Osteoporosis is a disease of progressive bone loss associated with an increased risk of fractures (broken bones). The term osteoporosis literally means porous bone. Osteoporosis is often called a 'silent' disease that often develops unnoticed over many years, with no symptoms or discomfort until a fracture occurs.
Although you can’t visibly see it, our bones are constantly remodelling throughout life. Older mature bone is removed and new bone tissue is created. That is how bones heal when you break them. It also affords us the opportunity (for better and worse) to influence the strength of our bones.
What Causes Osteoporosis?
Losing bone is a normal part of the ageing process, but some people lose bone density much faster than normal. This can lead to osteoporosis and an increased risk of fractures. We don’t know the exact cause, but common factors that can lead to osteoporosis include:
We reach peak bone mass by approximately 30 years old. Left unchecked, age related bone mass loss for both men and women is approximately 0.5% per year. For women this loss accelerates during the menopause transition to up to 2% annually, settling to a loss of approximately 1-1.5% per year a few years after menopause.
Women are at greater risk of osteoporosis than men. For women, menopause is a precarious time for bone health. During menopause estrogen levels drop dramatically which impacts normal bone remodelling and leading to osteoporosis in postmenopausal women. Combine this with normal age-related bone loss and age-related decline in physical activity, it’s no wonder so many postmenopausal women have osteoporosis.
Nutrition & Lifestyle
Poor nutrition, including a low calcium diet, low body weight and a sedentary lifestyle have been linked to osteoporosis, as have smoking and excessive alcohol use.
Medications & Other Illnesses
Osteoporosis has been linked to some medications including steroids, and to other health conditions such as some thyroid problems.
How To Prevent Osteoporosis
or Prevent It From Getting Worse
Irrespective of age and sex, the sooner you act, the stronger you can make your bones and the likelier you are to maintain them.
Ensure you get adequate amounts of calcium and Vitamin D.
You need Vitamin D to help your body absorb calcium. We make Vitamin D through our skin with sun exposure. In the UK, especially in the winter, it can be challenging to make enough Vitamin D so supplements are really helpful.
The recommendation for Vitamin D is 200-600 IU (international units) daily (American Academy of Orthopaedic Surgeons).
Calcium is essential to keep your bones healthy. Although calcium can’t prevent gradual bone loss after menopause, it continues to be essential in maintaining bone quality. The recommended daily intake of calcium varies at different stages of our life, but for men and women aged 19-50 years old it’s 1000mg per day, rising to 1200mg per day over 50 years old (American Academy of Orthopaedic Surgeons). Dairy products including yogurt and cheese are excellent source of calcium.
Exercise has the potential to prevent osteoporosis (if started early enough and continued throughout life), improve bone mass, and reduce the fracture risk in postmenopausal women. The important thing to be aware of, is that the level of benefit gained is related to the type of activity.
Aerobic exercises, especially walking, appear to be the most common and preferred exercise in older adults, but they have limited potential in improving bone mass as they provide minimal loading on the skeleton.
Strength training is excellent for improving bone density as peak load (the amount of force/stress) is the most important factor affecting bone mineral density. Muscle contractions during exercise increase mechanical stresses on bone which leads to increased bone density.
High impact loading, low repetition exercise appears to be the most beneficial for improving bone mineral density. Combining aerobic exercises such as walking with high impact exercises such as jogging or weight training are recommended to optimise benefits.
Pay special attention to exercises that improve your posture, such as moves for your upper back that strengthen the muscles between your shoulder blades. These can strengthen your spine-supporting muscles and reduce the sloping shoulders and rounding forward posture that older people get as they lose muscle mass and strength. This condition, called kyphosis, can be the result of bad posture as well as compression fractures in the spine. Keeping you back muscles strong can help prevent both.
Falls account for 50% of osteoporotic fractures, so choosing exercises to improve your balance are really important. Standing on one leg while brushing your teeth is an easy way to do 2 minutes of balance practice twice a day without having to find any additional time in your day. Try and make this a new habit.
Pilates us a fantastic form of exercise to improve your strength and balance. Particularly your postural muscles and core stability muscles. All of our Pilates classes at Chiltern Physiotherapy are taught by physiotherapists because it’s especially important if you’ve got low bone density to get proper exercise instruction and supervision from a knowledgeable professional. It is important to perform these exercises with proper form and intensity, so that you are placing the load where you want it and not where you don’t.
If you have any concerns about your bone density or would like to know what exercises are ideal for you, why not book an appointment with one of our physiotherapists who will be able to work with you to create and individualised exercise plan. You can book online via our website or call us on 01923 283845.
We also have a boutique gym inside Chiltern Physiotherapy called Renovate Wellness, where members can work out 6 days a week! As discussed above, strength training is one of the best things that you can do to strengthen your bones. Pop in to have a look around and chat to a member of the team. No joining fee and no long term commitment required. Check out our website for more information: www.renovategym.com