09/03/2026
🦴 BONE HEALTH after spinal cord injury matters.
After SCI, reduced muscle activation and weight bearing can lead to rapid bone loss—especially at the hip, distal femur & proximal tibia. Lower-extremity BMD may be 28–50% lower within 12–18 months after injury.
So how can we help protect bone? 👇
đź§Ť STAND + LOAD: Aim for ~60 min, 5x/week when medically appropriate. Standing frames, standing wheelchairs & gait training can provide important mechanical loading.
⚡ FES/NMES: Strong muscle contractions + resistance can provide additional stimulus to bone. Bone-focused programs often use 30–60 min, 3–5x/week consistently over several months.
đź§ TSS: May help increase muscle activation during standing, stepping & exercise. Research on TSS specifically for BMD is still emerging.
đź’Š MEDICATION: Bisphosphonates, zoledronic acid or denosumab may be considered by a physician when appropriate.
🥛 DON’T FORGET: Calcium, vitamin D & monitoring BMD are also important.
LOAD IT. ACTIVATE IT. REPEAT IT. 🦴💪
Bone health should be addressed EARLY after SCI—not after a fracture occurs.
Programs should be individualized based on BMD, fracture risk, injury level and medical status.