By Mia Bremer

The last time my good friend, Diana, went to the doctor, she was one inch shorter than she had been two years earlier. Her doctor told her it was because of small spinal fractures or compressions due to low bone mass. “I’m only 55 years old! How can that happen?” she wondered. Unfortunately, she is one of the more than 43% women over the age of 50 who will suffer from osteopenia (low bone mass) or 13% of women over 50 and 27% of women over 65 who will have osteoporosis (very low bone mass) in their lifetime. And with it, a higher chance of bone fractures.

More than 300,000 people are hospitalized in the United States with a hip fracture every year. From her appearance, Diana appear to be a candidate for osteoporosis. She has a larger boned frame, as do all the women in her family. She was an avid softball player when she was in her 20s and continues to walk with her husband most nights of the week. Her workout routine was sporadic with a concentration on cardio activities. This is a clue here as to why her workout wasn’t strengthening her bones. And, while genetics are one factor leading to osteoporosis, there are lots of preventative measures Diana, and all women (and men), can take to prevent bone loss or maintain bone mass.

How bones work

Bones consist of two parts. The outer, harder shell is called “cortical” bone. Inside is the lighter, thinner “trabecular” bone which you find in the center of each vertebra and the in the rounded ends of long bones. It’s this lattice-like trabecular bone that goes through many more remodeling cycles in its lifetime than does cortical bone.

Remodeling happens as bone is absorbed and re-formed throughout your life. When we’re adolescents and young adults, the rate of reabsorption is less than the rate of formation, thus we grow more bone. After that point, the regrowing happens at a slower rate than the reabsorption – unless we do something to help that bone regrow more quickly, such as impact exercise and resistance training.

What causes bone loss?

Genetic traits can increase a person’s risk for osteoporosis, such as:

● Northern European or Asian descent

● Fair complexion

● Small, thin frame

● Family history of osteoporosis

Besides genetics, other factors increase your risk. The single most important factor in low bone mass is the presence of estrogen. Estrogen acts as an anti-reabsorptive agent in the body by controlling the rate of bone removal from the body. Without estrogen, bone is removed more quickly than it is formed, resulting in a net loss of bone. Because women lose estrogen as they progress through menopause, osteoporosis affects women more often than men. In addition, men have a higher peak bone mass than women to begin with. However, it is not unheard of in men, particularly those who meet the genetic risk factors, so it shouldn’t be ruled out entirely.

Despite these risk factors, there are other factors that we can control. Dietary calcium intake, for example, can be controlled by adding low-fat dairy products to your diet, or taking a calcium supplement. Shoot for the following at the direction of your doctor:

● Adults over 25 years – 800mg/day

● Individual between 10-24 years – 1,200mg/day

● Postmenopausal women – 1,500 mg/day

A sedentary lifestyle is one of the biggest controllable factors you have to prevent osteoporosis. While estrogen replacement and other new drugs help prevent reabsorption of bone, they do not help grow new bone. People who are physically active have, without fail, shown to have higher bone mass than those who do not exercise or lead active lives. New research has shown just how much exercise is needed. From a number of research studies reported in the ACE Clinical Exercise Specialist Manual:

“The optimum exercise protocol must sufficiently overload the bone and push it beyond the “lazy zone” to promote bone formation. Exercises below this threshold will not promote bone growth. Therefore, exercises such as walking and running, which produce low-force magnitudes but high force repetitions, do not represent enough of a change in daily loading to signal an increase in bone mass.”  It goes on to say that athletes and recreational sports/exercise participants whose sport or workout involves high impact activities using power movements (jumping, wrestling, basketball, and resistance training to name a few) have increased bone mass over endurance athletes, swimmers, etc. Of course, endurance sports are great for other reasons, mainly cardiovascular health, and weight loss.

This means that for those of us who are able, we must safely add some impact exercises such as jumping to help increase bone formation. Those with injuries or disorders that affect the knee joints – which includes most of us as we age –  must continue to overload the bones by performing resistance (strength) training exercises a couple of time each week.

Exercises to Strengthen Bones for Older Adults:

Bug Stomping

Stand on one leg. Use a sturdy table or chair for support if needed. “Stomp” the other foot with force into the floor as if stomping a bug.

Try for 30 reps on each leg daily.

Jumping or Jumping Rope

Start with a very small jump, landing from toe to heel. Start with a few jumps daily and increase to 20-30 over time.

Stair Climbing

Walking up stairs or steps, pushing through the whole foot and engaging the abdominals is another way to add resistance and strengthen bones.

Resistance Training

Training the entire body using weights, bands, or machines place stress on the bones, as well as the muscles. Weight training is important for many reasons, including maintaining independence throughout your life and keeping bones strong.

Back Bends – not necessarily a strengthener but a safe way to move the spine and strengthen the back. Think about lifting up and back. Support the lower back with your hands.

Stretches to Modify if you have Osteoporosis:

Spinal Rotation – Supine Leg Drops

Rotational movements, especially if done incorrectly by leaning forward or back at the same time are contraindicated for people with osteoporosis. The spinal stretch below, however, is a safe stretch.

Side Stretches – This UP, not over

Rather than leaning to either side, which increases compressive forces on the spine, think UP, not over.