Until you get the book, any stretch where you are lying flat on your back or your stomach you know is safe.i.e. The physiotherapist used hot pads, electrical pulses that stimulate the muscles, acupuncture, and a minimal amount of ultrasound. Examples include the Jewitt, cruciform anterior spinal hyperextension, and Taylor brace. Also, through the years, I have suffered rib pain from doing very innocuous things (like turning over in bed, or receiving a hug). Did I mention Im ONLY 39 years old, and have had ZERO trauma to my back? 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. Avoid a memory foam mattress if you keep your room cooler than 65 degrees Fahrenheit at night (because they get too stiff). Use a pillow between your knees and ankles when sleeping on your side. Also, I cant seem to find the kyphosis weighted vest that Brenda is wearing. Brenda did. Consider this a temporary set back and an opportunity to learn very good body mechanics. The first 8 weeks are the hardest. The daily activity guide which is far more extensive than what I have online is a must after a compression fracture. She could hardly lift my head up off the floor. Consider wearing a waist belt to support the space between your lower ribs and pelvis. This article was last updated on October 10, 2022, Exercise Recommendations for Osteoporosis, Stronger Bones Stronger Body workout video, Dowagers Hump, buffalo hump, or neck hump, http://hudson.org.au/latest-news/muscle-mass-crucial-to-preventing-bone-fractures-in-young-people-with-cerebral-palsy/, https://melioguide.com/health-guides/better-sleep/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800651/, https://melioguide.com/health-guides/activities-of-daily-living/, https://melioguide.com/services/phone-or-online-consultation/. Margaret Martin is a Physical Therapist with 36 years of clinical experience. 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. I had a fragility fracture of T9 mid August 2019 (about 6 months ago). The exercises I have listed are appropriate as spine fracture treatment exercises and thoracic compression fracture exercises. Unlike people with sciatica, your back pain most likely will not be, if its from a vertebral fracture, will not be going into the leg. 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. Thank you again. I am 60 years old. To practise these exercises, follow the film or download the accompanying fact sheet, ' Exercises for back pain after spinal fractures '. I answer each of these questions in this blog post. She has said walking and stretching, but not what kind of stretching. 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. 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. If you understand intellectually what the exercise will do, then she really motivated in terms of her everyday life. Thanks for your thoughts. I unfortunately do not know of anyone in Winnipeg. Here are several movement strategies that will reduce your risk of a compression fracture. It has really helped with that long muscle in her back that is strained. Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Before the fracture I was very active and exercised regularly. I had never hurt my back before so had no idea what to expect. The weakened trabeculae in osteoporotic bone cant withstand those excessive forces. I just fractured my fifth thoracic vertebrae from severe osteoporosis. I still cannot walk or even sit independently without having to hold myself up. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program. If you are a woman, especially if you are post . Brenda finds that ittakes the 10 minutes for her body to release and relax into the stretch. Get fit and exercise. I was not familiar with paracetamol/ibuprofen protocol. Mum 83 is 4 weeks post L3 fracture. As such their use needs to be carefully balanced in the geriatric patient. ' 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. I have burning in my right flank, but only when I have been doing something to bring it on.like weeding the garden. I could not sit around even if I wanted to I had to keep moving so my back was not cramping and seizing up. Im wondering if you could please clarify which brace is better for kyphosis due to thoracic fractures along with bulging discs in lumbar area. I am also going through the decision of what to do re pharmaceuticals have not taken anything yet. Most of the fractures occur at the thoracolumbar junction. Products and services. Other conservative therapeutic options include limited bed rest, bracing, physical therapy, nerve root blocks, and epidural injections. She uses it for support when sitting in a chair because it helps cushion the lumbar area. Following 8 weeks of healing you can gradually go back to strengthening and following a regular exercise program. It took approximately 6 months to get to the point of being able to do anything. We talk through modifying activities that include how to safely feed their cat, etc. Before we begin, I have a video that addresses many peoples concerns about starting an exercise program after a compression fracture. 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? However, I have a number of clients who took several months, even some as long as nine months, to be comfortable driving. Following a compression fracture in the spine, patients are often instructed to wear a brace for 6 to 12 weeks, followed by supervised physical therapy exercise. Of all the individuals that Ive worked with who have compression fractures, Brenda is the most positive and persistent client. She is licensed to practice Physical Therapy in Ontario and California. 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. I have been searching and searching for some real information about living with compression fractures. I was misinformed from my drs, office ! 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. Symptoms of Spinal Compression Fractures - WebMD However, you should take a look at how your bone mineral density (BMD) scores have been changing over the last decade. This is so much more information that I have received from all the health professionals I have been consulting with. Exercise is an essential ingredient to bone health. As they were going down the snow run they hit a few bumps enough to cause a lumbar compression fracture and considerable pain. Im university faculty, and it struck me today that if we werent teaching from home because of the pandemic I would have had to take time off, I dont know how I could have gone into the classroom. Not only will the actual fractures themselves get worse but you are at a higher risk of fracturing more and more levels. Newer research shows that it can hinder healing. Theimportance of good body mechanics and diligence during your exercises is really important despite having that type of intervention. 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. Thank you so much for these videos and information. The group that did just extension exercises (group #1) had a very low rate of fracturing. When she does her stretching exercises, she has it underneath her as well. Thank you for this video. Thank you for reaching out and caring. 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. This type of fracture can be caused by a fall, a car accident, or any other type of trauma to the spine. The most recent fractures occurred a couple of months ago. The indications for surgical management of lumbar compression fractures are discussed in Surgical Intervention. She finds that the prolonged fascial stretches make her feel good. Using firm, closed-fist percussion the spine will be examined over the entire length. 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. She has been interviewed as an expert in osteoporosis prevention and treatment by WebMD, the Toronto Star, CTV Ottawa Morning Live, the Senior Rehab Project podcast, and Dr. Rebecca Risk's podcast, Falling Through the Cracks. I learned lots of exercises to help build strength. And is there a method for tying my shoes? 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. Brenda had pain for almost a year before it gradually started to subside. I compression fractured my L4 7 days ago. This material is comprehensive and very helpful. I am a 39 year old woman, whom has been sincerely stricken down in the prime of my life, with vertebral compression fractures. Journal of Clinical Neuroscience 2006; 12: 31-38 (Level of Evidence 1B). My physio has given me stretching and strengthening exercises to do. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. I also have lost 3 inches in height which l also found stressful. However, this does not distinguish whether the anterior or posterior column is involved. The neck, calf, hamstring and quadricep exercises done as outlined in Exercise for Better Bones would be safe to do. I had a fragility fracture of T9 mid August 2019 (about 6 months ago). She used it to get out of bed and to the bathroom in the morning. Lateral compressions that can be the cause of scoliotic deformation. Take it one day at a time, one exercise at a time, and progress at a pace that works for you. As will the vitamin and HRT regimes I believe. Thats much safer on the spine. I dont like the idea of any but. L1, and L4. Spinelive Spinal compression fractures. Anteroposterior and lateral radiographs of an L1 . Brenda finds the strengthening exercises to be very beneficial. Would you be kind enough to tell me what stretches I can do safely in the meantime. I encourage listeners to exercise in a regular basis. Oh- and tying shoes is definitely a problem! In the video, you will see Pat, one of my clients, demonstrating how to garden safely. I have a referral to an endocrinologist, but Im not starting drug treatment until Ive weighed up all the options, risks and benefits. I went back to work on reduced hours. Hi Margaret, I may have misused the term protocol, I was referring to the timing and amount of medication. Since you deal with osteoporosis patients I am curious..can a DXA scan be completely wrong? Many of their techniques are contraindicated for individuals with osteoporosis. A l1 compression fracture is a serious injury that can cause pain, disability, and even death. Recovery From Spinal Compression Fracture Surgery - WebMD I am unsure how best to treat it. But, Brenda was not aware of the kinds of exercises that were detrimental to her spine. You should not hesitate to purchase Exercise for Better Bones. She became more careful, watched the calcium in her diet, her vitamin D levels, and continued her exercise classes. A surgical technique called vertebral kyphoplasty would be the only way to fix her T9 compression fracture. The lumbar disk works as a cushion for the mechanical loads. This field is for validation purposes and should be left unchanged. I was given time off work and painkillers then physio which which was very painfull especially the crippling spasms and cramp. Thousands of Physical Therapists in the United States, Canada and around the world have completed her training course. Loss of height A curved, stooped shape to your spine The pain typically happens with a slight back strain during an everyday activity like: Lifting a bag of groceries Bending to the floor to pick. Daily activities can be problematic. Both of these items are covered in this blog post and in the Exercise for Better Bones program. Because she was physically fit before the compression fracture, her muscle memory is coming back. I wish more people asked me this question because so many people dont realize that yes, your vertebral fracture can get worse. As far as the medication I cannot make decisions for you. https://melioguide.com/health-guides/better-sleep/ Margaret. Have ordered the book, and looking forward to taking charge of my own recovery! Can lead to an increased thoracic kyphosis with missing prevalent fracture of the vertebrae in older adults. BMC Musculoskeletal Disorders. Hi, my husband found your article and suggested I watch it. The spine Journal 2006; 6:479-487 (Level of Evidence 1A), Chieh-Tasai W, et al. You can find a good therapist in your area. When refering to evidence in academic writing, you should always try to reference the primary (original) source. 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). Osteoporotic patients might have a loss of height. 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. When its not there, she can really feel the difference. Yoga and osteoporosis should you practice yoga if you have osteoporosis? We know from previous tutorials that the vertebral body is composed of a hard outer coating. She broke the study set into four exercise groups: 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. 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. Have you ever heard of this type of pain? My thoughts after reading your article is that I may not should flex forward to tie my boots. Are there any studies done with that scenario? 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. When Brenda goes to the large shopping stores, she will lean on the cart handle to take some of the pressure off her back. In the photo above, Pat is bending forward in an unsafe manner. Brendas video was very helpful in terms of all of this. Print. Good luck as you heal. In the beginning, shortly after the compression fracture food preparation was limited to semi-prepared or prepared foods. This course is accredited by all Physical Therapy Licensing boards across the United States. Others have asked and although Brenda would love to have the time and energy to reach out individually lifes challenges do not allow her to do so. This site uses Akismet to reduce spam. Wow! In this tutorial, were going to look at why the lumbar and thoracic spine is more at risk than other bones in the body of a compression fracture. Learn more about compression fractures onmy Osteoporosis Guidelines page. Burst fractures are classified either stable or unstable. Involved in lateroflexion and rotation of the spine, but to a lesser extent. Safe compression fracture exercises and safe movement are critical to reducing your risk of another compression fracture. Other clients have told me they have to be very diligent about avoiding anything that exacerbates the pain. Use a heating pad to help your muscles relax. Thoracic and lumbar fractures associated with skiing and snowboarding injuries according to the AO comprehensive classi cation. 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. A cough, a sneeze, a slight bend at the waist, these are all activities that I was doing when I broke each individual vertebrae. Axial compression causing burst fractures. There is always room for more caring in health care. Stop the stoop how to avoid kyphosis and rounded shoulders. Because of the increased mobility, the lumbar spine is more susceptible to injury. 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. The goals of compression fracture exercise program are to: 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. [2], Acute phase: Localised tenderness over the involved level is a known characteristic for acute fracture. Preventing and treating osteoporosis is the best way to decrease your risk for compression fractures. Could these rib pain incidents be related to osteoporosis? Osteoporotic compression fractures of the spine; current options and considerations for treatment. [8]It is important that the patient overcomes his fear of movement (kinesiophobia) and continues with his/her activities. They are trying their very best. When Follow your physical therapist and doctor's instructions regarding resumption of any type of exercise following a compression fracture. https://melioguide.com/services/phone-or-online-consultation/. In regards to orthotic back braces, sometimes we get used to the braces and then we almost dont want to take them off. Hi Margaret, I have been reading your book, and I have been doing your DVD. Compression Fracture Of The L1 Vertebra: Causes Treatment And Recovery This is a substantial difference. 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. My patient, Brenda, is here to share with you how her life has been impacted by compression fractures. 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. Medium-firm mattress is often recommended but you have to find the one that is right for you. Meanwhile, my doctor has advised on what I should NOT do, but not what I CAN do. Any injury that changes the shape of a lumbar vertebra will alter the lumbar. Patient is standing in the front of a mirror with the examiner behind him. You can look at the videos at anytime and as often as you like. As bones in the spinal column grow weaker or collapse due to disease or injury, they compress against other bones, nerves and tissues, causing limited movement and range of motion, pain and numbness. As a result, they start to fracture. If you do not have the flexibility in your hips to do so you can get get a sock helper. We have covered a wide range of issues related to compression fractures. 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. The biconcave vertebral compression fracture, like the wedge fracture can have different levels of compression. There are two more videos later in the blog. 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. Margaret. This is why she wanted to share her story. I also got shingles 3 months after the accident which my physio did not believe and expected me to keep attending sessions. Find the most gentle exercise he can do without making his pain worse and progress from there. Family physicians can help prevent vertebral fractures through management of risk factors and the treatment of osteoporosis. In younger people who don't have osteoporosis, compression fractures usually result from trauma (such as a car accident) or cancer. Check with your doctor about the best weight -bearing exercises for you, such as: Walking Yoga. When she starts to feel achy, she sits down for 15 minutes and puts it on. With time I encourage you to progress the chest stretch by lying on your back over a rolled-up blanket. Once you have been given the green light by your physician or surgeon to exercise, you can also start exploring intercourse again. Pull one side of the tube back until it is close to your shoulder. I would like your opinion on a Forteo vs Prolia vs doing neither and doing diet and PT. 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. 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.