Massage therapy · Kitchener–WaterlooOsteogenesis Imperfecta / Brittle Bone Disease

Osteogenesis imperfecta (OI) means imperfectly formed bone. People who have the condition have a genetic change that affects the body's ability to make strong bones. Some people have more severe forms of the condition, where bones break easily and a person can break hundreds of bones during their lifetime (NIAMS, 2022a). Many people have a milder form and can go through life without a lot of fractures.

In people with OI, one of the genes that tells the body how to make a protein called type I collagen doesn't work properly (NIAMS, 2022a). Collagen is a major part of the connective tissue in bones, and it is also important for the teeth, ligaments and the whites of the eyes (NIAMS, 2022a). Because of the faulty gene, either not enough collagen is made, or the collagen is of poor quality. Either way, the bones are fragile and can break easily.

The condition is a genetic disorder that affects about 1 in 15,000 births (Brittle Bone Society, n.d.). It is characterised by bones breaking easily, sometimes even without any injury (Brittle Bone Society, n.d.), and it is often apparent from an early age. Some forms of OI are very severe, with babies dying around the time of birth, or having severe structural deformities of the skeleton (NIAMS, 2022a). Other forms are less severe (although still serious) and cause fractures during childhood which can become less frequent in adulthood.

Osteogenesis Imperfecta Anatomy

The skeletal system is made up of all the joints and bones in the body. All of the bones are a complex group of living organs that are composed of multiple cells, protein fibres and a range of minerals. Collagen is the protein that forms the framework of bone. In OI, the collagen may be of poor quality or there may not be enough of it to support the minerals in the bone, which is why the bones are fragile (Brittle Bone Society, n.d.). The skeleton serves as a scaffold by delivering protection and support for the soft tissues that make up the remainder of the body, and provides attachment points that allow the muscles to move the joints. The skeleton continues growing throughout childhood and serves as a framework for the rest of the body to grow along with it.

How to Treat Osteogenesis Imperfecta

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Regular activity, such as swimming and walking, can help to strengthen the bones as well as the muscles supporting them (NIAMS, 2022b).
• Don't smoke, avoid second-hand smoke, and don't drink a lot of alcohol or caffeine, as these may weaken your bones (NIAMS, 2022b).
• Babies should not stay in a car seat for long periods; take frequent breaks on long journeys. A lie-flat car seat may be more suitable than a regular one, and an occupational therapist or physiotherapist can advise (Great Ormond Street Hospital, 2025).
• Never lift a baby with OI under the armpits or around the rib cage, as this can cause rib fractures. Slide one hand under the bottom and lower back and the other behind the trunk and head (Osteogenesis Imperfecta Foundation, n.d.; Great Ormond Street Hospital, 2025).
• Don't pull, twist or try to straighten the arms or legs. When changing a nappy (diaper), never hold or lift the baby by the ankles or legs; instead, slide a hand under the bottom to lift it, or roll the baby gently onto their side (Great Ormond Street Hospital, 2025; Osteogenesis Imperfecta Foundation, n.d.).

With OI, your medical team leads: they treat broken bones, decide on medicines and surgery, and advise when it's safe to bear weight again. Massage can't make bones stronger, but I can help with aching muscles, stiffness and strength, within your team's limits. After surgery, or a fracture that was treated with surgery or stops normal daily activities, I need your team's okay first.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I ask about past fractures and what you've been cleared to do, then gently assess movement and strength.

How I Adapt Treatment

• Light pressure, careful positioning and plenty of support
• No forceful stretching, twisting or pulling of the arms and legs
• Safe handling for babies and children, with parents welcome to stay

What We Work On

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (2022a) Osteogenesis Imperfecta. Available at: https://www.niams.nih.gov/health-topics/osteogenesis-imperfecta (Accessed: 7 October 2026).
2. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (2022b) Osteogenesis Imperfecta: Diagnosis, Treatment, and Steps to Take. Available at: https://www.niams.nih.gov/health-topics/osteogenesis-imperfecta/diagnosis-treatment-and-steps-to-take (Accessed: 7 October 2026).
3. Brittle Bone Society (n.d.) About OI. Available at: https://www.brittlebone.org/information-resources/about-oi/ (Accessed: 7 October 2026).
4. Great Ormond Street Hospital for Children NHS Foundation Trust (2025) Caring for a fragile baby. Available at: https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/caring-for-a-fragile-baby/ (Accessed: 7 October 2026).
5. Osteogenesis Imperfecta Foundation (n.d.) Infant Care Suggestions for Parents. Available at: https://oif.org/infant-care-suggestions-for-parents/ (Accessed: 7 October 2026).