exercise • safe movement • tai chi • overtraining
Guidelines for Safe Movement
Keeping active is one of the best ways to maintain
bone health. A person who has had an osteoporotic
fracture may avoid routine or new activities for fear of
experiencing another fracture. However, experts
recommend that people with osteoporosis continue to be
active and involved in activities at home, work and in
By practicing proper posture and learning the correct
way to move (called body mechanics), you can
protect your bones while remaining physically active.
One of the most important concepts in body mechanics and
posture is alignment, which refers to the
relationship of the head, shoulders, spine and hips to
each other. Proper alignment puts less stress on the
spine and ensures good posture. A slumped, head-forward
posture puts harmful stress on the spine, as does
bending forward or twisting your spine.
For the person with osteoporosis, general muscle
strength and flexibility is especially important.
Keeping active helps maintain muscle tone, reflexes and
balance. Follow these guidelines to move safely
throughout your day.
- Stand with your back against a wall with your
heels 2 inches from the wall.
- Tighten your abdominal muscles and flatten your
back against the wall.
- Lift your breastbone, keep you head up and look
- Bring your shoulders back towards the wall.
There should be a small hollow at the small of your
- Maintaining this position, move away from the
wall and check your posture in a full length mirror
from the front and side.
- Wear comfortable, supportive shoes with
Keep your head high, chin in,
shoulder blades slightly "pinched." Maintain the
natural arch of your lower back as you flatten
your stomach. Your feet should point straight
ahead with your knees lined up over your second
toe. If you are standing in one place for any
length of time, put one foot up on a stool or in
an open cupboard. Switch feet periodically.
When sitting, use a rolled towel or
pillow to support your lower back. The support
should be thick enough to cushion your lower
back and maintain the normal arch. Keep your
head, back and hips in alignment, and keep your
hips and knees at the same level. If your feet
do not rest flat on the floor, use a small
footstool. When reading, do not lean over your
work, but maintain the natural curve of your
back. At a desk, prop up a clipboard so it
slants towards you like a drafting table. Use a
footstool or foot rest when seated for long
periods of time. To stand up from the chair,
move your hips forward to the front of the chair
and use your leg muscles to lift yourself up.
Walk with your chin in, head held
high and shoulder blades slightly "pinched."
Your feet should point straight ahead, not out
to one side. Your knees should be lined up over
where your 2nd toe is in your shoe. You may need
to turn the knee outward consciously in order to
line your foot up properly. Do not let your
knees lock back as you bring your weight over
your foot, but keep them slightly bent. Keep
hips, knees and toes properly lined up when
climbing stairs as well.
Bending and Lifting
To pick up an item, stand with your
feet flat and about shoulder-width apart from
one another. Both arms should touch your ribs or
thighs unless you are using one hand for
support. Maintaining your lower back curve,
squat, kneel or sit in a chair. Keep one foot
flat on the floor to keep equal force at the
hip, knee and ankle. Bring the item close to
your body at waist level. Gently breathe in
while using your leg and thigh muscles to lift
the object and straighten up. When you reach an
upright position, exhale. Never lift objects,
packages or babies weighting more than ten
|To tie your shoes or dry your feet, sit in a
chair, place your foot on a footstool or box,
maintain proper back alignment and lean forward
from the hips to tie or dry. When carrying
groceries, request that the bags be packed
light. Divide heavy items into separate bags and
hold bags close to your body. You may also use a
cart with wheels to transport bags from the
store to home or from the car into the house.
When unpacking, place packages on a chair or
counter top instead of the floor.
Consider using a fanny pack instead of a
|Housework can involve strenuous physical
exertion. For the person with osteoporosis,
proper body mechanics when doing chores is
essential. To protect your back from injury,
consider these movements for vacuuming, mopping
or sweeping floors, cleaning the bathtub, or
gardening. For vacuuming type activities,
maintain proper alignment by imagining your
upper arms strapped to your chest from shoulders
to elbows so they cannot move. Always face your
work directly to keep from twisting your back.
Keep your feet apart with one foot in front of
the other. Shift your weight from one leg to the
other to move the vacuum, broom, mop or rake
back and forth. Lean forward from the hips and
bend at the knees instead of the waist. Avoid
polishing floors to a high gloss, which makes
them slippery. If you wish to scrub a spot on
the floor on your hands and knees that's fine as
long as you can move up and down from the floor
easily and safely. Putting yourself in an "all
fours" position is a way to protect your back
when gardening as well. In the bathroom, use a
scrub brush or sponge on a long handle so you
can scrub in an upright or kneeling position to
keep your back straight.
Down in Bed or Getting Out of Bed
Sit on the edge of the bed. Lean
toward the head of the bed supporting your body
with both hands. As you lower yourself toward
the mattress, bring your legs and feet onto the
bed. Whey lying in bed on your side, use pillows
between your knees and under your head to keep
your spine aligned or roll onto your back
keeping your knees bent and moving your head,
shoulders and hips together. To get out of bed
reverse these steps. Keep both arms in front of
you. Breathe in and roll onto your side. Use
your hands to raise your upper body as you move
your legs over the side of the bed in one
motion. Sit on the edge of the bed for a moment
before standing up.
Use both arms together to avoid twisting your
spine. Don't reach for a shelf higher than you can
easily reach with both arms. Stand on a safety step
stool with high handrails or use a reaching device, but
only lift lightweight objects. Reorganize work areas so
items that are used regularly are stored at waist or eye
Coughing or Sneezing
Develop the habit of supporting your
back with one hand whenever you cough or sneeze.
Place your hand behind your back or on your
knee. This protects the spine and intervertebral
discs (the tough cushions of cartilage between
the vertebrae that act as shock absorbers) from
damage caused by a sudden bend forward.
for Safe Movement
- Don't walk or exercise on slippery
- Don't wear "scuffs" or "mules" (backless
bedroom slippers) or shoes with slippery
- Don't slouch when standing, walking or
sitting at a desk.
- Don't sit in a deep, cushioned chair or
couch that causes you to sink into it. Use
upright chairs with arms. Place your feet on
a footstool if they don't rest flat on the
- Don't move too quickly.
- Don't engage in sports or activities
that require twisting the spine or bending
forward from the waist, such as conventional
sit-ups, toe touches or swinging a golf
- Don't force yourself to complete a task
or exercise if you feel short of breath, are
in pain or are fatigued.
- Don't take to your chair or bed for
extended periods of time. Inactivity is one
of the worst things for osteoporosis.
Do's for Safe Movement
- Always pay attention to proper posture.
- Lift your breastbone.
- Keep your head erect and look
- Keep your shoulders back, lightly
"pinch" shoulder blades.
- Tighten you abdominal muscles and
- Whenever possible, walk or climb the
stairs. When walking stairs, always use the
- Always bend from the hips and knees, not
from the waist.
Almost every activity can be adapted to meet your
age, ability, lifestyle and strength. Therefore, you may
wish to speak with your doctor, a physiatrist or
physical therapist about your special concerns regarding
safe movement and posture before practicing any of these
movements, posture exercises or activities in the video.