For many people, a diagnosis of osteoporosis comes as an unwelcome surprise and the implications we typically associate with it can leave us reeling – at least in the short term. Here are some examples of initial reactions some of my patients have shared over the years:
“I was already feeling a little down…you’re getting older, your body is changing. It felt like a downward spiral. I left the doctor’s office and just cried.”
“I feel fragile now…like I’m already broken.”
“I’m worried, scared, and completely overwhelmed.”
“I’m so afraid of breaking a bone that I’ve stopped doing everything.”
These types of emotional responses are quite common, and perhaps you relate to some, or all of these feelings. I’m reminded of my own reaction of disbelief when first diagnosed almost twenty years ago – ’How could this have happened to me? I’ve been exercising, eating well…”
What we must avoid, however, is allowing these feelings of worry and anxiety to lead to what is called “fear-avoidance behavior” – one of the reactions described above.
Defining Fear Avoidance Behavior
Fear-avoidance behavior is a psychological response where individuals avoid certain activities, movements, or situations because they fear pain, injury, or a worsening of their condition. This excessive worry can not only develop after experiencing pain or injury, but also simply after receiving a diagnosis that is perceived as potentially leading to those injuries. The associated inactivity often leads to muscle deconditioning, decreased flexibility, and sadly, wind up being the very cause of what was feared – a fracture. Let’s be clear, the worst thing we can do is nothing!
Dispelling Fears and Misunderstandings
Please check out my previous blogs about preventing falls, the best exercises to do, nutrition, and all things bone health related, but here, let’s take a moment to dispel three of the most common fears people experience when faced with a diagnosis of osteoporosis.
Fear of Falling and Fractures: The research is clear: Adults who exercise regularly (including walking) are far less likely to fall and therefore experience far less fractures. A review of 16 meta-analyses showed consistent evidence that exercise significantly reduces fractures in community-dwelling adults > 60 years. (1)
Fear of Stooped Posture: There is abundant evidence that back strengthening exercises improve posture, reduce hyperkyphosis*, and prevent the vertebral fractures that often lead to “stooped” posture. (2)
Fear of Loss of Independence: Scores of research studies demonstrate the correlation between maintaining (even modest) physical fitness and remaining safely in one’s home. (3, 4)
When Osteoporosis Makes You Feel Old
Staying active, especially in ways that bring you joy, is one of the most important lifestyle habits we should nurture. Engaging in social activities, hobbies, or new learning experiences can be fun and enriching.
One thing I also do is reject negative stereotypes associated with aging. When I come across real-life examples of this, I post them on my “vision board”. One such example is a woman who took up track and field in her seventies because she was “bored”, AND, she had osteoporosis! (5)
Another example came last year when I attended the annual Physical Therapy convention in Boston. At the end of a lecture about aging well, we were all treated to a performance by a dance group called “The Pacemakers”. It was fabulous, and I loved watching how much fun they were all having! Please check out this two minute video – it’s very uplifting. https://www.youtube.com/watch?v=YS5R272tjvc
Osteoporosis may be a part of aging, but it doesn’t have to define how we feel about ourselves. Taking proactive steps by exercising safely and consistently, aiming to maintain as healthy a lifestyle as possible (remember, nobody is perfect), and striving for a positive mindset is key.
I hope to see you in Strong Bones class!
- Stubbs B, et al. What Works to Prevent Falls in Community-dwelling Older Adults? Umbrella Review of Meta-analyses of Randomized Controlled Trials. Physical Therapy 2015 Aug;95(8):1095-1110.
- Katzman WB, et al. Targeted Spine Strengthening Exercise and Posture Training Program to Reduce Hyperkyphosis in Older Adults: Results from the Study of Hyperkyphosis, Exercise, and Function (SHEAF) Randomized Controlled Trial. Osteoporosis International 2017;28(10):2831‐2841.
- Liu CJ, et al. Progressive Resistance Strength Training for Improving Physical Function in Older Adults. Cochrane Database System Rev. 2009 July 8; (3): CD002759.
- Lousuebsakul-Matthews V, et al. Non-sedentary Lifestyle Can Reduce Hip Fracture Risk Among Older Caucasian Adults: The Adventist Health Study-2. British Medical Journal 2015; 8(3): 220-229.
- Grierson, B. What Makes Olga Run? Henry Holt and Company, LLC, NY, 2014.
