How Physiotherapy Supports Bone Health in Osteoporosis
- Good Country Physio
- Sep 25
- 5 min read
Physiotherapy plays a vital role in preventing and managing osteoporosis. To talk a little bit more about the relationship of physiotherapy and Osteoporosis we were joined by Angela Willsmore APA Titled Sports and Exercise Physiotherapist, APA Titled Musculoskeletal Physiotherapist and director of Good Country Physiotherapy. In this conversation we learn more about how Physiotherapy can help with strong bones.
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How does physiotherapy play a role in the prevention and management of osteoporosis?
We quite often get patients referred directly to us for management of osteoporosis. It's usually after they've had bone mineral density testing completed which has shown bone loss on their imaging and so they'll be referred to us, to assist them with managing their symptoms. Sometimes they may not have any pain or significant dysfunction, but they need advice and education around moving safely through various different forms of exercise, to help improve and maintain their bone health. Sometimes they'll be referred to us with a specific injury or after a fall, they might have a fracture of their spine or some other injury that might have occurred which has shown up that they then have thinning of their bones. Patients can come with an injury or potentially without an injury, but the common theme is the loss of bone density.
How do you help patients overcome the fear of falling or breaking a bone while staying active?
Fear of falling is an important thing to address with patients who have had a fall. People who've had a fall are more fearful of falling and they have an increased risk of falling again. We try to address that through a number of different ways: education about environmental hazards that might exist in their home environment. So that might be rugs or mats on the floor, facilitating rail installment in bathrooms: make spaces safer for them. Working together with an occupational therapist or other members of an allied health team to assist in that way. Then addressing their functional deficits, specifically in relation to their balance and ensuring they feel confident in a range of different balance challenges. We will take outcome measures initially to get a baseline of where their balance is at and then provide them with either some exercises they do at home or we run a number of different exercise classes they can engage in to address those deficits.
We know weight bearing exercise is really critical to managing and monitoring bone loading and bone density. Making sure people are feeling strong and confident in the way they move - encourages them to keep moving.
What changes would you like to see to make physiotherapy and healthcare more accessible for rural patients with osteoporosis?
We try to address them in terms of having physiotherapy services available in a range of locations across the Limestone Coast. So we've got clinics in Naracoorte, Bordertown, Keith and Kingston South East. So people are able to access our physiotherapy team from all of those locations and hopefully that means there's somewhere close by that they can access services. We also offer home visit services.
In terms of affordability, we have a number of different funding programs that we are involved in that provide access to affordable physio services so that doesn't become a barrier.
That might mean referral under a chronic condition management plan (through Medicare) that people might be familiar with, through a GP. A referral from a GP and a diagnosis of osteoporosis would qualify somebody for one of those chronic disease management referrals. That gives people an option of up to five allied health visits, so not only physio but five allied health visits across a calendar year and that provides a rebate towards covering the cost of the consult.
There's another program and I would encourage anyone over the age of 65 to make sure that they're registered with this. It's called My Aged Care and people can be eligible for a range of different funding options through that. It requires an assessment, then people are allocated a level of care based on their care needs which may include physiotherapy.
We like to make sure that we can provide a service to everybody who needs it and that cost and location are not a barrier for people.
What do you currently consider when seeing patients throughout the different stages of life in order to promote bone health?
As part of my routine screening I ask about bone density and we know that there are certain things that put people at greater risk of reduced bone density. So I'm alert to those risks when I'm undertaking my initial assessment and they're telling their story. Certainly if they're a menopausal or post-menopausal woman I'm keen to make sure that they've had some sort of bone density testing at some stage or they have that at least on their radar to be undertaking that.
Working rurally we see patients for quite lengthy appointment times at the minimum of 30 minutes to 45 minutes - hour. So we have lots of time with people and we're able to really get a full picture of their health and where they're at in their life at that point in time. It's not just a consideration of their sore ankle, there are many things we can look at in terms of the whole person. From there we can make recommendations to make sure these things aren't missed because there are plenty of cases that go untreated and are not managed appropriately.
We try to be preventative with health care rather than reactive.
We have a really strong focus across all patient groups to encourage people to be physically active. It's a big part of what we do and we want to provide people with opportunities to do that safely, in a supportive way so that they embrace exercise.
If you could give one simple tip to someone on the Limestone Coast to protect their bones, what would it be?
I would love to see everybody moving at every opportunity. The more movement the better.
Whatever way that is, in whatever way they feel comfortable. There's no one-size-fits-all, with this but we really need as a society people to be moving. So much of our lives are becoming very sedentary and a lot of our work is based around computers and you know movement is not as much of a vital part of everyday life as it once was and I'd really like to see that change.
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Gabrielle Prider and Chelsea Holmes
4th Year Physiotherapy Students at the University of South Australia
Undertaking their Health Promotion placement at Good Country Physiotherapy, supervised by Angela Willsmore