Author: Arvin Alvea

Announcing New SAC Chair – Dr. Rowena Ridout

Written on October 1, 2021. Posted in Latest News.

Dr. Rowena Ridout is the new chair of Osteoporosis Canada’s Scientific Advisory Council. Rowena has been involved with Osteoporosis Canada since 2010 as an active member of the Scientific Advisory Council. Presently, Rowena is a member of Osteoporosis Canada’s Board of Directors and is involved in the development of the new clinical practice guidelines. She has sat on numerous SAC committees. Rowena was previously the medical advisor for COPN.

Dr. Ridout is an endocrinologist at the Toronto Western Hospital, University Health Network and a staff physician at the UHN/MSH Osteoporosis Program. She completed her undergraduate and postgraduate medical training at the University of Toronto. She has been involved in clinical research in osteoporosis including the attainment and maintenance of peak bone mass, the treatment of steroid-induced osteoporosis in boys with Duchene Muscular Dystrophy and interventions in the fracture clinic. She is an Assistant Professor of Medicine at the University of Toronto, and her primary academic activity is teaching and education.

Osteoporosis Canada and the Scientific Advisory Council would also like to recognize and extend sincere thanks to Dr. Sandra Kim for her work and leadership as the SAC Chair 2018-2021.

Please welcome Dr. Ridout!

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Make Bone Health a Priority & Reduce Your Risk of Osteoporosis

Written on September 22, 2021. Posted in OC Replay.

Osteoporosis is a disease that takes years to develop without any warning symptoms. Bone mass is gradually lost, making the bones weaker and more prone to fracturing or breaking. The first warning sign of osteoporosis is often a fracture.

Don’t miss our expert panel as they discuss the role of the pharmacist, nutrition and exercise to make bone health a priority and reduce your risk of osteoporosis.

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Cooking Demo Webinar: Grilled Beef and Halloumi Skewers

Written on August 20, 2021. Posted in OC Replay, Webinar.

Professional Home Economist Emily Richards demonstrates a great summertime meal. The featured recipe takes advantage of all the local produce available and uses thick-cut grilling steak like top sirloin or strip loin steak which goes further when cut into cubes for kabob skewers. The addition of Halloumi (a grilling cheese) is the perfect partner to the tender grilled beef and vegetables. Try serving with grilled rapini for a new way to enjoy a summertime veggie.

Each serving has 18 g protein and 175 mg calcium

All, Nutrition

PHAC Osteoporosis Key Findings

Written on August 18, 2021. Posted in Latest News.

Latest News

PHAC Osteoporosis Key Findings

August 18, 2021

Osteoporosis Canada has been working closely with the Public Health Agency of Canada (PHAC) over the past few years assisting in the collection of data in Canada’s Canadian Chronic Disease Surveillance System (CCDSS).

The following infographic Osteoporosis and related fractures in Canada, 2021 is based on the most recent CCDSS data and provides an update on key findings from PHAC’s 2020 Report. It is just one outcome in the last decade resulting from Osteoporosis Canada working in partnership with PHAC.

The infographic provides an update on key findings from PHAC’s 2020 report Osteoporosis and related fractures in Canada: Report from the Canadian Chronic Disease Surveillance System (CCDSS) 2020 using the most recent data available in the CCDSS.

Read the full report

Osteoporosis and Related Fractures in Canada cover

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Yoga and Osteoporosis: Suggestions for Safe and Appropriate Practice – Part 2

Written on August 12, 2021. Posted in Exercise, OC Blog.

Yoga has many benefits to mind, body and spirit. But for someone with osteoporosis or at risk of a broken bone, there are some movements that should be modified or avoided.

You should modify any postures or movements that:

make you bend your spine forward, backward or twist as far as you can (example: rag doll)
are done in sitting (example: seated twists)
force your hip into full rotation (example: pigeon)
are repetitive (doing a movement over and over – example: rolling like a ball)
rapid (moving quickly – example: jumping your feet to your hands from downward facing dog)
weighted (holding a weight or something heavy while you do the movement – example: Russian twist with a dumbbell)
any of the above in combination (e.g., repetitively bending forward as far as you can)

Sometimes it is not the end position that is the problem, it is how you get in and out of the position. For example, downward facing dog encourages a straight back and is a safe posture to do with osteoporosis – but, it is dangerous for your spine to get out of the posture by jumping your feet to your hands and rolling up through your spine.

A better way to transition out of downward facing dog is to drop to your knees. Come into standing by bringing one foot forward into a kneeling position and push up into standing, keeping your back tall and straight. If that is difficult or your balance is wobbly, then do it next to a wall or very sturdy chair. Downward facing dog is best done with a qualified yoga instructor to make sure it is done correctly.

You need to modify these movements because they put a lot of pressure on your spine and hip bones in ways that increase your risk of breaking a bone. Since osteoporosis already makes your bones more likely to break, you should try to decrease any other factors that could cause them to break. Modifying the movements listed above may help decrease your risk for a broken bone when practising yoga.

Here are some suggestions for yoga postures to continue to do, to avoid and to modify. This is not an exhaustive list but will help give you an idea of what you might need to start or stop doing. If you are uncertain, contact a physiotherapist for advice.

Wide angle shot of young mixed race female doing home workout or yoga from home, following an online workout on computer or online.

Yoga postures you can continue to do with proper instruction and guidance

Corpse
Bridge
Warrior
Mountain
Chair
Crocodile
Sphinx
Locust

Yoga postures you should avoid:

Spinal rocking
Rag doll
Saw
Plow
Pigeon

Yoga postures you should continue to do with proper guidance, instruction AND modifications:

Twists – don’t go as far as you can, do them lying down instead of sitting: in a knees-down twist lying on your back, rest your knees on a nearby wall or folded blanket so you don’t go too far
Child’s Pose – put a yoga block under your head or place your forehead on stacked fists to avoid a rounded back
Thread the needle – do it lying on your back, keep your head down on the ground to avoid a rounded back

What about props? Props should only be used when they help you make the posture safer or more aligned but shouldn’t be used to help push you further or deeper into a position. For example, you could use a sturdy chair to help you do a modified downward facing dog, but you shouldn’t use a yoga strap to help pull you further into a forward bend.

Chair yoga may be appropriate in some situations but could increase the risk for spine fracture if not done carefully. If you are very unsteady on your feet or are unable to get down to the ground, then chair yoga could be an option. However, you must be very cautious about alignment since all the yoga postures in chair yoga will be done in a seated position. Sitting puts a lot of pressure through the bones in the back, increasing the risk for a broken bone. Sitting and bending or twisting increases the risk even more. If you are doing chair yoga, you should be especially careful to modify bending or twisting the spine and focus more on postures that encourage a straight or lengthened spine. Standing or lying down are better positions to be in if they are safe for you. Hot yoga can cause people to overstretch into unsafe positions and should be avoided for people with osteoporosis.

With the guidance of an exercise professional who is trained to work with people with osteoporosis, yoga can be safe, beneficial and enjoyable. Remember to seek out a yoga instructor that has training to help you make modifications and a class that is appropriate for you, and to practise at your own level.

For more information on exercise for strong and healthy bones click here.

Written By

By Dr. Caitlin McArthur

Registered Physiotherapist, PhD

As featured in COPN’s Unbreakable Issue 14

Yoga and Osteoporosis: Suggestions for Safe and Appropriate Practice – Part 1

Written on July 16, 2021. Posted in OC Blog, Uncategorized.

One of the most common questions I get from people with a new diagnosis of osteoporosis is can I do yoga? Yoga is defined as “a system of physical postures, breathing techniques, and sometimes meditation derived from yoga but often practised independently especially in Western cultures to promote physical and emotional well-being.” While yoga has many benefits to mind, body and spirit, there are some postures that might not be safe for people with osteoporosis.

Some people may be worried about the yoga practice they have been doing for many years, while others may be wondering about starting yoga to become more active. Below you will find general guidelines for people thinking about starting yoga and those who have some experience, including what to look for in a yoga class and instructor.

THE RISKS AND BENEFITS OF YOGA FOR PEOPLE WITH OSTEOPOROSIS

Like all activities, there are risks and benefits of practising yoga. One risk of yoga can be to experience a fracture.

A fracture could happen when you are doing movements that could pose a risk such as the seated twist and pigeon pose, or if you were to fall. There have been case reports of people with osteoporosis experiencing fractures during yoga. On the other hand, yoga may benefit your quality of life and has been shown to improve balance for people with osteoporosis. However, there is not enough good evidence to say that yoga improves bone mineral density. Based on your own health and abilities, you need to decide if practising yoga is right for you. If you decide yoga is right for you, you also need to be sure to modify riskier positions.

OVERALL PRINCIPLES FOR A SAFE YOGA PRACTICE WITH OSTEOPOROSIS

Tip 1: Consult a physiotherapist if you are new to yoga, have a history of spine fractures, or you are feeling uncertain about what to do. It is especially important to find a physiotherapist who has training for working with people with osteoporosis. Bone Fit™ is a training program for exercise professionals, like physiotherapists, who work with people with osteoporosis. You can find a Bone Fit™ trained physiotherapist using the Bone Fit™ locator by visiting the website.

Tip 2: Seek out a yoga class designed for people with osteoporosis and other health conditions (e.g., osteoarthritis) and ensure your instructor has proper training for working with this population. Yoga instructors can also become Bone Fit™ trained and you can check the locator here. You should also make sure your yoga instructor is certified. Certified instructors are listed on registries such as Yoga Alliance.

Tip 3: Make sure your yoga instructor knows you have osteoporosis so they can give you the appropriate modifications throughout the class. If they don’t know, they won’t be able to help you practise safely.

Tip 4: Focus on controlled movements and less on intensity of the postures. Yoga is not about competition between you and the person on the mat beside you, so work at your own level and pace. Injuries can occur when you try to force yourself into extreme positions.

HERE ARE SOME THINGS YOU CAN THINK ABOUT THROUGHOUT YOUR YOGA PRACTICE TO HELP KEEP YOU SAFE:

Keep your balance steady: Focus on one point with your eyes and maintain firm contact with a support object (wall, ground, steady chair) with your feet and/or hands.

Keep good alignment: Try to keep your spine as tall, lengthened and as straight as possible throughout each posture and transitions between postures.

For more information on exercise for bone health and managing osteoporosis click here.

WRITTEN BY

Dr. Caitlin McArthur
Registered Physiotherapist, PhD
As featured in COPN’s Unbreakable Issue 13

Living with Long-Term Pain is a Real Thing

Written on July 16, 2021. Posted in OC Blog.

Everyone has at one time experienced acute pain. The recent article on “Osteoporosis and Pain-Helping Your Body Help Itself” explains acute pain as a pain that starts suddenly and has a purpose; it is a signal that makes us aware of an injury. But what if that signal doesn’t turn off; what if the alarms keep ringing? After a shoulder surgery in 2009, my body decided to keep this pain signal going; it didn’t turn off. I am now one of the one in five Canadians who live with ongoing pain. This is referred to as persistent or chronic pain.

In 2018, I wrote my first article about living with chronic pain and the challenges I faced navigating through a healthcare system inadequately equipped to identify and treat chronic pain. Since then, I have done many presentations and written articles on pain, with the goal of increasing awareness that chronic pain is real and that we can live well with pain.

Recently the World Health Organization recognized chronic pain as a disease in its own right. Chronic pain affects our daily lives in many ways: it disrupts our sleep; it results in anxiety and distress; it causes many to lose work; it can lead to substance use disorder and suicidal thoughts. This list barely touches on the impact this illness called chronic pain can have on an individual and their families.

I had to go through many doors and was left with excruciating pain for years before I finally met a pain physician who could help me. I was fortunate to receive effective pain care and to build a pain care team and a personal pain self-management tool kit that helps me live a rewarding life with pain. A pain team can consist of many different professionals: a pain specialist, a physiotherapist, a massage therapist and a nurse practitioner, with the patient at the centre. Remember you are the most important person of your team; you are the lead with the rest to support you. My pain self-management tools are specific to me and my needs, as my team is. I say specific to me because pain is complex and very individualized, so our self management needs to be the same.

Self management and a support team are important because medications and pain treatments do not necessarily take away all our pain. With a topical cream, medications and treatments, I do get some pain relief but I needed the assistance of my support team and much trial and error to find what self-management tools worked for me.

THE SELF-MANAGEMENT TOOLS THAT HAVE IMPROVED MY QUALITY OF LIFE AND ENABLED ME TO RETURN TO WORK ARE:

Practising mindfulness, deep breathing and other relaxation techniques
Regular exercise
Eating a balanced diet
Maintaining a positive attitude
Pain peer support
Developing a pain flare-up plan
Practising good posture
Developing good sleep habits
I also had the privilege of receiving guidance from an occupational therapist on how to adjust my workstation and return to work without having pain flare-ups

Knowledge and acceptance were key for me. I learned about pain science by reading evidence-based articles and attending a pain self-management program. This may seem like a lot and at the beginning I did feel overwhelmed but these steps have changed my life. With knowledge, a personal pain tool kit, an amazing pain team and new daily habits, my pain is now just a buzz in the background, a dull roar.

I have not discussed medications, pain treatments and interventions because these are complex and are decisions to make with your physician. One thing to know about pain medications is they can play an important role and need to be taken as prescribed. To be effective, they need to be taken at a specific time. Discuss timing and possible side effects with your physician. Also ask your physician about the availability of professionally run pain self-management programs and any local pain peer support groups.

Fractures can lead to long-term pain. If you know someone living with pain, whether from an osteoporotic fracture or other reason, be kind; you do not know what kind of day they are having. Also do not let chronic pain steal your joy for life. Be patient and kind to yourself and, over time, with pain self-management supports, you too can live a joyful life.

WRITTEN BY

Virginia McIntyre
Chair, Canadian Osteoporosis Patient Network (COPN);
Board Member, People in Pain Network (PIPN); Director,
Maritimes People in Pain Network; Facilitator,
Annapolis Valley Pain Self-Management Education/Support Group

Jack Hirsh Award Recipient

Written on June 3, 2021. Posted in Latest News.

Jack Hirsh Award

Rick Adachi MD, FRCPC

The McMaster Academic and Education Department of Medicine Awards review committee have selected an outstanding group of individuals for the 2020-2021 academic year.

Past Osteoporosis Canada Scientific Advisory Council Member, Dr. Rick Adachi is the winner of the Jack Hirsh Award. This is the preeminent achievement award given by the McMaster Department of Medicine.

The award is given annually to a full-time member of the McMaster community with a primary or secondary appointment in medicine. Dr Adachi is retiring this year and this award is fitting recognition of his contributions to the Department.

Congratulations Dr. Adachi!

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Yoga and Osteoporosis: Suggestions for Safe and Appropriate Practice

Written on June 3, 2021. Posted in OC Replay, Webinar.

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