Osteoporosis affects an estimated 28 million people, 80% of which are women. Most of these women probably believe that this condition is just what happens as you get older but osteoporosis is a preventable disease! Prevention must begin early however because by the age of 20 years of age, you have acquired 90% of your total peak bone mass. The good news is that your bones are a dynamic, living substance-always in process of breaking down and rebuilding. Your best defense against osteoporosis is to help your body have the things it needs to be healthy. Being dense takes a smart woman!
Let’s start with some facts. Osteoporosis is a condition where there is less bone- it becomes more fragile making it easier to beak. When you have lost just some of your bone density it is a condition called osteopenia. This is a precursor to osteoporosis and it is imperative that you discuss options to improve your bone health BEFORE it progresses to osteoporosis. When you only have about 75% of your peak bone mass you will be diagnosed with osteoporosis. Bones in the spine usually show signs of osteoporosis first because your vertebrae are mostly made of trabecular (soft) bone. Because we have some many activities and movement patterns that bring us into forward bending, these weakened vertebra tend to collapse in the front thus causing a “wedge” deformity. As the front portion of your vertebra collapse, your spine starts to hunch forward, resulting in the common prominent hump in the midback called a thoracic kyphosis or Dowagers Hump. Other bones often at risk for damage and thus fractures are the bones of the wrist and hips.
So what is a woman to do? First, take care of your children’s bone health by assuring they have adequate calcium in their diet and they get plenty of exercise to promote healthy bone growth. Remember, prevention is the best policy. For adult women, it is very important to advocate for your health with your health care providers to assure you are tested if you have many risks factors for osteoporosis. Risk factors include a family history of osteoporosis, being post-menopausal or a smoker, excessive alcohol consumption, being sedentary or having a low calcium diet.
If you are diagnosed with ostoepenia or osteoporosis work with your doctor to determine if medications are appropriate. Discuss the need for calcium supplements or if any medications are contributing to your condition. You must have adequate calcium intake and the best thing to do is eat plenty of foods rich in calcium. As an insurance policy you should take a calcium supplement on a regular basis. Women over 65 years of age or who are post-menopausal should have 1500 mg of calcium every day.
The other very important element to manage osteopenia or osteoporosis is EXERCISE. Not all types of exercise are the best to deal with osteoporosis. Remember how your spine has a tendency to fold forward? A proper exercise program includes exercises that stretch tight muscles in the front of your trunk (flexors) and to strengthen muscles in the back (extensors). A qualified physical therapist can assess your posture and devise a program to address the specific areas that you need to correct postural deviations.
Exercise with weights provides a stimulus to the bones that increase bone building and is an important part of an exercise program. It is generally recommended that you do resistive training at least twice a week. There are several ways to do resistive exercises. The most common would be lifting weights. You can use hand (free) weights or machines that have a progressive weight resistance. You can also use resistive bands and your body weight to provide the stimulus of the muscle/tendon pulling on the bone. Start with a weight you can lift with a little effort 10 times and do 2 sets. Increase your repetitions slowly and try to add some weight every other week. Listen to your body and be consistent.
Walking or other weight-bearing exercises also provide the type of stimulus to your bones that promotes bone building. Walking should be done 4-5 times per week for the best results with a goal of 30 minutes. However, you need to respect your body and start an appropriate level. For sedentary or deconditioned women, this may mean starting with just 5-10 minutes walks initially. Remember it helps to keep things interesting. Try a dance class or try hiking with a friend. To be successful, you must stick to this for the long haul.
The pain most often associated with osteoporosis occurs when you suffer a fracture. It is very important to prevent this occurrence. In addition to properly managing your condition, you must take steps to assure your home and work places are free of fall hazards. This means removing throw rugs or cords that are stretched across walking areas, and have adequate lighting. The other issue in fall prevention is to improve your balance. This can be done through exercise or activities that appropriately challenge your balance.
Remember, properly managing osteopenia or osteoporosis is about getting all the facts. You need to balance your diet, proper medical management and proper exercise. If you don’t know where to start, ask your doctor to refer you to a physical therapist with experience treating women with osteoporosis.
Kathy Elston, PT