some clients might have had a bit of back pain that goes away after six to eight weeks. They’re the lucky ones. Their compressions fracture may not always stay like that.
Brenda’s experience shows that you should find a health practitioner that you trust and has knowledge in treatment of osteoporosis and compression fractures.
There are many things that you can do to make your life with a compression fracture. We covered these in this blog post.
Safe compression fracture exercises and safe movement are critical to reducing your risk of another compression fracture.
I hope that this blog does help make the life of listeners a little bit easier out there, and if anybody wants to add their comments at the end the blog, feel free to do so.
References
- Mokhtarzadeh H, Anderson DE. The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management. Curr Osteoporos Rep. 2016 Apr 4. [Epub ahead of print]
- Kim L Bennell, Bernadette Matthews, Alison Greig, Andrew Briggs, Anne Keppy, Margaret Sherburn, Judy Larsen, John Wark. Effects of an Exercise and Manual Therapy Program on Physical Impairments, Function and Quality-of-life in People with Osteoporotic Vertebral Fracture: A Randomized, Single-blind Controlled Pilot Trial. BMC Musculoskeletal Disorders. Posted 03/19/2010
- Clark E.M., Gooberman-Hill R, Peters TJ. Using self-reports of pain and other variables to distinguish between older women with back pain due to vertebral fractures and those with back pain due to degenerative changes. Osteoporosis International. April 2016, Volume 27, Issue 4, pp 1459-1467
- EvstigneevaL et al. Effect of twelve-month physical exercise program on patients with osteoporotic vertebral fractures: a randomized, controlled trial. Osteoporos Int. 2016 Mar 16. [Epub ahead of print]
- Sinaki M, Mikkelsen BA, Postmenopausal spinal osteoporosis: flexion versus extension exercises, Arch Phys Med Rehabil. 1984 Oct; 65(1): 593-6
- Association of Incident, Clinically Undiagnosed Radiographic Vertebral Fractures With Follow‐Up Back Pain Symptoms in Older Men: the Osteoporotic Fractures in Men (MrOS) Study, Howard A Fink et al, Journal of Bone and Mineral Density, September 7, 2017
Osteoporosis Guidelines
Learn more about compression fractures on my Osteoporosis Guidelines page.
Comments
October 5, 2016 at 9:36am
Mariette Ledo
WOW! Thank you so much for this blog Margaret and to Brenda, a big thank you for sharing your journey with us.
I have really appreciated all the tips you have shared and will definitely look into some of the equipment you suggest.
I too have been active most of my life and am finding the overall adjustments I have to make as a result of my osteoporosis a bit...overwhelming at times but this video has been very inspirational. Thank you so much!
October 17, 2017 at 8:01pm
Callum Palmer
Considering just how much of a major impact a vertebral fracture can have on your life, it is nice to know some of the therapies that can help. In fact, my wife has recently had to start dealing with a compression fracture, so hopefully some of these techniques can help while we look for a chiropractor. At the very least the targeted stretching seems like something we can do while we get her some help.
October 17, 2017 at 10:41pm
Margaret Martin replies
Hi Callum, If you do work with a chiropractor ensure that they are knowledgeable about osteoporosis. Many of their techniques are contraindicated for individuals with osteoporosis. No one with low bone density should be manipulated as the forces can cause a (another) spinal fracture.
November 15, 2017 at 10:25pm
Jordan Miner
I've been thinking about some different options for my grandmother's osteoporotic fracture treatments, and I think that being able to get some help would be good. I'm glad you talked about being able to use heat pads and I think that being able to try that would be good. I'm going to have to look for some osteoporotic fracture treatments and see what else we can do! Thanks!
December 11, 2017 at 4:37am
Terry hodson
I Am 87,never had a fracture but am at high risk,l have taken fosamax for years but did not show improvement however after two Prolia shots I have gone from osteoporosis to osteopenia,I will continue though very expensive $1200:for two. Dr, does not take Medicare but files with them,Medicare denied payment because too much time had elapsed between between the two shots should be no more than 166 days and I had180days! I was misinformed from my drs, office !
January 3, 2018 at 11:49am
Kate
Hi, thank you for very informative video. It was almost like reading about myself. I am going for Kyphoplasty in 10 days time. What has helped me enormously has been reform Pilates, spine neutral. My Physical Therapist recommended it to me. I am 9 weeks after my V fractures, T 9 included! I also have lost 3 inches in height which l also found stressful. I agree that it is very important that your Dr has knowledge and experience of Osteoporosis and will refer you without a battle to the experts. My heatpad is one of the most important things in my life at the moment. Thank you again
January 30, 2018 at 3:17am
Lorraine
My son is 54 years of age and has cerebral palsy (spastic quadriplegia) he has had Prolia injections twice a year for five years. My question is are there other people who have cerebral palsy having Prolia injections and if so what are the implications for people unable to exercise?
January 30, 2018 at 9:34pm
Margaret Martin replies
Hi Lorraine,
My understanding is that Prolia does not require any exercise in order build bone.
It appears that you are not alone in your question. A researcher in your part of the world is currently conducting a trial:
http://hudson.org.au/latest-news/muscle-mass-crucial-to-preventing-bone-fractures-in-young-people-with-cerebral-palsy/
You may be able to reach out to her. Her trial is in adults over the age of 18 years.
She may know of others like your son who have had Prolia injections since this is her area of interest and study.
February 23, 2018 at 4:41pm
Margaret Gerth
Thank you for this video. I have severe compression fractures at T12 and L4 since a fall in October. I have been on Prolia for 4 years. I am waiting for an appointment at the spine clinic to see if I am a candidate for vertebroplasty or kyphoplasty. Meanwhile, my doctor has advised on what I should NOT do, but not what I CAN do. She has said walking and stretching, but not what kind of stretching. I have ordered your book through Book Depository but it has not yet arrived. Would you be kind enough to tell me what stretches I can do safely in the meantime. I am tired of just sitting and waiting! Thank you!
I wish you were in B.C. I would come to see you!
March 5, 2018 at 10:21pm
Margaret Martin replies
This winter I wish I was in BC as well! Normally vertebroplasties and kyphoplasties are only within 6 weeks of the compression occurring. Otherwise the vertebrae has healed itself in the compressed shape. Until you get the book, any stretch where you are lying flat on your back or your stomach you know is safe.i.e. hamstring stretch can be done lying on your bed with the support of a bathrobe or yoga belt wrapped around your foot. Bend both your knees. Extend one foot towards the ceiling as you support it with the belt. Keep your elbows by your side. Incorporate your breath and your pelvic floor and deep abdominals into your stretch. You will see all the safe stretches in the book.
February 28, 2018 at 1:27am
Melissa Brown
I cried watching this. Gave me some hope. I’m 7 weeks in and wow this is so painful. I would love to know the best way to sleep. Mornings are so hard!!
March 6, 2018 at 9:17pm
Margaret Martin replies
Hi Melissa, I hope that the information provided in my sleep blogs gives you some sleeping options. http://melioguide.com/health-guides/better-sleep/
Margaret
March 6, 2018 at 4:45am
Johanna
Hi, my husband found your article and suggested I watch it. I can so relate to all the aspects of pain and limited movement although I wasnt quite as bad as above. I am 46 and had a trampoline accident 6 months ago, initially I was fine went to work etc over three weeks I had nausea vertigo headaches diarrhea loss of appetite, migraine and burning churning stomache pain which felt like a gripping from behind my ribs. I went to a chiropracter I thought that would sort everything wrong it got worse. Had 2 xrays one neck and one middle back nothing showed a but if small degenerative change in my neck. I was given time off work and painkillers then physio which which was very painfull especially the crippling spasms and cramp. I finally had a MRI after 4 months to be told I had a compression fracture at T11, bone spurs and prolapsed discs and at the same time that a fracture takes 6/8 weeks to heal so my injury was over and I should not sit on the couch all day thinking about my back by the specialist. I work as a phlebotomist taking blood standing all day! I could not sit around even if I wanted to I had to keep moving so my back was not cramping and seizing up. I had never hurt my back before so had no idea what to expect. I also got shingles 3 months after the accident which my physio did not believe and expected me to keep attending sessions. I went back to work on reduced hours. I got a second opinion from a specialised spine doctor, this person was more empathetic with my situation and said sometimes this takes longer to heal BUT that the fracture was old and I had sprained my spine all over and perhaps spinal cord. Does this sound normal to you? I would appreciate your comments. I am now on my third physio and have improved a heap but had my first four hours on my own at work today and an in a lot of pain now. I have 2 weeks left if reduced hours then back on my own for good! thank you for sharing your experiences it helps and makes me feel not so isolated. Accupuncture has helped me immensly I felt relief after the first session and its made my muscles relax and starting to let go after around 6 sessions.
March 6, 2018 at 1:41pm
Margaret Martin replies
Hi Johanna, So glad that Brenda's story was helpful to you. This is why she wanted to share her story. Your situation does not sound unusual. Every individual is so different in their body's response. It sounds like you are in good hands and with this Physical Therapist you should be given exercises to make your spinal muscles (and your bones) stronger. Take care, Margaret
May 17, 2018 at 5:49am
Sue Townson
Wow! I have been searching and searching for some real information about living with compression fractures. This is so much more information that I have received from all the health professionals I have been consulting with. I have had the impression that now I have this disability I just have to live with it! No guidance has been given at all. So thank you very much for sharing this. It is invaluable.
June 1, 2018 at 7:41pm
Richard Martin replies
Hi Sue: Glad to hear that you have found the post and Brenda's story. Thank you for your kind comments.
June 1, 2018 at 5:25am
Sue Townson
I have just watched Brenda's interview and it is everything I have experienced. Here in New Zealand it has been extremely difficult to find out how to handle all of this. I too have been very mindful of bone strength and my genetic vulnerability way before menopause. I have always had an active lifestyle, my nutrition has always been really good especially from the calcium angle and I have never smoked and had very little alcohol BUT I couldn't change my mother!
After a high impact fall from my horse I broke my pelvis and whilst rehabbing from this I hurt my back from a minor movement and then again and then again. I was in excruciating pain more that the pelvis injury but nothing was investigated by physio or doctor until my friends insisted that I needed to get an xray or mri and finally I did and it showed my five lumbar vertebrae have compression fractures. Like Brenda I was extremely disappointed with the medical profession as I grappled with such a loss of mobility and independence. I have ordered your book and hope that will give me some guidance to nurture my strength and hopefully can contact you for a more individual consultation. Many thanks again.
June 1, 2018 at 7:42pm
Richard Martin replies
Hi Sue: Thank you for sharing your story and experiences. Thank you for ordering Margaret's book.
June 8, 2018 at 11:57pm
Jeanna M Suzor
I'm wondering if you could please clarify which brace is better for kyphosis due to thoracic fractures along with bulging discs in lumbar area. These problems started 6 mths ago and I was just diagnosed with the fractures a month ago. The most recent fractures occurred a couple of months ago.
July 2, 2018 at 11:36am
Judy chow
I just have a L2compression fracture. Thank you so very much for your useful information
July 18, 2018 at 1:16pm
Jean Sawatzky
Hi Margaret Martin,
Thank you for your video. Is there any way to forward my email to Brenda? I have several compression fractures. I am on week 4 and no improvement. I live in Winnipeg and would like to know if you know of a good dr or physio therapist that deals with compression fractures? Also can you still exercise if you are still in pain? Will it help or make it worse? Thank you Jean
July 18, 2018 at 8:10pm
Margaret Martin replies
Hi Jean, You are most welcome. Others have asked and although Brenda would love to have the time and energy to reach out individually life's challenges do not allow her to do so. The first 8 weeks are the hardest. You should not be doing any active exercises at this time, it can make your pain worse. It is a very good time to work on the breathing (as discussed in the book and on the site) as well as to ensure you are doing all your daily activities with utmost care and good body mechanics. The neck, calf, hamstring and quadricep exercises done as outlined in Exercise for Better Bones would be safe to do. I unfortunately do not know of anyone in Winnipeg. Your pain should get better with time. Margaret
August 2, 2018 at 3:09pm
Jack kent
This material is comprehensive and very helpful. Thank you very much for posting.
Mum 83 is 4 weeks post L3 fracture. Pain is still there but getting better.
Looking at the exercises described - thanks - will see what is possible.
Heat seems to help. Someone suggested cold but that doesn't seem to help.
If the cold doesn't help, is it necessary ? In early stages of injury, I understand.
Mum is usually a fast healer.
Thanks.
Jack
August 6, 2018 at 7:48pm
Margaret Martin replies
Hi Jack, Thank you for your kind comments and feedback. I do try to make the information practical and clear. Be sure your mother is very careful with her activities of daily living. Heat is especially helpful since it relaxes the muscles. As far as cold - the physician who came up with RICE (rest, ice, compress and elevate) recently wrote a book explaining how he wished he had never suggested Ice. Newer research shows that it can hinder healing.
All the best to you and your Mum.
Margaret
August 11, 2018 at 10:59am
Colleen Yates
Thank you so much for these videos and information. I do have your book and have flagged all the exercises you recommended. Two compression fractures and I’m afraid to do much. Also, I can’t seem to find the kyphosis weighted vest that Brenda is wearing. Can you tell me where to purchase one?
Thank you again,
Colleen Yates
August 11, 2018 at 1:26pm
Margaret Martin replies
Hi Colleen,
You are very welcome. I wish I had the opportunity of working one on one with you. Your email address tells me you have been very active throughout your life. To protect your bones from further limiting your movement and your quality of life it is very important that you make time to move intelligently everyday. After the first 8 weeks of a new vertebral fracture you can gradually incorporate more extension exercises/movements into your day. Ensure that your MD gives you the green light.
My clients who regularly do their exercises feel stronger and have less pain. Occasionally life gets in the way of being able to devote time to her regular exercises. Their pain returns, some experience another vertebral fracture. All tell me that the decline in strength impacts their quality of life.
Build up gradually and stay as strong as you can.
As for the weighted kypho-orthosis the company that was making them is no longer but you can try using a little backpack purse. Brenda uses a similar one when she is out at galleries etc.
Here is one I recommend from amazon(dot)com: https://amzn.to/2MePiGd
And the same from amazon(dot)ca: https://amzn.to/2B3jC1T
In the study using the weighted kypho-orthosis the weight was limited to approx. 3 lbs and resting between the lower third of the shoulder blades.
All the best,
Margaret
August 22, 2018 at 5:14am
Karen Martin
Hi Margaret, thank you so much for this valuable information, more useful than anything else I've found on the net. Or from my doctors. Two different doctors seen within the first week of my T11 20% compression fracture, and all they said was "take painkillers as needed" and then started to talk about Prolia. I had to suggest the paracetamol/ibuprofen protocol myself, ask what were the best actions to promote healing - lying down vs sitting vs standing etc. Then ask for medical certificate for time off work. I cried for two days, it seemed like the life I had and my future Latin dancing, backpacking, gardening old age (I called it "late middle age") was going to turn into a recliner-centered existence like my mum's. Then I found this site, and I now feel positive and in control of my life again. Have ordered the book, and looking forward to taking charge of my own recovery!
August 22, 2018 at 6:03pm
Margaret Martin replies
Hi Karen, thank you for sharing your story. I am glad the combination of medications helped you. Following 8 weeks of healing you can gradually go back to strengthening and following a regular exercise program.
I was not familiar with paracetamol/ibuprofen protocol. I found one study on it https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800651/ it concludes that: "There was no difference in analgesic effects or side effects observed using oral paracetamol, ibuprofen or a combination of both in patients with mild to moderate pain after soft tissue injuries". But I am glad it helped you!
All the best, Margaret
August 23, 2018 at 3:23pm
Karen Martin
Hi Margaret, I may have misused the term 'protocol', I was referring to the timing and amount of medication. I had been advised many years previously to take ibuprofen and paracetamol alternatively every 2 hours (with limits on total amounts taken in 24 hours). This time I wasn't offered advice as to timing, and had to ask if this would be the appropriate way to take the medication. My chief disappointment was that the actual injury was so quickly glossed over in the rush to get me onto pharmaceuticals. I understand the seriousness of osteoporosis, but my first concern is to make the best recovery from this current fracture, then to focus on avoiding future ones. I was given a brochure listing calcium-rich foods, which I pretty much knew about anyway. I would have preferred one with the information you have provided about getting in and out of bed, what to avoid doing, posture etc. I have a referral to an endocrinologist, but I'm not starting drug treatment until I've weighed up all the options, risks and benefits. I've used the FRAX tool to discover that my terrifying double risk of sustaining a hip fracture is actually a .6% increase (ie from .6% to 1.2%) and I'm thinking I could take that risk for 12 months to see if a nutrition/exercise program will work instead. At least I can now discuss my situation and options with my medical practitioners with knowledge and understanding, thanks to the valuable information and inks to studies you provide.
October 10, 2018 at 4:13pm
Nana S.
I have a patient with lumbar compression fracture and he's afraid of doing any exs or even getting up from a chair because he thinks he's gonna break his back. I explained to him that not doing exs is going to get worse but he's still afraid. I instructed him on body mechanics and to avoid forward bending and twisting his back. Any advice? What else can I tell him?
October 10, 2018 at 9:47pm
Margaret Martin replies
Hi Nana, If he is within his 8 week healing window you then reinforcing good body mechanics is a great start the next step might be to start with teaching him good breathing techniques that would help with his anxiety as well as core stability. He may then be comfortable progressing to isometrics, incorporating his breath with every contraction. Exhaling thru pursed lips as he visualizes "drawing up the big boys" as they would say in Australia. Start small. He has to regain trust in his body. Find the most gentle exercise he can do without making his pain worse and progress from there. It may be ankle pumps or butt squeezes.
He is lucky to have you as a therapist. Thank you for reaching out and caring. There is always room for more caring in health care.
Margaret
February 23, 2019 at 7:45am
Donald McCoy
I compression fractured my L4 - 7 days ago. Dr. gave me back brace and ask me to visit him in 5 weeks. My question is what can I do to help my back within next 5 weeks? And is there a method for tying my shoes? My thoughts after reading your article is that I may not should flex forward to tie my boots.
February 26, 2019 at 10:15am
Richard Martin replies
Hi Donald, There is a ton you should do or rather should not do. My web site does have a number of daily activity suggestions but my book has more. Within the book, Exercise for Better Bones, you will find a link to over 30 + suggestions on daily activity modifications that you should consider. In the meantime, I suggest you put on your socks while flat on your back in bed. If you do not have the flexibility in your hips to do so you can get get a sock helper. Here is a link to what is available on the site:
http://melioguide.com/health-guides/activities-of-daily-living/
The Beginner Balance exercises would also be good for you to do at this time. Once you get the okay from your physician you can start into the Posture and Beginner strength exercises in Exercise for Better Bones.
Consider this a temporary set back and an opportunity to learn very good body mechanics.
Margaret
March 20, 2019 at 11:14am
Ann Bouwkamp
I fractured T7 in March of 2017. I was in pain that was basically intolerable. It took approximately 6 months to get to the point of being able to do anything. The orthopedic spine MD stated that it was too severe to do a vertebroplasty. I now this January 2019 fractured my T9 vertebrae. I am finally starting to feel better. They want me to start a Forteo which is very expensive - which my copay is $900 a month. I would like your opinion on a Forteo vs Prolia vs doing neither and doing diet and PT. I eat fairly healthy anyway. Thanks for your thoughts. Loved reading your blog and when home from our winter home will be ordering your books.
March 29, 2019 at 9:40am
Margaret Martin replies
Hi Ann, Sorry to read about your vertebral fractures. Since you have had a second fracture, despite a change in diet and PT, it appears that it is not enough to protect you from future fractures. Each vertebral fracture incrementally increases your risk of future fractures. Not knowing your general health or your ability to regularly strength train aggressively enough to build bone makes it impossible to provide an appropriate response. Due to the Personal Health Information Protection Act of Ontario, I do not use a public forum to discuss individual situations.
Studies have shown that both drugs and even the combination of the two drugs helps to protect you against more fractures.
The expense of Forteo would be for 18 months whereas the expense of Prolia would be for 10 years. The decision to take a pharmaceutical needs to be discussed with your health care provider, including your PT. As you realize there are many factors, cost being one of them, to consider. Good luck with this decision. All the best,
Margaret
March 28, 2019 at 11:51am
Ann Bouwkamp
It says my comment is awaiting moderation...what does that mean?
Ann Bouwkamp
March 29, 2019 at 9:41am
Margaret Martin replies
Hi Ann. We hold every comment posted on our site and review it before either responding to it, deleting it, or publishing it.
August 9, 2019 at 6:30pm
Brenda McCloy
Hi. I got your book from library and love it. Will be purchasing book but was wondering whether your video would be of benefit as well. I am also going through the decision of what to do re pharmaceuticals have not taken anything yet. Your article was very informative. I don’t like the idea of any but.... at age 40 I had a T5 fracture from a fall on ice. My FRAX now is 25% with an 11% risk of hip fracture. I am quite active and have not had any height loss or fractures since I was seen by a specialist in 2001.T5 is stable. And I have had a few falls until I worked on my balance! I am now 71 years old. I am now working on spine and upper body strength especially and have seen a physio therapist who has an interest in osteoporosis. So I guess my question besides the video should I begin now with meds or just continue eating well and up my strengthening and wait til I break a bone? Are there any studies done with that scenario?
August 10, 2019 at 7:18pm
Margaret Martin replies
Hi Brenda, Thank you for sharing your story and for your kind praises.
The DVD is great if you fall into the Beginner / Active category in the book and you would prefer to follow along with a daily 30 minute program rather than do it on your own. Basic equipment is required and is outlined in the DVD.
As far as the medication I cannot make decisions for you. However, you should take a look at how your bone mineral density (BMD) scores have been changing over the last decade. If your diet and exercise pattern has remained constant and your BMD has been staying fairly constant then you know you are on the right track. If your BMD numbers have been worsening but you feel that you could improve your nutrition and your exercise to reduce bone loss then it is an approach worth taking regardless of whether you take pharmaceuticals. I strongly recommended that you speak to the bone specialist that is seeing you (rheumatologist or endocrinologist) to help you weigh the pros and cons.
I do not wish you to break a bone. Hip fractures can change your life in ways that you will not regain.
Margaret
January 31, 2020 at 1:48am
Jenny
Margaret/Richard: My sincerest appreciation for ALL of the information provided, as this was genuinely the most informative online information I have read, in the last 5 months of exhaustive research. I am a 39 year old woman, whom has been sincerely stricken down in the prime of my life, with vertebral compression fractures. Due to an underlying health condition, I was placed on high dose prednisone steroids, that in just 2 years time, weakened my bones so severely, that I have encountered SEVEN vertebral compression fractures in the last 5 months. I have seen countless specialists for these fractures, all of whom say they’ve never seen such, and in turn are at a loss on how to advise any sort of short or long term treatment plan. My GP, an internal medicine specialist, has began slowly tapering me off of the high dose steroids, introduced vitamin D and hormone replacement therapy to my daily regime, and as well started me on the first “yearly/bi-yearly” round of the IV infusion medication “Reclast”. No specialist/MD i have seen will recommended Kyphoplasty, due to the volume of fractures I have, and even so much as a brace recommendation has been hard to yield from anyone, due to me having both Lumbar & Thoracic fractures. The only constants in advice I encounter, are to not start any sort of physical therapies until 12+ weeks after my last fracture, which is becoming impossible because I continue getting compression fractures, and multitudes of apologies in not being able to recommend how to move forward, because they’ve “never seen such”. I still cannot walk or even sit independently without having to hold myself up. I have to sleep in a hospital type bed due to the fact of not being able to lay flat, and sleep at nearly a ninety degree angle. I sincerely live in near DIRE back pain. Did I mention I’m ONLY 39 years old, and have had ZERO trauma to my back? A cough, a sneeze, a slight bend at the waist, these are all activities that I was doing when I broke each individual vertebrae. Im convinced that at some point some sort of healing and/or mending must begin, if nothing more than my own bodies fight to heal itself. The Reclast infusion seems to have been the best pain relief and benefit thus far. Tapering the steroids will help. As will the vitamin and HRT regimes I believe. I take ZERO pain medication for this, as sincerely NOTHING helps alleviate ANY of my back pain. I would GREATLY appreciate any advice you have in what type of expert/specialist I need to find that can help with my back and these fractures. All the neurosurgeons and “spine” specialists do not have any advice for me. The PT therapists I’ve consulted with are too scared to even advise how to brush my hair or teeth correctly for my issues, as for fear a light breeze my way could finish breaking me completely. There has to be someone, somewhere, that has the knowledge you two incredibly sound and vertebral fracture educated individuals have, that can help me and advise me in what to do regarding any sort of treatments moving forward? Whom is this “specialist” I need, and how do I find them? Many thanks and my sincerest appreciation in advance for your help!
Sincerely,
Jenny (US; Alabama)
February 4, 2020 at 3:28pm
Jeri Ettleson
Hi Margaret, I have been reading your book, and I have been doing your DVD. I am 60 years old. I had a fragility fracture of T9 mid August 2019 (about 6 months ago). Before the fracture I was very active and exercised regularly. I went through 6 weeks of physical therapy, but I still have pain. What is unusual is that the pain comes later in the day and it is on the right side of my abdomen in the front (just under my ribs). The pain is not in my back! It subsides if I lay down. I have asked many health care providers and no one has ever heard of this type of residual pain from a thoracic compression fracture. Have you ever heard of this type of pain? I am unsure how best to treat it. How long does it typically take for the pain from a spinal compression fracture to go away? Also, through the years, I have suffered rib pain from doing very innocuous things (like turning over in bed, or receiving a hug). My ribs were not fractured, but it took several weeks for the pain to resolve. Could these rib pain incidents be related to osteoporosis?
February 7, 2020 at 11:59am
Richard Martin replies
Hi Jeri. Margaret is unable to answer your question without a proper assessment. You should either consult with a Physical Therapist close to home or consider this service. http://melioguide.com/services/phone-or-online-consultation/
February 4, 2020 at 3:35pm
Jeri Ettleson
Hi Margaret, Thank you for all the helpful information on osteoporosis. I have been reading your book, and I have been doing your DVD. I am 60 years old. I had a fragility fracture of T9 mid August 2019 (about 6 months ago). Before the fracture I was very active and exercised regularly. Now my lifestyle has changed and I cannot be nearly as active as I was. About 3 months after the fracture I went through several weeks of physical therapy, but I still have pain. What is unusual is that the pain comes later in the day and it is on the right side of my abdomen in the front (just under my ribs). The pain is not in my back! It subsides if I lay down. I have asked many health care providers and no one has ever heard of this type of residual pain from a thoracic compression fracture. Have you ever heard of this type of pain? I am unsure how best to treat it. How long does it typically take for the pain from a spinal compression fracture to go away? Also, through the years, I have suffered rib pain from doing very innocuous things (like turning over in bed, or receiving a hug). My ribs were not fractured, but it took several weeks for the pain to resolve. Could these rib pain incidents be related to osteoporosis?
February 7, 2020 at 11:58am
Richard Martin replies
Hi Jeri. Margaret is unable to answer your question without a proper assessment. You should either consult with a Physical Therapist close to home or consider this service. http://melioguide.com/services/phone-or-online-consultation/
August 30, 2020 at 4:58am
Deborah
Hi, I had a crush fracture of T8 4 months ago. I still suffer pain and discomfort. If I don’t brace myself correctly when I sneeze I feel a terrible crushing pain. Similarly to Jeri Ettleson, most of my pain is on the right side, but at the back, through the rib area. My physio has given me stretching and strengthening exercises to do. I have days when I feel the pain is never going to go away.
Will I ever be pain free?!
September 13, 2020 at 1:49pm
Margaret Martin replies
Hi Debbie, I am sorry about your T8 crush fracture. Four months is still early days. It is common for the pain from thoracic crush or compression fractures to be felt in your rib area. This is because the nerves that exit the thoracic spine from T2 to T12 wrap around the torso to innervate the back, sides, and front of your body as well as your organs.
Brenda had pain for almost a year before it gradually started to subside. I still see her once or twice a month for massage, taping, and exercise modifications and she has managed to keep herself pretty much pain-free.
Other clients have told me they have to be very diligent about avoiding anything that exacerbates the pain. We talk through modifying activities that include how to safely feed their cat, etc.
Be sure you communicate openly with your physio so that she/she can ensure that all the exercises you do do not increase our pain. Also, do not assume that your physio understands osteoporosis be sure to ask what training or postgraduate courses they have taken in the area.
Be vigilant about your activities of daily living - go back often to the link to safe moves located inside Exercise for Better Bones.
Stay safe.
Margaret
September 13, 2020 at 4:37pm
Ann Bouwkamp
I’ve had four compression vertebral fractures ...so sorry for your pain and I sympathize with you. My pain lasted approximately six months each time. I started Prolia last December with my second injection being in June of this year (2020). I feel very good and had been at Mary Free Bed, a rehabilitation facility to build core muscle. I walk approximately five miles daily and as of this October, I will be at a year since a fracture. Mary Free Bed has been a God send as they have specialists in osteoporosis. Hope you improve and daily living becomes easier for you.
October 26, 2020 at 7:08pm
publichistoryuiuc
I am very grateful for this site and especially the exchange between Deborah and Margaret. I have a T6 compression fracture of "indeterminate age," according to the x-ray tech, but I think it is at about 3 months old and have been wondering why it still hurts. After finally seeing a spine specialist today and doing some more reading on the web I can now see that I am being too impatient, especially as I did not know until it was detected 3 weeks ago that that was my problem. I was told today that complete healing can take a year. I am hoping that with more careful moving, which I have been trying to do, I will feel better, and eventually get to the point that I can do more than take walks to strengthen my bones. I am sorry many others are also in such pain, it certainly is life changing in a number of ways. But it is relieving to see that people are finding ways to go on. I will definitely look for the book, though I'm not sure I'll be up to exercises for awhile (spine doctor said no PT yet, though maybe later it would help, just walk for now). But advice on daily movement is very helpful. I'm finding there is more of this on sites from Canada than here in the U.S., yet another thing to be envious of!
November 3, 2020 at 9:14am
Margaret Martin replies
I will share your comment with Deborah. She like many of my clients find alot of relief to their pain by spending a little time 5 - 10 minutes lying as flat as they are comfortable being and doing a gentle chest stretch, you will find this in the Posture Exercise section of my book.
You should not hesitate to purchase Exercise for Better Bones. The daily activity guide which is far more extensive than what I have online is a must after a compression fracture. I would also encourage you to explore all Posture exercises which are far more gentle that the task we do everyday. As well the safe stretches and certainly the Beginner Balance exercises would all be appropriate and helpful for you at this time.
Glad you are walking, it is good for our body and spirit as well as being good stress management tool.
Keep well. Stay safe.
October 27, 2020 at 7:21am
Ann Bouwkamp
I just fractured my fifth thoracic vertebrae from severe osteoporosis. I’m glad you are doing well. It does take up to six months plus. I went to Mary Free Bed Rehabilitation Facility in Grand Rapids, Michigan for PT. I learned lots of exercises to help build strength. I walk approximately 5-6 miles daily. I think it is very important to have a physical therapist who specializes in PT for osteoporotic patients. They also taught me about how to pick things up, laying in bed, etc. They likened the healing to when a knuckle has a skin crack and if you keep bending it that it takes longer to heal. I bought a long handled grabber. It’s helped tremendously. I will also be getting my third Prolia treatment. It’s very painful but MFB PT gave me hope. (I’m 69 years old and need to do whatever I can to keep upright.) Good luck as you heal.
November 7, 2020 at 1:32pm
Kathryn Oberdeck
Thanks so much. I will definitely get the book. I'm re-entering my information because apparently I was searching around your blog on one of my work emails rather than my personal one. Unfortunately in the week after my meeting with the spine specialist my pain got a lot stronger. I think I moved the wrong way a few times while cooking and shopping and now have learned the cost of that. Now I can't get out of bed unassisted and have had to pester my doctors about pain medications. They ended up with Tramadol at least at night but I am nervous about going this route.... Anyway, this site remains very helpful in terms of my thinking about what I can and can't do. I'm university faculty, and it struck me today that if we weren't teaching from home because of the pandemic I would have had to take time off, I don't know how I could have gone into the classroom. Anyway, I'm impressed by all these brave folks and just trying to find out as much as I can regarding what I can safely do to help myself get better and prevent more fractures, and how I can keep from getting discouraged. Brenda's video was very helpful in terms of all of this.
November 8, 2020 at 8:21am
Richard Martin replies
Thank you.
January 6, 2021 at 11:15am
Kathryn Oberdeck
Hello, a question about DXA scans if you can answer....subsequent to this whole discussion I had a DXA scan that seemed to indicate that my bones were actually in good shape for a 30 year old, much less for an almost 63 year old like me. As I have even more recently had a second in 2 spine x-rays that indicate "demineralization" along with additional vertebral compressions, I am confused, as well as alarmed. Since you deal with osteoporosis patients I am curious.....can a DXA scan be completely wrong? They did not tell me as they were supposed to not to take calcium 24 hours before, could that make a difference? Desperate to know what really is causing all this and how I can best help myself. Primary's nurse's answer was "well, you have osteoarthritis so that is also causing bone weakness".
April 24, 2021 at 8:32am
Pamela Winsor
I have two lumbar fractures, L1 and L5,from an unfortunate movement I made last week. I bought a brace and am taking tylenol, and using Lidocaine patches, The pain is difficult. I iive alone and shopping, doing dishes, cooking, laundry are all hard. I am afraid of making things worse.
My main question is whether it is okay to take a walk, in the middle of the day when pain is a little better. I bought a brace. I would like to try a short walk but don't want to make things worse.
Oh- and tying shoes is definitely a problem!
I already own your book. Thank you!
May 14, 2021 at 7:05am
Richard Martin replies
HI Pamela. Margaret cannot give out medical advice without a consultation. Please bring this question to your physician. Thank you.
April 1, 2023 at 6:40pm
Shirley Bell
Hi, I was in a car accident 4 weeks ago and sustained a burst compression fracture of L2 (major injury, more minor injury was hairline fracture if sternum and some bruising various places). I am finding your site very informative, I have a couple of questions though - since my fracture is traumatic in nature and not due to osteoporosis/osteopenia am I still able to follow your progression of exercises and movements? Also, when I was discharged from the hospital (admitted x 8 days) I was not told when exactly I would be able to start seeing my physiotherapist to start a proper program. I have an appointment with the orthopedic surgeon 8 weeks post accident, and I did not need surgery as there was minimal intrusion into the spinal cord (no paralysis). I was shown how to get into and out of bed and good posture while using a Rollator, so for now I'm at home and being very careful how I move and walking back and forth in my house over and over! I've been unable to contact the surgeon's office to ask questions so have no guidance there - sorry for the long-winded second question but do you think I should get your book and start exercises or wait until the appt with the Ortho surgeon? I'm normally a very active and healthy person (alpine hiking, trail running, active job)! Thank you for any input you may have, I wish I lived closer to you and could see you in person! (58 F near Hamilton ON)