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A student of my Physical Therapy continuing education course for Physical Therapists on the treatment of osteoporosis, Building Better Bones, asked me to discuss if a client has postmenopausal osteoporosis symptoms.

There are a number physical postmenopausal osteoporosis symptoms that can help you, the health care professional, determine if your client is at risk of osteoporosis.

I cover these individual postmenopausal osteoporosis symptoms in my course — MelioGuide Building Better Bones. This course is a continuing education and professional development for Physical Therapists, Kinesiologists, and Occupational Therapists.

One leading sign of the presence of osteoporosis in your client is the distance between the rib and pelvis.

I was recently contacted by a MelioGuide Building Better Bones student to provide more clarity about rib to pelvis distance as a clinical indicator of osteoporosis.

osteoporosis guidelines from melioguide

Postmenopausal Osteoporosis Symptoms

Rib – pelvic distance of less than 2 fingers breaths has been identified as a clinical indicator of osteoporosis. Could you more clearly define how you measure rib-pelvic distance and let me know what is ideal?

No Space Between Rib and Hip Bones

If there is no space between the rib and hip bones, this is an indicator of postmenopausal osteoporosis symptoms. The rib — pelvic distance (space between the rib and hip bones) is usually 2 to 3 finger-breadths.

When someone starts to get vertebral compression fractures the height of the vertebra is reduced sometimes by 60% or more of the original height.

Thus a compression fracture in the lumbar spine would significantly reduce the overall distance between the pelvis and the ribs (space between the rib and hip bones).  Some of my clients no longer have any space left between their ribs and their pelvis.

The floating ribs can actually settle into the pelvis.  It can be a source of discomfort.

How to Measure Space Between Rib and Hip Bones

  1. The patient stands erect with arms outstretched at 90 degrees.
  2. The examiner stands behind the patient and inserts his or her fingers into the space between the inferior margin of the ribs and the superior surface of the pelvis in the mid-axillary line.
  3. The rib-pelvis distance is the closest whole number of finger-breadths between these structures.

Physical Therapy Continuing Education

To learn more about how to Physical Therapy Continuing Education, visit my page dedicated to Physical Therapy Continuing Education.


August 3, 2015 at 10:23pm

Stephani Gelsinon

Thanks for your informative website. I am interested in purchasing your books.

August 4, 2015 at 9:13am

Richard Martin replies

Hi Stephani:

Margaret's books are available on Amazon.

February 22, 2021 at 7:04am

Toby Cooper

Have you trained any therapists who are in the New York-Long island area? Please email me at xxxx. Thank you.

February 22, 2021 at 9:54am

Richard Martin replies

Hi Toby. For a number of years, our training course was available via MedBridge. It is possible that there were therapist trained near you but we do not have access to that list. We have the course on our site but we have not seen anyone join from your region. If you are comfortable with remote consultation, Margaret provide a Zoom based coaching consultation:

I have removed your email from the post as that invites SPAMMERS. Good luck with your search.