As we age, the density of our bones steadily decreases. How many elderly people do you know who have suffered a major bone break from a fall? In the field of physical therapy, we see it more often than we want to. Bone mineral density (BMD) is a major concern for any population, but is particularly critical for post-menopausal women to monitor their BMD due to onset osteoporosis. In this blog post, we will discuss how BMD fluctuates throughout a lifetime and the things we can do to prevent it to maintain the integrity of our skeleton!
Bones change… but why?
Bones have a hard outer layer (compact bone) and a fibrous, pocketed inner core (spongy bone). Bone is a living tissue–in other words, it is constantly changing and adapting to our internal mineral balance as well as the mechanical forces exerted on it. If we are putting more force on a certain area of bone, then the bone will fortify with calcium in that area to prevent damage. If the body needs calcium, then it will use bone as a mineral well. As children, our bones are growing quickly and therefore the rate of deposition (forming bone) is higher than resorption (dissolving bone). This process is increased if exposed to exercise from an early age. As humans get older, the ratio of deposition to resorption begins to equalize, and eventually teeter to the side of greater resorption, particularly with women. The cause of osteoporosis is still debated, but hormonal changes dictate the resorption that occurs within spongy bone and can result in more brittle bones. This can lead to orthopedic issues ranging from spinal deformities to injuries with greater severity like collapsed vertebrae or full bone breaks. Luckily there are a few things we can do to reduce our risks or maintain our current bone density.
Ways to sustain healthy bone mineral density:
- Exercise: Bone deposition responds very well to dynamic exercise. Charles H. Turner and Alexander G. Robling of Indiana University School of Medicine describe both bone density increasing mechanisms as well as exercise regimens that can greatly affect bone mineral density later in life. Your bones are not just made of calcium, they also have fluid-filled holes and channels called your lacunar-canalicular network. Bone cells are sensitive to the sloshing around of this fluid when you exercise, and can respond by increasing intracellular calcium thus boosting the production of your bone matrix (47). They suggest to start exercise at an early age, because the younger you are, the more osteoblasts (or bone-making cells) are available for this process (49). So if you have kids, tell them to get outside and start sloshing their bones around! Turner and Robling also mention that you don’t need to exercise for hours to experience these results. They determined that shorter sessions five days a week generated greater BMD than longer sessions twice a week (48). This could be any form of dynamic exercise, whether that is walking or jogging, resistance training, HIIT training, dancing to your favorite song… literally anything that involves you on your feet and moving at your joints. Easy enough, right?
- Food & Nutrition: We all have heard that milk gives you strong bones… but is that enough? Vitamin D also plays a major role in absorbing calcium from our foods. Osteoblasts actively use vitamin D to fortify bone material. Vitamin D can be found in fish, egg yolks, liver, and in supplements (which we will discuss later). Calcium can be found in most dairy, but many foods with the most calcium are actually non-dairy, like collard greens, broccoli, kale, beans, and tofu. Consult your doctor to see how much calcium and vitamin D you should consume for healthy, strong bones.
- Supplements: If you want to ensure that you are receiving adequate amounts of vitamin D and calcium for healthy BMD, supplements are a great option. Luckily, at Core Performance Physical Therapy, we sell supplements from California Physician’s Supplements. I love their Bone Care, which includes top-quality calcium citrate and vitamin D3 without any colors or preservatives. Whichever you choose, make sure you check the quality of your supplements… not all are made the same!
Your skeleton does some seriously important stuff… gives your body rigid mechanical ability, protects our internal organs like your heart and lungs, and serves as a source of minerals necessary for many things including muscular contraction. Without it, we would all be slithering slugs! Take care of your bones as you get older through proper diet, dynamic exercise, and maybe some supplements. Your aging body will thank you!
References: Charles H. Turner and Alexander G. Robling. 2003. Designing Exercise Regimens to Increase Bone Strength. Exercise and Sports Science Reviews. 45-50.
Lena Parker
Yoga Instructor, PT Aide
Comments
When you have this condition, your bones get weak and thin. They become more likely to break. It’s a silent condition, which means you don’t feel any symptoms. Without a bone density test, you may not realize you have osteoporosis until you break a bone. The X-rays measure how much calcium and minerals are in a part of your bone. The more minerals you have, the better. That means your bones are stronger, denser, and less likely to break. The lower your mineral content, the greater your chance of breaking a bone in a fall.
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