Symptoms
- ■ No symptoms in early stages — often discovered only after a low-trauma fracture
- ■ Back pain from vertebral compression fractures causing height loss and kyphosis
- ■ A gradual stooped posture (Dowager's hump) from multiple vertebral wedge fractures
- ■ Fractures from minimal trauma such as a fall from standing height or even a cough
- ■ Hip pain and difficulty walking after a hip fracture, which is a medical emergency
Causes
- ■ Postmenopausal estrogen deficiency accelerating bone resorption over formation
- ■ Age-related decline in bone-forming osteoblast activity and calcium absorption
- ■ Prolonged corticosteroid use suppressing bone formation and increasing resorption
- ■ Calcium and vitamin D deficiency impairing bone mineralization
- ■ Sedentary lifestyle lacking the mechanical loading stimulus needed for bone maintenance
Diagnosis
- ■ DEXA scan (Dual-energy X-ray absorptiometry) measuring bone mineral density T-score at hip and lumbar spine
- ■ FRAX tool calculating 10-year major osteoporotic fracture probability
- ■ Blood tests for Vitamin D, calcium, PTH, and markers of bone turnover (CTX, P1NP)
- ■ Fall risk assessment using Timed Up and Go Test and Berg Balance Scale
* Evidence-Based Interventions
Clinical
Approaches
Weight-Bearing Exercise
Targeted ground-reaction force loading exercises (walking, step training) that stimulate osteoblast bone-building activity.
Resistance Training
Progressive strengthening of major muscle groups creating bone-stimulating mechanical forces at attachment sites.
Balance & Fall Prevention
Multifactorial fall risk reduction including balance training, home hazard assessment, and footwear review.
Posture Correction
Thoracic extension exercises to counteract kyphosis and reduce vertebral fracture risk from forward loading.
🏠 Home Exercises Guide
Strengthen your recovery. Perform these exercises strictly under pain-free limits:
📋 Execution Blueprint: Heel Drops (Bone Loading)
- 1Stand tall beside a wall or sturdy surface for light safety support.
- 2Rise up onto your toes as high as possible, raising both heels off the floor.
- 3Drop your heels down to the floor with a deliberate, firm impact (not a controlled lowering).
- 4The heel impact generates ground reaction forces that stimulate hip and spine bone formation.
- 5Perform 10-20 heel drops daily as part of your bone-loading program.
* FAQs
Common Questions
Yes, weight-bearing and resistance exercise stimulates osteoblasts (bone-building cells) to increase bone formation. Studies show 1-3% BMD improvements at the hip and spine with structured exercise programs over 12 months.
Yes, with appropriate modifications. High-impact exercises are avoided for severe osteoporosis. Instead, we prescribe safe bone-loading exercises, balance training, and progressive resistance that are safe and beneficial.
Avoid: high-impact exercises, spinal flexion under load (forward bending exercises like sit-ups), combined spinal flexion-rotation, and activities with high fall risk (e.g., contact sports). We teach safe alternatives for all these movement patterns.
FRAX is a WHO-validated tool that uses age, sex, BMI, fracture history, and other risk factors to calculate your 10-year probability of a major osteoporotic fracture (hip, spine, wrist, humerus). It guides treatment decisions.
All women should have a baseline DEXA scan at menopause or at age 65. Younger women with risk factors (smoking, steroid use, family history, low BMI) should be screened earlier.
Vitamin D is essential for intestinal calcium absorption. Deficiency leads to secondary hyperparathyroidism, which drives bone resorption. Given Vellore's climate, we assess Vitamin D levels and supplement if below 30 ng/mL.
Yes, post-vertebral fracture physiotherapy focuses on pain relief, gentle mobilization, thoracic extension exercises to reduce progressive kyphosis, and critical fall prevention training to avoid further fractures.
Hip fractures in the elderly carry a 20-30% one-year mortality rate due to complications. This underscores the critical importance of both preventing falls and maintaining good bone density throughout aging.
Begin Your
Recovery Today*
Comprehensive clinical assessment within 48 hours.
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Includes clinical check, analysis, and personal recovery planning for Osteoporosis & Bone Health under Dr. Karolin Rockson, PT (BPT), Ex. CMC - Vellore.
Verified Author Protocol
Dr. Karolin Rockson, PT (BPT), Ex. CMC - Vellore
Board: Indian Association of Physiotherapists (IAP)
Reg No: PT-84729