What Is Osteoporosis?
Peak bone mass occurs in most adults around 30 years old. Before this age, our bone mass increases. After age 30, we lose more bone mass than we gain from the normal, natural processes of bone remodeling. The amount of bone mass that you have built up by age 30 plays a huge role in determining your risk for osteoporosis or osteopenia.
Osteoporosis is a bone disease that causes bones to weaken and become brittle. According to the National Osteoporosis Foundation, “studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis”. The most common areas for breaks due to this condition are the hip, spine and wrist. Osteoporosis is sometimes referred to as a “silent disease” because it can largely go undiagnosed until it is a problem. An example of severe osteoporosis is the extreme kyphotic posture seen in the elderly that is caused by compression fractures in the spine.
Osteopenia, often a precursor to osteoporosis, refers to lower than optimal bone density, but not low enough to be considered osteoporosis, and is more common in women than men, especially following menopause. This is a diagnosis to pay attention to, not to just write off as a “rite of passage” with age.
How often do you hear about an elderly person who fell, broke their hip, and never truly recovered? That is a much more common scenario than for a 50 or 60 year old, but once menopause sets in, women, especially, are susceptible targets for this disease. According to the Association of Rehabilitation Nurses , “A woman’s risk of having a hip fracture from osteoporosis equal to her combined risk of breast, uterine, and ovarian cancer!
How Do I Prevent Osteoporosis? Is it reversible?
Osteoporosis is largely preventable, however, according to the National Osteoporosis Foundation, there are certain pre-disposing risk factors:
- Caucasian or Asian ancestry
- Family history of fractures or osteoporosis
- Age 50 and beyond
Other risk factors that you can change:
- Cigarettes and excessive alcohol consumption
- Low body weight
- Not doing estrogen replacement therapy if post-menopausal (this is a conversation between you and your doctor)
- Unhealthy nutrition (i.e. making sure that you meet the recommendations for Vitamin D and Calcium)
- Lack of exercise, or sedentary lifestyle
Let’s touch on exercise for a moment. This is one of the easiest actions that you can take toward the health of your bones. We discuss exercises for healthy bones below.
My Doctor Told Me That I Have Osteoporosis, So Now What?
If you already have been diagnosed with osteoporosis, what can you do about it? Treatments can include hormone-replacement therapy for post-menopausal women, drugs prescribed specifically for osteoporosis, taking daily doses of vitamin D and Calcium and of course, exercise. Learn what types of exercises really work while reducing stress and other menopausal symptoms.
Working on balance is essential for anyone, let alone those with osteoporosis or osteopenia. I, Sue, have all of my clients work on balance, no matter what their age. We rely heavily on our vision for balance. As people age and their eyesight changes, this directly effects their balance. Have you seen older folks walking and looking down right in front of them, shuffling their feet, instead of being upright and looking ahead? A lot of people in their late 40’s and 50’s start to need reading glasses, which really presents a challenge if they are wearing them while walking down stairs. Another common cause of balance issues is medications. Blood pressure medications, for example, can make people feel dizzy. All of this aside, everyone needs to work on their balance.
A great way to work on balance is to stand next to a wall or railing and while holding on, shift all of your weight into one foot, then lift the other. Hold for 30 seconds. The goal, of course, is to not hold on to anything. From there, progressions involve moving your head so that you condition your balance while changing your visual reference. Closing your eyes while standing on two feet is challenging for some people, but standing on one foot with eyes closed is definitely a challenge for most. Definitely stand near a wall or chair that you can grab if you need to. For an elderly person, there is a fine line between improving balance and taking unnecessary risks, so they really should be taught how to do this safely.
How does exercise strengthen my bones?
“Run Forest Run! Forest Gump had something going for him….running is an example of a high-impact weight-bearing exercise that, unless you are at high risk of breaking a bone due to osteoporosis, helps strengthen bones. Other forms of high-impact exercise include
jumping rope, climbing stairs, dancing, tennis, skiing (for prevention), hill climbing, and more. In fact, jumping rope is an awesome way to burn lot s of calories in quickly while benefiting your bones. If you worry about tripping on the rope, try “fake jump roping” without a rope. In a New York Times article, “Building Up Bones, With a Little Bashing”, Dr. Vonda Wright, an orthopedic surgeon at the Center for Sports Medicine at the University of Pittsburgh, suggests jumping rope or hopping 100 times a day. Not into jumping rope? Try good old-fashioned skipping.
If you are at risk for breaking bones, low-impact exercises such as walking or elliptical machines still help strengthen your bones. Tai Chi is another great option for both balance and strength.
Gravity is your friend when it comes to strong bones. Our bones need gravitational pull in order to strengthen from exercise, so aerobic activities such as cycling and swimming are not very effective. Shallow end water aerobics however, is a great low-impact option.
Strength training creates a pull on the muscles and tendons, which creates stress on the bones in a good way that stimulates them to strengthen. At least twice a week weight lifting, body-weight training, resistance band training, Pilates and yoga all can build strong bones. Of course, someone with osteoporosis or at risk for it needs to be extremely careful about their alignment and posture while exercising. For example, some Pilates or yoga positions would be contraindicated, such as the Pilates “rolling like a ball” exercise or forward bends or twists in yoga. .
A couple of great exercises that are also totally functional for daily life include body-weight squats (for hips and spine) and pushups (for arms and wrists). When you squat, if you feel challenged by balance or strength, start by squatting to a chair or bench.
Always start your squat by sitting your hips back vs. bending your knees. If you can do up to 15 body-weight squats easily, try adding some weights.
For the upper body, pushups rock! If just starting, start at the wall. Progress to the floor either from your feet for full pushups, or from your knees, for modified pushups. Build up to 10-15 pushups with good form, meaning shoulders down away from your ears and low back in a neutral, not sagging, position.
If you think that you are at risk for osteopenia or osteoporosis, by all means, check with your doctor about screening. The most common screening method for bone health is a “dexa scan”. The National Osteoporosis Foundation has guidelines for who should consider the screening. In particular, if you are a post-menopausal woman, or a man age 50 or older, and have broken a bone recently, you are a prime candidate for bone density screening.
Here are a couple of books that can guide you through this process:
Exercises for Osteoporosis, Third Ed…
Bone density affects us all at some point in our lives, so taking the steps to ensure that our bones are healthy and strong as children, young adults, and beyond is important. Other risk factors aside, not exercising and working on balance are two risk factors that you can really do something about!
Find out here what else you can do to treat osteoporosis.
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By Sue Bream yoursimplehealthylife.com