What is Osteopenia & Osteoporosis?

Osteoporosis is a condition that develops when bone mineral density and bone mass decreases, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures (broken bones). Osteoporosis is known as a silent condition as it does not cause pain, and is usually only picked up when a patient first has a fall or fracture.

Osteopenia is the pre-decessor to osteoporosis. It describes a decrease in bone mineral density (BMD) below normal reference values on a dexa scan, yet not low enough to meet the diagnostic criteria for osteoporosis.

The World Health Organisation (WHO) defines osteopenia as a t-score on a DEXA scan between -1 to -2.5, while values less than -2.5 are diagnostic for osteoporosis.

How is it diagnosed?

A DEXA scan is used to check your bone density. You can be referred by your GP. It is especially important to have your bone health checked if you have any of the following pre-disposing factors:

• Aged over 40-50 years

• History of fractures

• Family history of osteopenia/osteoporosis

• Previous long term steroid use (This includes steroids for asthma treatment)

• Previous cancer treatment

• History of thyroid problems

• Malabsorption issues - (Crohn’s Disease, Digestive/Gut problems)

• Early menopause

• Dietary changes

• History of anorexia/bulimia in youth/currently

How can I prevent Osteopenia/Osteoporosis?

Most of our bone density is built in our teenage years to our 20’s and our bone mass peaks as we approach 30 years old. It is important in these years to participate in impact exercise (running, jumping, skipping, weight-bearing exercises through our wrists and legs) as well as strength training with heavy weights. Nutrition is also important; ensuring we are consuming appropriate levels of vitamin D and Calcium, especially for bone building.

Osteoblast Class

Our Osteoblast Class is an evidence-based bone health program for those with a diagnosis of Osteopenia or Osteoporosis*. Designed by our Senior APA Physiotherapist Roisín Whitford, the program commenced in August 2022 and has been growing in popularity ever since. Roisín previously worked in the Orthopaedics and Trauma sector in the UK, and has experience in early fracture detection and best practice management. Her goal is to identify people at risk of fracture and bone density issues and prevent it in the first instance. We also run a Saturday Osteoblast Mat (Pilates for Osteopenia/Osteoporosis) to complement this class. 

We recommend you attend an Initial Consultation with one of our Physiotherapists to discuss your bone health history, fracture history, medical history and any falls history prior to joining this bone health program. For your initial appointment, we ask that you bring (if possible) any DEXA scan (bone density scan) or available x-rays. You can also forward these to reception@totalphysiosydney.com.au. Your initial assessment will include balance and strength tests to establish your baseline prior to entering the program and an opportunity to discuss any pre-existing muscle/joint injuries. Outcome measures^ are recorded and reported back to your GP. You will also receive an Osteoblast report and it is recommended you rebook 12 weeks later for repeat testing. Every client who enters the program will receive a hard copy or digital education pack via email, which explains the condition in more detail, pre-disposing factors and nutritional advice and education on safe lifting and bending techniques.

Our Osteoblast Class is a 45-minute small-group (up to 8 participants) circuit-style exercise session. The class incorporates:

• Progressive tracked strength training - Clients in this class often start lifting lighter dumbbells and build up towards 40kg+ barbell lifting as able.

• Weight-bearing exercises - This is to build-up strength around joints at risk of fracture - particularly the wrist joint and hip joint.

• Progressive impact exercises - To build bone density.

• Pilates-style balance and stability training - For falls prevention.

• A positive, fun and supportive group exercise environment.

Thrive Mat (Pilates for Osteopenia/Osteoporosis) 9am Saturdays

• A Beginners Mat Pilates class for people with a diagnosis of osteopenia or osteoporosis.

• The class is underpinned by the 5 key concepts of pilates: breathing, centering, rib cage placement, shoulder blade placement, head & neck position.

• Focuses on movements to strengthen the muscles surrounding the pelvis, hips, spine and wrist, which are the most common areas affected by osteopenia/osteoporosis and are at risk of fracture.

• The class also incorporates balance and stability movements to prevent falls.

Why is this program important?

It is in line with the goals of the National Strategic Plan for Osteoporosis, as set out by the Australian Government Department of Health.

• We strive to bridge the gap between diagnosis and appropriate bone health management, with falls and fracture prevention, to empower patients to take control of their own bone health.

• It is also in line with best practice current exercise recommendations for bone health as per Healthy Bones Australia Recommendations Update Feb 2024.

What the current exercise recommendations for osteopenia & osteoporosis?

• Resistance (Weight) Training 2-3 Days Per week; 2-3 sets of 5-8 reps; 5-8 Effort on BORG Scale (Rate of Perceived effort)

• Weight-Bearing Impact Exercise Minimum 3 days per week. Gradually increase to >2-4 times body weight as tolerated

• Balance/Mobility Training Minimum 3 days per week. Progressively Challenging

• Posture/Spine Exercises 2-3 days per week. 2-3 sets of 10-15 repetitions

When are the classes?

Osteoblast Class: Monday 11:30am - 12:15pm, Tuesday 5:00pm - 5:45pm, Wednesday 11:30am - 12:15pm & 12:30pm - 1:15pm, Friday 10:30am - 11:15am with Roisín Whitford

Thrive Mat (Pilates for Osteopenia/Osteoporosis) 09:00am-09:45am with Michaela Murphy

Can I claim on my Private Health Insurance?

Yes, this program is claimable on Private Health Insurance under Item # 560. If you have a Medicare Care Plan, this can be used towards 1:1 consultations as part of the program. If you intend to claim through Private Health, please contact our clinic and we will send you a monthly statement to be lodged directly with your health fund provider.

How do I join?

You must be referred into this class by one of our Physiotherapists after a 1:1 Initial Consultation to establish your baseline entry level and complete your initial Osteo-blast report card. Send us an email, call or drop into our clinic! Healthcare providers can email their referrals to: reception@totalphysiosydney.com.au.

Please note that, as this is a clinical program, our Reception/Physio team will need to reserve your spot in this class and you will not be able to book online via our app.

*NB exclusion criteria: Acute fracture within 6-8 weeks

^Outcome measures: FRAX score, Grip Strength, Strength 5RM and CTSIB