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As we age, our bodies will naturally change: degenerative changes will cause joint stiffness; hormonal changes will cause muscle mass and bone density to decrease.

Since they can cause aches and pains for the majority of daily activities (such as cleaning, shopping, and traveling), these alterations could have an impact on anyone’s quality of life. In addition, these alterations become risk factors for more severe damage if we ignore them.

Osteopaths are essential in helping senior citizens maximize the function of several bodily systems to improve their mobility and independence (by preventing falls).

1. Encouraging movement

First, let’s discuss how we might help our senior patients move more freely. A large number of patients older than 60 will see their osteopath with signs of osteoarthritis. Here are a few:

  • Joint stiffness – more noticeable upon awakening or after being inactive for a long period of time.
  • Swelling – This might be caused by soft tissue inflammation around the joint
  • Bone spurs – These extra bits of bone, which feel like hard lumps, can form around the affected joint
  • Tenderness – You might feel tender when you apply even light pressure to your joints

A low back-related stiffness may impact how quickly you can get out of bed in the morning or how low you can bend to grab something, while a hip-related stiffness may alter your stride and decrease the distance you walk each day. Every patient will express their own level of suffering, which serves as a reminder that pain is, above all, a subjective sensation.

By performing passive mobility tests and pain provocation tests, osteopaths may evaluate a patient’s range of motion and pinpoint problem areas. Following an evaluation of the sensitivity and range of motion of the affected tissues, the osteopath can design a customized treatment program to help each patient take back control of their pain.

A ten-year follow-up research discovered that conservative therapies can improve mobility and foster independence in carrying out daily living tasks. These interventions include exercises, manual therapy, and gait training [1].

Regarding the manual therapy aspect, osteopaths use a variety of techniques to improve the mobility of elderly patients. Here are a few, among others:

  • Mobilizations with movement (MWM)
  • Short- and long-lever joint mobilizations
  • Muscle energy techniques
  • Assisted stretches
  • High velocity thrusts (if indicated)

Your osteopath will select the best approaches to enhance your mobility improvements based on the severity of your complaints.

2. Encouraging self-reliance

Osteopathy promotes functional abilities, addresses physical limits, and improves general well-being to help older persons keep their independence.

The two main conditions that will affect an aged person’s ability to remain independent are osteoporosis and sarcopenia, which are typically coupled to form osteosarcopenia.

  • Sarcopenia is the loss of muscle and strength that can happen when someone gets older and does less physical activity
  • Osteoporosis is a condition where bone strength is reduced because of changes in bone structure (mass and quality), and the risk of breaking a bone is increased.

When these two things come together, your chances of fracturing one of these three major bones—your wrist, hip, or lower back—while falling will rise. Furthermore, it is estimated that 69% of fractures in the elderly population occur as a result of falls and slips[2].s

In the elderly population, osteoporotic or fragility fractures are more prevalent (1 in 3 women, 1 in 5 males) than heart attacks, strokes, and breast cancer combined.

Hence, osteopaths play a crucial part in empowering elderly individuals to fully utilize a variety of bodily systems to improve their mobility and independence (by preventing falls).

The risk of falls will be screened using a battery of tests:

  • Strength assessment, using resisted contractions or a sit-to-stand endurance test (30 secs)
  • Balance test, like the 4-Stage Balance Test [3]
  • Gait assessment, using the Timed Up & Go test for example

To build muscular capacity through a customized exercise program and restore confidence—which is typically absent with imbalance—the osteopathic treatment will use simpler progressions of the most compromised areas of the evaluation. Manual therapy will also be used in situations of joint or muscle discomfort.
In the end, patient education is crucial during osteopathic sessions since even small changes may have a significant impact. For example:

  • Removing rugs in rooms most at risk (lower risk of falls)
  • Encourage increasing daily walking range (using smartphone App)
  • Discussion about lifestyle modifications (smoke cessation, sun exposure or Vitamin D supplementation)
  • Teach how to fall as it’s sometimes inevitable, but it will prevent further damage


[1] Jette, D. U., & Branch, L. G. (1992). A ten-year follow-up of a home exercise program for the elderly. JAMA, 263(20), 3029-3034.

[2] CaMos – Canadian Multicentre Osteoporosis Study


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