(646) 355-8777

Herman & Wallace Blog

Do You Know the Top 3 Signs of Osteoporosis?

Do you work with osteoporosis patients? This may be a trick question because you probably do whether you know it or not- even if you are a pediatric therapist! Osteoporosis is defined by the World Health Organization1 as a systematic skeletal disease characterized by:

  • Low bone mass
  • Micro-architectural deterioration of bone tissue
  • Consequent increase in bone fragility and susceptibility to a fracture

Osteoporosis occurs in men, women and even children. It is sometimes called the “silent disease” because often people don’t know they have it until they break a bone. And even then, compression fractures are painful only 20-30% of the time. Old fractures are often found on x-rays when a person is imaged for illnesses such as pneumonia. According to the National Osteoporosis Foundation2, about one in two women and one in four men over the age of 50 will suffer a fracture due to bone fragility. At this point in time, it is estimated 80% of patients entering Emergency Departments with a fragility fracture (a fall from a standing height) are never followed up for care.

As therapists, we see patients for a variety of diagnoses with co-morbidities but osteoporosis may not be listed. This could be because they have never been identified. We are in a prime position to screen for signs associated with the disorder. Below are the top 3 signs to look for:

  • History of fracture from minimal trauma (fall from a standing height, sneeze, lifting groceries, etc.) The typical fracture areas are wrist, hip, and spine although fragility fractures can happen anywhere in the body.
  • Hyper-kyphosis. Note, I said hyper-kyphosis, not kyphosis. We are meant to have a thoracic kyphosis but an excessive curve, particularly when it hinges around T8 area may indicate a collapse of the anterior portion of the vertebral bodies. This is the pie shaped wedging seen on x-rays and further increases the stress on the anterior aspect of the spine. Observe your patients’ sagittal posture for proper alignment.
  • Loss of height. Ask your patient their tallest height remembered; then measure them. A loss of 4 cm (1.5 inches) or more may indicate fractures in the spine.

Remember pain may or may not accompany a compression fracture. Patients may complain of a “catch” or muscle spasm or nothing at all. These quick and simple screens can alert the healthcare provider and may help prevent further disintegration of the bones. Research is showing that not only weight bearing exercises but a site specific back and hip strengthening program decreases the risk of fracture.3


1. World Health Organization. www.who.int
2. National Osteoporosis Foundation. www.nof.org
3. Current Osteoporosis Reports. Sept, 2010. The Role of Exercise in the Treatment of Osteoporosis. Sinaki M, Pfeifer M, Preisinger E, Itoi E, Rissoli R, Boonen S, Geusens P, Minne HW.

Connecting Breath and the Pelvic Floor
A Healing Journey around Boundaries, Self-Care and...

Upcoming Continuing Education Courses

Bowel Pathology and Function - Remote Course

Aug 7, 2020 - Aug 8, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Birmingham, AL (SOLD OUT)

Aug 8, 2020 - Aug 9, 2020
Location: Shelby Baptist Medical Center

Trauma Awareness for the Pelvic Therapist - Remote Course (Rescheduled)

Aug 8, 2020 - Aug 9, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Boston, MA (RESCHEDULED)

Aug 8, 2020 - Aug 9, 2020
Location: Marathon Physical Therapy

Colon System & Physiology - Remote Course

Aug 12, 2020
Location: Short Form Remote Course

Pediatric Functional Gastrointestinal Disorders - Pullman, WA (RESCHEDULED)

Aug 14, 2020 - Aug 16, 2020
Location: Pullman Regional Hospital

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Aug 15, 2020 - Aug 16, 2020
Location: Replacement Remote Course

Pediatric Functional Gastrointestinal Disorders - Remote Course (SOLD OUT)

Aug 15, 2020 - Aug 16, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Jonesboro, AR (Rescheduled)

Aug 15, 2020 - Aug 16, 2020
Location: Arkansas State University

Pelvic Floor Level 1 - Colorado Springs, CO (SOLD OUT)

Aug 15, 2020 - Aug 16, 2020
Location: Colorado Sport and Spine

Pelvic Floor Level 2A - Bangor, ME (RESCHEDULED)

Aug 15, 2020 - Aug 16, 2020
Location: Husson University

Mobilization of Visceral Fascia: The Reproductive System - Remote Course

Aug 21, 2020 - Aug 23, 2020
Location: Replacement Remote Course

Mobilization of Visceral Fascia: The Reproductive System of Men and Women - Salt Lake City, UT (Rescheduled)

Aug 21, 2020 - Aug 23, 2020
Location: Rocky Mountain University of Health Professions

Pelvic Floor Level 2A - Minneapolis, MN (Rescheduled)

Aug 22, 2020 - Aug 23, 2020
Location: Allina Hospitals and Clinics

Pelvic Floor Level 1 - Albany, NY (RESCHEDULED)

Aug 22, 2020 - Aug 23, 2020
Location: The Sage Colleges

Pelvic Floor Level 1 - Alexandria, VA (SOLD OUT)

Aug 22, 2020 - Aug 23, 2020
Location: Inova Physical Therapy Center

Pelvic Floor Level 2A - Remote Course

Aug 22, 2020 - Aug 23, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2A - Coon Rapids, MN

Aug 22, 2020 - Aug 23, 2020
Location: Mercy Hospital

Pelvic Floor Level 2B - Houston, TX (Rescheduled)

Aug 22, 2020 - Aug 23, 2020
Location: Texas Children’s Hospital

Breastfeeding Conditions - Princeton, NJ (RESCHEDULED)

Aug 22, 2020 - Aug 23, 2020
Location: Princeton Healthcare System

Pelvic Floor Level 2B - Manchester, NH

Aug 22, 2020 - Aug 23, 2020
Location: Franklin Pierce University

Pelvic Floor Level 1 Part 1 - Remote Course

Aug 27, 2020 - Aug 28, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 - Remote Course (SOLD OUT)

Aug 28, 2020 - Aug 30, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Charlotte NC Satellite Course

Aug 28, 2020 - Aug 30, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Garden City Satellite Course (SOLD OUT)

Aug 28, 2020 - Aug 30, 2020
Location: Metro Physical & Aquatic Therapy

Pelvic Floor Level 1 - Zion, IL Satellite Course

Aug 28, 2020 - Aug 30, 2020
Location: Replacement Remote Course

Postpartum Rehabilitation - Remote Course (SOLD OUT)

Aug 29, 2020 - Aug 30, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Maywood, IL (Rescheduled)

Aug 29, 2020 - Aug 30, 2020
Location: Loyola University Health System