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Faces of osteoporosis: meet the physiotherapist


23 Apr 2021

Physiotherapist Sarah Legg talks about the different types of activity that help her patients to increase their confidence in movement and improve bone health.

I’m a physiotherapist working in rheumatology at the Royal United Hospitals Trusts in Bath. I work with people who have different types of arthritis but also have a particular interest in working with people with osteoporosis.

People living with osteoporosis are referred to our physiotherapy department from the consultant team, specialist nurses and GPs. Usually, they have questions about what exercise and activities are safe and helpful for bone health.

We aim to help improve confidence in movement

We aim to help improve confidence in movement through exercises and education. Some people who come to us are already active and want to find out if they need to change the way they exercise or the type of exercise they do, while others may have been less active and are unsure where to start.

We can provide individual exercise programs, group exercise programs (when social distancing allows), and referrals into community exercise schemes to encourage the good work to continue long term!

As physiotherapists we also help people with pain due to broken bones or changes in their posture, to learn how best to manage their symptoms. This includes back care advice for those who have had spinal fractures.

Staying active helps to support your bone health

Exercise is important in the management of osteoporosis because bone health can be influenced by how you use your body. The Royal Osteoporosis Society (ROS) has great information about the best exercises to do when you have osteoporosis, including helpful factsheets and videos.

Bone responds to being used so we encourage a variety of different types of activity:

  • Impact exercises, such as stamping or jumping, have been shown to help strengthen bones.
  • Balance exercises, such as walking heel to toe in a safe place, are important as they reduce the risk of falls that could cause fractures.
  • Strength exercises, such as push-ups against a kitchen surface or squats, can help to improve bone health and also reduce the risk of falling too.

We’ve had to adapt how we work during the pandemic

The work I enjoy most is running the osteoporosis exercise class. During the pandemic we have had to adapt, so currently only one person comes into the gym at a time. They are taught the exercises and then supported with telephone calls through the program. I’m looking forward to running full classes in person again soon. I also enjoy sharing information about osteoporosis with my colleagues and other physiotherapy teams, to support best practice care.

Last summer I had the opportunity to record a podcast all about exercise and staying active with osteoporosis with the Bath Institute for Rheumatic Diseases, in place of the face-to-face public information events they usually hold.

Overcoming fear of movement

It can be challenging when people with osteoporosis become afraid of movement, in case they break a bone. We spend time reassuring people about the safety of movement after they have broken a bone due to osteoporosis, or if they are worried this may happen to them. They may have heard well meaning, but incorrect, advice about reducing risk by moving less. Unfortunately, moving less can lead to becoming weaker and balance becoming worse, both of which can increase the chances of injury after falling.

In summary, it’s really important to keep active! This will look different for everyone, but even making small changes to your activity levels can be helpful.


Sarah Legg - Physiotherapist, Royal United Hospitals Bath NHS Foundation Trust