Importance of Exercise in Osteoarthritis

Osteoarthritis, though usually diagnosed in the later ages, actually starts much earlier. Just like car tyres get worn out over time and with use, our joints too undergo wear and tear throughout life. Food, environment, lifestyle, weight, physical activity, genes, exercises, previous injuries or surgeries, etc. all will determine the severity of the degeneration, the age that it will start, and the rate it will progress.

Some people will power on, and continue their activities and exercises till pain is unbearable; while others will stop everything and take “rest” at the first hint of pain.

Is one better than the other? Well, no!

If you have pain, do not continue the same program. Exercises have to be modified, please ask for help!

But also, please do not choose to rest! Exercise is the most important part of treatment for osteoarthritis.

Osteoarthritis cannot be cured. The treatments are all designed to reduce pain, increase movement, and eventually slow down the progression.

Well-designed exercises can help to strengthen muscles, increase flexibility and mobility, may help maintain or reduce weight, and also keep the bones healthy.

Most of us exercise to remain “fit”. Don’t you think then, that the exercises we choose should work WITH our body and not AGAINST it??

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WARM UP

Warm up in a warm city?? Is it really necessary? What does that really mean?

1. If you are exercising first thing in the morning, you probably need a “proper” warm up. Sleeping makes the body stiff, especially so if you’ve slept in an air-conditioned room. The metabolic processes have slowed down too, and so have your reflexes. You need to prepare your body for the demands that you will put on it. You should spend at least 20 min doing light, aerobic, whole body movements and stretches before increasing the intensity to what your actual exercise for the day is.

2. If you are exercising an hour or two after you wake up, and you have been moving around the house getting things done, you probably do not need a full warm up. You might do alright with a 2-3 minute quick warm up followed by a few quick stretches.

3. If you have been sitting in the office all day and plan your exercise session after that, you will need a moderate warm up, but a good amount of stretching to prepare for your exercise.

4. The type and intensity of the warm up also depends on the exercise itself. For a cardio activity like a 5-10 k run, a light 5-7 minute jog and a whole body active stretches routine will be a good warm up. For a generalised whole body beginner-intermediate strength training routine, warming up the whole body with a light version of calisthenic-like free hand exercises and stretches is best. But if you plan an advanced level, heavy strength routine, a light 5-7 minute jog, followed by whole body free-hand exercises and stretches, and then a lighter set of each of the exercises before the actual sets should all be part of your warm up.

5. Warm up is not only for cardio/sport/gym strength. Even for a Yoga session, your body needs to be warmed up. Before going into the actual poses, it would be good to do a lighter version of them or some similar stretches.

Your body will perform best when you prepare it by clearly demonstrating what you really need from it. There will then be enough blood flow to the required areas, enough glucose and oxygen supplied, muscles pliable and prepped up, joints moved through the full required ranges and not surprised or suddenly shocked with the movement or forces, brain perfectly synced with body to provide best support and coordinate the movement, heart and lungs ready for the upcoming demand to scale up performance, nervous system and reflexes sharpened and prepared to anticipate sudden changes.

A good warm up is like the key that smoothly opens a door. Always use it.

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WORLD CANCER DAY

As I sat down to write a blog for World Cancer Day, I found this great article from 2017 that validated everything that we believe in and apply when we design programs for cancer survivors at Prakruti.

So instead of writing a blog, I have just abridged this article and highlighted a few areas.

Initiating Exercise Interventions to Promote Wellness in Cancer Patients and Survivors

By

Anna L. Schwartz, PhD, FNP, Hendrik Dirk de Heer, PhD, MPH and Jennifer W. Bea, PhD

Oct 15, 2017

The article discusses exercise recommendations for cancer survivors at different stages of survivorship as defined by the American College of Sports Medicine (ACSM) and the impact of acute, long-term, and late effects of cancer and its treatment on the ability to exercise.

Cancer treatment causes profound debilitation that leads to reduced physical function and impairs quality of life. Negative sequelae have been observed across a range of treatment type — from surgery, to radiation, to hormonal treatment and targeted therapies. The declines in physical abilities and physiologic function that are commonly observed in cancer patients can be minimized or prevented with a well-thought-out progressive program of restorative exercise. Exercise during and following treatment has been associated with reductions in cancer recurrence and disease-specific mortality rates of 30% to 60% in breast and colorectal cancers. Exercise also has been found to prevent or ameliorate many treatment-related negative effects — such as fatigue, muscle weakness, declines in cardiovascular function and reduced quality of life.

Only a moderate amount of physical activity is required to achieve many of the protective benefits of exercise. Walking for 30 minutes 5 days a week at a speed of about 2.5 miles per hour conveys health benefits and is an attainable goal for most cancer survivors.

Acute treatment-related side effects are those that occur during active treatment for cancer, when patients are often immunocompromised. Exercise is possible during active treatment and any planned exercise program should be adapted to the individual’s abilities and should focus on improving specific physical limitations.

Long-term effects of cancer treatment are side effects that begin during treatment and linger many months or years after the completion of treatment. Long-term effects often necessitate adapting an individualized restorative exercise program to minimize the risk of injury or lymphedema.

Late effects of cancer treatment can develop years after treatment has ended and may impair the survivor’s functional ability and ability to exercise.

It is time that we change our thinking about caring for cancer survivors and become proactive advocates for restorative exercise during and following treatment. Ideally, restorative exercise should begin as soon as possible after diagnosis to enable the cancer patient to improve his or her tolerance of treatment, and to reap the physical and emotional benefits of exercise. However, it is never too late to refer a survivor to an exercise program. Exercise at any point in the survivorship trajectory helps to maintain and improve functional ability, body composition, and quality of life.

Prakruti SSPC has always believed in individualized exercise programs based on simple patient-centric goal-setting for each phase. We have experts to manage lymphedema while we look after your strength and nutritional health so that you can have better mobility and function.

Do consult us if you or a dear one needs our help.

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Why I love my walking stick

I often see older patients (and sometimes even younger ones) with lower limb dysfunctions, who resist using a walking stick for support — choosing reduced mobility and pain instead — with the misplaced belief that avoiding using one makes them more tough and hardy.
Obviously they look at it as a “dependency”, a sign of weakness and disability.
But what if you look at a cane as an instrument of “independence” and ability? After all, mountaineers carry one (and sometimes two) to enable them to overcome the obstacles they face on treks.
Look at what a cane can do for you:
1. If you are allowed to walk but are unable to walk much because of pain in the knees/ankle/hip, a cane will help you to walk more distances by taking the load off the painful limb or joint.
2. If your gait (walking pattern) is altered because of very weak leg muscles or because you are protecting a painful area in your leg, just using a cane will help you to walk straighter and in the long run prevent damage to other joints of your body.
3. If your balance is poor, or if you often tend to hold on to a wall or furniture, a cane might help you prevent an unnecessary fall and injury, as it will improve your balance.
4. If you have lost your independence after your injury/disability, you can regain it if you choose to use a cane, especially when going outdoors for work or pleasure.
5. Gaining confidence and mobility will improve your psycho-social health; and increasing the distance you can walk will help control weight and other systemic disorders. You will do more, see more of the world, and be more useful to those around you.
I used a trekking stick when I trekked the high mountains. Then an unfortunate accident on one of my treks has left me with an excessive weakness in my left leg.
I use a walking stick now, on my long walks either here in Mumbai or for sight-seeing on holidays. Without a stick I would not be able to walk more than half a kilometer, and if I did, I would end up with back and knee pain. With a stick, I can easily walk fifteen kilometers every day, without a hint of pain.
My stick sets me free, makes me independent, empowers me, and keeps me safe.
I love my walking stick!

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OSTEOPOROSIS

The human body is made up of large quantities of gaseous elements like Oxygen, Carbon, Hydrogen, Nitrogen; smaller quantities of minerals like Calcium, Phosphorus, Potassium, Sulphur, Sodium, Chlorine, Magnesium; and then some other trace elements.

Calcium is the most abundant mineral found in the human body. We think that our bones and teeth are mostly made of calcium, but they are not: Calcium is only a small part of their composition. In fact, the total amount of calcium that our body holds, is only 1.5 – 2 % of its entire weight.

Then why is Calcium so important?

Calcium is required for each and every muscle contraction, even for the beating of your heart. Blood clotting, normal functioning of many enzymes (and these enzymes control each and every function of the body), and the rhythm of your heart is dependent on calcium. And, obviously, it is required for the composition of your bones and teeth. Bones form your skeletal system, give structure to the body, and also protect your vital organs.

As Calcium is required for the most important functions of the body, obviously the blood always has to carry enough of it at all times, and make it available for the body to use. Unless something terribly wrong is going on in the body, your blood calcium levels will always remain adequate. If enough is not made available from food, it is withdrawn from the calcium bank in your bones.

Your bones act as the calcium stores for the body. There is a continuous building and breaking down activity going on in the bones throughout life. The “building up” activity is dominant till the early thirties, and the “breaking down” activity is more after that. If you do not deposit enough calcium in this bone bank in your childhood and early adulthood, you are likely to use the calcium stores faster as you age. Bone structure and strength is at its “peak” in your early thirties. This “Peak Bone Mass” is dependent on genetics too. Women unfortunately, tend to have less peak bone mass than men, and they also lose more bone mass after menopause. The amount of calcium that your bones can absorb and store reduces as you age, and it is almost impossible to build up the stores in later life.

People who smoke, and those that drink excessive amounts of alcohol and caffeine are likely to have lower calcium deposits and lose them faster. Regular consumption of carbonated drinks (soft drinks); high intake of saturated animal fats, and sweets or simple sugars also can cause excessive bone loss.

While opinion on whether one should have milk, and whether it is harmful to the human body is divided, it is still true that milk and milk products are the easiest sources of calcium available to us. Calcium can also be obtained from green vegetables, nuts, whole grains, and fish bones.

After building up calcium stores, it is also important to maintain them through life. This can be done by encouraging the bones to absorb more every day, and you can do this by including a moderate amount of weight (strength) training throughout life. The force applied on the bones by a strong muscle contraction will stimulate the bones to absorb calcium.

Calcium absorption by the bone is also affected by your protein intake. Too less or too much protein, are both likely to cause bone loss. Plant foods (vegetables, grains, and fruits) fulfil most of our vitamin and mineral requirements, and vitamins and minerals play a vital role in Hormonal balance and Calcium absorption. So varied intake of plant foods is indirectly vital for maintaining strong bones.

A discussion on bone health cannot be complete without the mention of the “good” fats Omega 3 and 6. These too are important to maintain strong bones as you age. Several seeds and nuts can provide these in your daily diet.

Eating extremely low-calorie diets can actually stimulate bone loss. Studies show that eating balanced meals and maintaining an even and adequate calorie intake throughout life helps to maintain available bone mass. Going through repeated cycles of weight gain and loss through life might affect bone health drastically.

I think the most important nutritional supplement you can take to ensure bone health is an adequate amount of water. Just a slight dehydration on a daily basis can keep your body in a continuously “stressed” mode, triggering biochemical reactions that will promote bone loss. Remember, water is also important for digestion and absorption of all nutrients, so even if you “eat healthy”, the body might not get the benefit of nutrients unless you “drink healthy”.

So you see, just like everything in life, balance and moderation is also the key to bone health.

#PrakrutiSSPC #WorldosteoporosisDay #Benefitsofcalcium #rightnutrition #healthybones #healthyus!

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WORLD OBESITY DAY

World Obesity Day is observed globally on 11 October with the view of promoting practical solutions to end the global obesity crisis.
Dr. Harshada Rajadhyaksha shares her view on this occasion.

End Weight Stigma

Just think,
When you meet a person for the first time, what is the first thought that comes to mind?
Do you notice their colour, race, clothes, religion, profession, economic status? Their personality? Do you notice their size?
We are taught that first impressions count. But first impressions are only a quick judgement, aren’t they?
Haven’t we all, at some time in life, made a quick judgement, and then changed our hastily-made opinions about people we know?
Can we look at people without forming opinions? Because, whether we voice these opinions or not, by just having them, we own them.
World Obesity Day this year, has the theme “End Weight Stigma”.
“Stigma”: A disgrace associated with a particular circumstance, or a quality, or even a person.
Just like people are of different colour and height; have different backgrounds, languages, and beliefs; they also have different sizes and weight.
If weight does not negatively affect health, there is no reason to notice it. It has no meaning whatsoever in the interaction you will have with the person.
“Obesity” on the other hand, is a disease that afflicts a section of society; just like “Arthritis” is a disease that afflicts a section of society. A person is not obese, a person suffers from Obesity; just like a person suffers from Arthritis.
Obesity is also a result of our collective choices: The lifestyle choices we made when we chose industrialization and urbanization over manual labour and foraging. The choices we make daily when we choose to use our devices of convenience, and eat our artificial foods.
Our species chose to live, eat, and work this way. We are collectively, genetically going to evolve and live with the diseases we inherit.
Yes, I did say “inherit”. Research shows that we are all linked by genetics more closely than we earlier thought. This means that the lifestyle choices our species made over the last few decades have probably affected the genes we inherited and will pass down.
I believe obesity is one of these genetically passed-down diseases. Do not judge a person who suffers from obesity. Each one of us will suffer from a lifestyle related disease at some point in our life; some of these diseases are visible, others are not. Obesity is visible, Arthritis is often invisible.
Let us take the away the stigma and come up with compassionate and practical solutions for those who suffer from Obesity. Let us accept that Obesity is a disease, and look at ways to prevent it. Let us admit that we need to return to more natural food and work choices so that the future generations do not have to deal with an endemic crisis.

#PrakrutiSSPC #stormoutthestigma #acceptthefacts #letsfightitout #Togetherwecanmovemountains!

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Plastic and the Environment

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Diabetes Mellitus

Our body is made up of numerous cells and they are working round the clock throughout life. Food is their fuel, and the way our body handles the food that we eat is the determinant of how our cells work. When the energy delivery mechanism fails cellular function is affected, and things begin to go wrong. Diabetes is thus at the center of several illnesses.

But our body has a tremendous capacity to heal itself, and our job is only to keep it in an environment where it can do so. Please do read an article written by Dr. Devendra Raut for World Diabetes Day.

- Dr. Harshada Rajadhyaksha

Diabetes in India:

According to Diabetes Atlas 4th edition published by the International Diabetes Federation, the number of people with diabetes in India around 50.8 million in 2010 is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken.

Origin of Diabetes Mellitus:

Diabetes has been known since the first century B.C.E., when a Greek physician, Aretus the Cappadocian, named it diabainein, meaning “a siphon,” referring to excessive urination. The word diabetes was first recorded in 1425, and in 1675, the Greek mellitus, “like honey,” was added, to reflect the sweet smell and taste of patient’s urine.

Diabetes Mellitus:

Diabetes mellitus is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or cells do not respond to insulin that is produced.

Types of Diabetes Mellitus:

  • Type 1 diabetes (Absolute insulin deficiency).
  1. Immune-mediated diabetes: Accounts for only 5–10% of those with diabetes, also known as insulin dependent diabetes or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the B-cells of the pancreas.
  2. Idiopathic diabetes: No known aetiologies. This form of diabetes is strongly inherited, lacks immunological evidence for B-cell autoimmunity and is not HLA associated.
  • Type 2 diabetes (ranging from insulin resistance with relative insulin deficiency to an insulin secretory defect with insulin deficiency): Accounts for 90–95% of those with diabetes, also known as non–insulin-dependent diabetes or adult onset diabetes, encompasses individuals who have insulin resistance / insulin deficiency.
  • Gestational Diabetes Mellitus: Occurs when women without previous history of diabetes develop high blood glucose level during her pregnancy.

Symptoms of DM:

High blood sugar patients show classical symptoms of polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), at times weight loss and blurred vision.

Diagnosis of DM:

(Prediabetes level)

  1. Fasting Plasma Glucose (100 – 126 mg/dl)
  2. 2 h Oral Glucose Tolerance test (140 – 199 mg/dl)
  3. HbA1C range of 5.7–6.4% (HgA1C reflects time averaged blood glucose during the previous 2 and 3 months).

Note: Levels exceeding the upper limit is considered as diabetic

Complications:

Retinopathy (potential loss of vision)

Neuropathy (risk of foot ulcers and amputations)

Nephropathy (leading to renal failure)

Cardiovascular complications

Ulceration

Micro-vascular complications and macro-vascular disease like coronary artery, cerebro-vascular and peripheral vascular diseases

Lifestyle, Genetics, and Medical Conditions:

Type 2 DM is primarily due to lifestyle factors and genetics. A number of lifestyle factors like physical inactivity, sedentary lifestyle, cigarette smoking and generous consumption of alcohol contribute to development of type 2 DM. Obesity has been found in approximately 55% of type 2 DM patients.

Management:

Insulin replacement therapy is mainstay for type 1 DM patients; while diet and lifestyle modifications are considered the cornerstone for management of type 2 DM. Oral hypoglycaemic agents are also useful for type 2 DM patients. Eating high fibre and unsaturated fat and diet low in saturated and trans-fats and glycemic index, regular exercise, abstinence from smoking and moderate consumption of alcohol should be implemented as part of lifestyle modification.

Exercise:

  • Aerobi exercise (walking briskly, swimming, dancing, riding bicycle or playing sport)

  • Strength training to build muscle (do strength training with hand weights, elastic bands or weight machines 2-3 times/week)

  • Stretching exercises or yoga (Stretching increase flexibility, lower your stress and help prevent sore muscles)

  • Extra activity to daily routine (Gardening, walk when you talk)

Talk to healthcare professional before you start planning your exercise routine

Herbal treatment of diabetes:

In last few decades eco-friendly, bio-friendly, cost effective and relatively safe, plant-based medicines have been the main stream. World Health Organisation (WHO) has listed 21,000 plants, among these 2500 species are in India, out of which 150 species are used commercially on fairly large scale for medicinal purposes around the world. India is the largest producer of medicinal herbs and is called the botanical garden of the world.

A list of medicinal plants with proven anti-diabetic and related beneficial effects and of herbal drugs used in treatment of diabetes like Banaba leaves, Indian Gooseberry (amla), Cinnamon, Okra, Curry leaves etc.

Diet:

Eat more of:

  • Healthy fats from raw nuts, olive oil, fish oils, flax seeds or avocados
  • Fruits and vegetables – ideally fresh, the more colourful the better; whole fruit rather than juices
  • High-fiber cereals and breads
  • Fish and shellfish, free-range chicken or turkey
  • High-quality protein such as cheese, unsweetened yogurt etc.

Eat less of:

  • Trans fats from deep-fried foods
  • Packaged and fast foods, especially those high in sugar, baked goods, sweets, chips, desserts
  • White bread, sugary cereals, refined pastas
  • Processed meat and red meat from animals fed with antibiotics and growth hormones
  • Low-fat products that have replaced fat with added sugar i.e. fat-free yogurt

- Dr. Devendra Raut

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Be stronger than the challenge, and let the challenge make you stronger!!!

Be stronger than the challenge,

And let the challenge make you stronger!

Our young therapist Dr. Priyanka Bodhe has written a wonderful article inspired by a woman she knows. Read what she has to say about dealing with one of the outcomes of breast cancer treatment, lymphedema.

- Dr. Harshada Rajadhyaksha


Recently, I came across a lady, otherwise healthy, who discovered a pea sized lump in her axilla. Having lost a very dear family member to breast cancer not more than a year ago, she became very conscious and immediately met a doctor to seek medical help. A few tests and they detected her with early stage of breast cancer which has also affected few lymph nodes in the axilla. Within a week she underwent Lumpectomy (surgical removal of the lump). For further management she has been advised few chemotherapy sessions and one radiation.

They say “The best protection is early detection”. But this has also arose few questions in my mind.

  • Is breast cancer genetic and only women with family history carry the risk of developing the disease? If it was not for this 37 year old young lady, to have lost a near one to the disease, would she have become aware and alert about the monster that was about to grow in her body so early?
  • And will chemotherapy and radiation end her fight or will they leave behind them some scars?

I m not an expert in the topic but witnessing the growing incidence of breast cancer in the community, I would like to highlight certain after effects of cancer treatment and what we as Physiotherapists can do to improve the Quality of life of those affected.

Firstly, let me start by wiping out the belief that family history is the biggest risk factor. Because in reality only 5-10% of cases are due to faulty genes. Thus, regular mammograms and clinical breast examination annually for all women above 40 years of age and every 3 years for women between 25- 40 years of age can help detect the disease in its earliest stage.

Secondly, chemotherapy and radiation therapy might not end her fight as they carry certain side effects such as:

  • General de-conditioning and weakness of muscles
  • Cancer related fatigue
  • Breathlessness
  • Joint pain and stiffness
  • Soft tissue fibrosis
  • Radiation related shoulder capsular thickening
  • Lymph edema
  • Postural changes

In other patients surgery might be opted for. Surgical management may include a lumpectomy as mentioned earlier or mastectomy-radical or modified.

Post surgery complications:

  • Scars and skin adhesions
  • Swelling/Lymph edema
  • Upper limb, trunk and abdominal weakness
  • Chest , neck and shoulder muscle tightness
  • Axillary web syndrome/ cording with reduced flexibility, pain and weakness of upper limb

How can physiotherapy benefit in preventing and managing these side effects? When should one start physiotherapy?

  • Physical therapy integrated with these cancer treatments create a more comprehensive approach to survivorship.
  • It reduces mortality by 40% in breast cancer patients

  • Among all the known complications, recognition and prevention of lymph edema, is critical in breast cancer rehabilitation.
  • Lymphedema manifests itself as swelling in the affected  arm because of a blockage of lymph passages and the body’s inability to drain fluid from surrounding tissues.

Treatment for lymphedema includes:

  • Education about skin care

  • Compression: compression bandages or compression sleeves and garments are designed to create pressure in arm and hand to keep lymph moving in the right direction.

  • Manual lymphatic drainage or massage: uses light touch to move excess lymph and fluid out of the tissues and back into the lymphatic vessels.

  • Exercise: includes basic mobility and strength exercises, individually designed for every patients by a physiotherapist.

  • Hydrotherapy: water offers buoyancy and upthrust. “Water supports us, assists movement and causes resistance leading to strengthening”. Exercising in water will help in improving cardiovascular endurance, reducing lymph edema, improving range of motion and decreasing stress.

Physiotherapy might not be “The answer” to all the complications but it plays a major role and goes a long way in preventing and managing the breast cancer treatment after effects thus improving the quality of life of those who seek help.

Kill cancer, before it kills you…!!!

Turn a setback, into a comeback…!!!

-Dr. Priyanka Bodhe

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“You can’t help getting older, but you don’t have to get old.”

“You can’t help getting older, but you don’t have to get old.” _ George Burns

Aren’t we all always looking for tips to stay and look young? The market is flooded with beauty products to achieve this result; the media is overflowing with information to stay “fit”; and billions are spent on cosmetic surgeries to pull off what make up and exercise cannot.

The body is a continuously evolving system, and everyday billions of cells die, another billion new ones taking up their space. As we grow older, this process goes on, but there are lesser new cells generated, and this is inevitable.

Bone being a living tissue, also ages and weakens as we grow older. This is inescapable, but osteoporosis (brittle bones) is preventable!

In our quest to stay young, let us not forget the primary scaffolding of our body that upholds all else!

-Dr. Harshada Rajadhyaksha

Osteoporosis is a “silent disease”, as it progresses without any symptoms until fracture occurs. Your wrist, hip and spine are the common sites for osteoporotic fractures. Post spine and hip fracture, immobilization being essential for healing, still has a detrimental effect on health and quality of living.

Bone is a highly dynamic organ. It constantly undergoes resorption and regeneration. By third decade of life, bone attains its peak mass. As age progresses, in both men and women, balance between resorption and regeneration becomes progressively negative. Post menopause, there is an abrupt drop of oestrogen. Oestrogen hormone plays a crucial role in bone modulation. Thus, we can see old age and oestrogen deficiency are the most critical factors for developing osteoporosis. Besides this, risk factors affecting bone density  include genetics (Europeans, Asians), lifestyle (smoking, alcohol, low vitamin D levels due to less sunlight exposure, calcium deficient diet), low physical activity and certain medications.

Confirmatory tests include Bone Mass Density (BMD) analysis which determines both osteoporosis and its early signal osteopenia.

Osteoporosis has no cure but yes we can definitely stop /slow down its progress. Early detection is the best prevention. There are injections available for people who are highly osteoporotic, probably due to any medical condition like prostate / breast cancer, even may be due to prolonged immobilization as that itself causes disuse osteoporosis. These injections needs to be taken on yearly basis to improve bone density as in these scenarios prevention of associated complications is the primary concern.

For elderly population, due to improper muscle strength, balance, coordination there is increased fall risk. Even minimal stress during a fall has a good potential to cause fracture in osteoporotic bones. Simple steps like railings in bathrooms, rooms, maintaining adequate space and good footwear will help reducing the fall risk, thus preventing any incidence of fracture.

One should start working towards modifiable risk factors such as lifestyle modifications. This may include smoking cessation, avoidance of excessive alcohol. In terms of nutrition, one should have calcium and Vitamin D rich foods but also adequate calorie intake to prevent malnutrition. Prevention can be started from any age as goals differ for age groups. For childhood and adolescence – achievement of peak bone mass, middle age – preservation of bone and muscle strength and mass, old age –optimization of gait and balance, muscle strength.

Exercise plays a key role in building and maintaining bone health. Research has proved resistance, aerobic, high impact training, whether done in isolation or combination can improve bone density in osteoporotic persons. One should not rush into unaccustomed exercises (swimming, cycling may be good for your heart but not appropriate to improve bone density). It is important to do what is the most appropriate.

Everything in moderation is always better.  Combination of healthy lifestyle, proper nutrition and appropriate goal oriented exercise can prove to be extremely beneficial. No two osteoporotic individuals are same and hence one can always look out for an expert advice for an individualized program.

- Dr. V. Sivajanani

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  • Dr Harshada Rajadhyaksha

    In Sanskrit, the word “Prakruti” means “Nature”: the primal motive force of the Universe; Ayurveda recognized that no two humans are alike, and called this basic, very unique, individual constitution, “Prakruti”.

    At Prakruti Sports Science and Physiotherapy Clinic, we provide the environment, expertise, and support required to assist natural healing.

    True healing begins from within the self: Doctors and Healers can only assist along the process. After 22 years, we continue to remain humble in our approach to diagnosis and treatment, our focus remains on the complete wellbeing of our patients, and we continue to promote the prevention of lifestyle-related diseases in the community.

    Our patients’ trust and faith in us, and our honest concern for their wellbeing has been the foundation of our success.