Bone Health: Osteoporosis and beyond
Lifting weights is a great way to build stronger bones!
Fractures, or broken bones, are a leading cause of injury in the elderly. Fractures of the hips in particular are highly debilitating and an estimated 33% of people over the age of 50 die within 1 year after hip fracture! An alarming number, for certain.
Fortunately, bone health is not an uncontrollable element of a persons health.
Lets have a deeper look.
What are bones?
Bones are the basic rigid structures of bodies that provide support and protection for our varies organs and other structures. They also act as the levers which muscles pull upon to facilitate movement, provide storage for various minerals that are necessary for bodily functions and health, produce blood cells (within the marrow), and provide some fat storage.
Bone is made of collagen fibers in addition to various minerals, which in various combinations lead to more or less rigidity and “hardness”
Why do they weaken?
Bone mineral density (BMD) is a measure of how much mineral salt (Primarily calcium and phosphate) exists in the bone matrix. The higher the density of the bone, the harder that bone will be and the more force that bone may be able to withstand.
Bones are constantly being maintained by specialized cells call osteoblasts and osteoclasts. Osteoblasts are responsible for ADDING additional mineral to bone (making them harder) while osteoclasts are responsible for removing mineral. From age 0-20, osteoblasts are significantly more active than osteoclasts, leading to bone mineral deposition. After that, activity tends to even out and be more dependent on bodily needs and imposed demands.
If osteoclasts become more active than osteoblasts, bone mineral density decreases. This can happen for a variety of reasons, including mineral deficiencies, malnutrition, prolonged corticosteroid use, and the one that is maybe MOST controllable… Lack of stress/loading to the bone.
exercise and bone health
Since bone is living, active tissue, our bodies can stimulate more or less bone mineral deposition based on the demands that are imposed upon them. We all know that applying stress to muscles in the form of lifting weights causes your muscles to grow stronger, and bones are no different. If they are repeatedly exposed to stress, they will adapt to it! Conversely, if they are not exposed to stress (prolonged periods of inactivity/bed rest), they will grow weaker.
There are many ways to expose our bones to healthy amounts of stress. Generally speaking, any sort of weight bearing activity is applying force to the bones of the legs, spine, and trunk. This includes standing and walking. However in order to provide enough stimulus for positive adaptations, activity will likely need to progress to higher intensity activities including squatting, jumping, hopping, dancing, weight training. An added bonus of exercise for bone health is that not only do you get stimulus/load through the weight bearing activities, but when you are using muscles those muscles attach to our bones and pull on them, further causing stimulus and providing a gentle reminder to our body's natural feedback loop to deposit additional minerals!
Osteoporosis and osteopenia
If bone mineral density decreases significantly enough, a DEXA scan may be used to identify the level of mineral loss. Bases on these measurements, an individual may be given a diagnosis of osteopenia (mild mineral density loss) or osteoporosis (severe mineral loss).
There is much that could be said about these diagnoses, the medication and other interventions commonly used to treat it, and more. But most importantly for this subject matter, it is important to understand two simple, evidence-based facts:
It is SAFE to exercise with osteoporosis/osteopenia!
Exercise is the #1 most well-evidenced and effective treatment for osteoporosis/osteopenia!
Take home points
Fractures, or broken bones, are a huge concern in the elderly that are significantly more likely if an individual has poor bone density.
Bone mineral density changes based on a number of factors within our body, but most importantly, based on the amount of stress we place repeatedly on our bones.
Inactivity leads to dramatically decreased bone health.
Weight bearing exercise and weight training are safe and highly effective ways to increase bone mineral density and bone health, even in the presence of previously diagnosed osteoporosis or osteopenia.
It is important to work with a qualified expert to identify a safe and appropriate starting point and progression for your exercise program to improve bone health!