What does the rib cage have to do with balance?

With the diagnosis of osteoporosis there comes a fear of broken bones aka fractures. We are often told, “Don’t bend and twist, and whatever you do, don’t fall”. So now we also have the added layer of fear of falling.

I want to take a few moments to discuss how stiffness or loss of mobility in the spine, loss of muscle strength, and how the shape or position of the rib cage over the pelvis play a role in vertebral fractures especially with osteoporosis.

Loss of mobility and what happens next

Mobility is the amount and freedom of movement we have in the body. If one area of the spine or shoulder or hip area lack mobility, then other joints in the chain will learn to take up the slack. Here’s an example, imagine a bicycle chain and all its individual links. If two links are stuck together and they move as a unit, then the links on either side will move more to compensate.

What we see clinically is that if the rib cage has lost some of its mobility and the ability to straighten and reverse the osteoporotic hump or twist or rotate right and left then we don’t respond quickly enough to keep our balance when challenged. We also start to see more repeated compression of vertebra to vertebra during daily activities that can set us up for spinal fractures.

Yoga postures increase mobility in the joints by moving the body in all three planes of motion. Many of the postures can be done safely with osteoporosis, but may require modifications using props and focused attention on alignment rather than looking like the 22 year old gumbie on the mat next to you. We need to learn to practice smarter, not harder.

About the muscle stiffness

Stiffness refers to how easy a movement feels, but also how well we can call upon muscles to react in time to keep us upright and on our feet. By the time osteoporosis is diagnosed there is already stiffness in the rib cage. This is often the result of muscles getting tighter on the front side of the body and longer on the back side. It’s as if the muscles get shorter from all our sitting, looking at phone and laptops.

Mind you I am aware that as I write this I am sitting with my laptop on my lap and I fear I may be slouching to accommodate seeing the screen. We are not perfect by any means! I’ll be sure to stretch my back and shoulders into the opposite position when I get up to hopefully minimize the long term effects. But I digress…

Regardless of how we achieved this posture, be it the above example or just bony changes in the shape of the vertebrae due to osteoporosis, we have some work to do to try to correct this. I hear my mother griping at me when I was twelve to stand up straight. Boy, do I wish I had even tried. My yoga practice has become an integral part of my journey to reverse all the years of slouching by helping me to lengthen and stretch muscles that have shortened over the years.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.

Then there is muscle weakness

Muscle weakness tends to sneak up on us until suddenly we find we can not do an activity as easily we used to. The old adage, “use it or lose it” does ring true. The body will only move through range of motion it can control. The loss of mobility and the muscle stiffness result from our repeated postures, repeated motions, and lack of use.

It becomes important with osteoporosis for us to include strengthening that helps us stand taller. This focuses on the back muscles and shoulder blade muscles that help us reverse the rounding in the mid-back. the posterior hip muscles like the gluteus maximus or “glutes” as they are often called.

The good news is we can help these tight muscles with stretches and then strengthen the upper back and spinal muscles to reverse the slouch. Again I will mention yoga as I find it trains our bodies for many movements we do regularly off the mat from squatting, to stairs, to turning or changing direction, to standing on one foot, and to reaching overhead to name a few.

Regardless if it is a lack of mobility, flexibility, or strength and coordination, the loss of movement in the rib cage area of the spine makes it harder for us to accommodate or recover when our foot slips or toe catches or if we turn suddenly. Turning suddenly often throws us out of our center of gravity and the stiffness slows our muscle’s reaction time. Then we don’t quite have the movement within the body to respond and pull ourselves back to center. Balance training works on our muscular coordination and reaction time so we can regain our balance rather than fall.

Good news! Body in Tune would love to collaborate with you to teach you this precise yoga practice and to support your ongoing practice so you can enjoy your life off the mat with confidence.

The osteoporotic hump and balance

The “don’t bend and twist” instruction comes from the fear that repeated stress or compression of the front of the vertebra, the vertebral body, will eventually cause what is called a compression fracture. Compression fractures also happen when we fall and land hard on our backside, especially if the ribcage is bent forward.

The research tells us that the more forward our head is from the shoulders and that if the ribcage and pelvis are not stacked vertically and level, respectively, we are more likely to lose our balance and have a fall than if we were in the posture in which we stood in our younger years. This is partly because we are already standing in a position that requires more work to maintain. As such it is much harder to recover from being bumped.

With the forward head also come a decrease in the range of motion and the ease with which we can look over our shoulder without also using our trunk to turn further. This lack of mobility affects the coordination of our movements especially if we rely on our eyes and where we focus our gaze to help us balance. Yoga is a great tool to help practice balance and coordination for fall prevention.

So what are we to do?

The Bone Health and Osteoporosis Foundation instructs us to work on our balance and upper back strength and to practice safe spinal alignment every day. Additionally we need to include to resistance training 3x per week and 150 min of moderate cardiovascular exercise per week. One of the purposes of the upper back strengthening is to attempt to correct the osteoporotic hump in our mid-back. But what you may not know is that strengthening the muscles that uncurl the spine, also help control the mobility and flexibility of the vertebra in the entire spine.

Again I will mention the power that yoga offers us, moving in all three planes of motion; forward/backward, side-to-side, and rotation. We learn to coordinate the muscle control to stabilize, gain mobility, gain strength, improve flexibility, and improve our posture all by using body weight resistance. It is a powerful tool to have in your toolbox and as part of your osteoporosis exercise plan.

I would welcome the opportunity to be part of your support team with regards to women’s health, your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.