By Nancy Alexander, PT, CSCS
Fact: You can increase your bone strength and improve your balance at any age… it’s true – at ANY age.
Did you know that bone remodels throughout our life? … It is a continuous process. After the active skeletal growth phase in youth, and after menopause in women (a bit later in men), the remodeling process becomes unbalanced and we begin to lose more bone than we replace. This results in a net decrease in the total amount of bone.
Conditions that exhibit decreased bone density like osteoporosis and osteopenia don’t have to happen if we have enough bone mass. If we have enough reserve it’s not an issue. And, we can increase it with exercise.
In addition, we can improve our balance at any age. Balance is neurological in nature and this system does break down some as we age. But research shows us again and again that with targeted exercise, this can be reversed.
Ten million Americans have osteoporosis – 9 million of these are over the age of 50; another 34 million Americans have low bone density. Your bone density is so important as you age. One half of women and two in five men will develop osteoporosis during their lifetime. Osteoporosis is the underlying cause of approximately 2 million fractures every year. Back pain, caused by changes in the vertebrae, may be the first sign that something is wrong. (Source: National Osteoporosis Foundation)
Do you know which bones are more likely to fracture when you have osteoporosis?
There are two types of bone tissue: cortical and trabecular. Areas with more trabecular bone tissue are at greatest risk for fracture when you have osteoporosis. These include the ends of long bones (eg femur or hip); radius (wrist); and the vertebra (spine).
With osteoporosis, you can see bone loss and architectural changes when imaged. This is not the case with osteopenia. Osteopenia is sometimes called “early stage” osteoporosis. I think this is a bit of a misnomer. Low bone mass (osteopenia) does not always mean you will get osteoporosis, but it is a risk.
Approximately 48 million Americans over the age of 50 years have low bone mass. Genetics play a role and so does race and ethnicity. It can be affected by poor diet, lack of exercise, smoking and drinking alcohol too much.
I once worked with a patient who had fractured his shoulder blade when he fell while skiing. He was in his 50’s at the time. As a skier myself, the more I thought about his fall it just didn’t make sense to me. That fall should not have caused his shoulder blade to break. I shared my concerns with him at his next visit and he was thinking the same thing. I suggested he have his bone density checked and sure enough, he had osteopenia. The good news was now he could put in place strategies to help increase his bone strength.
Bone density is assessed by something called a Dexa Scan. This is considered the gold standard for measuring bone density. The World Health Organization (WHO) uses a classification known as the T-Score. Here are the scores and what they mean:
-1 to (+) = healthy bone
-1 to -2.5 = osteopenia
<-2.5 = osteoporosis
It is important to know your numbers. So many people I ask have been scanned but are not able to tell me their T scores. Knowledge is power. By knowing your score, you can see where you lay on this scale and investigate what strategies you need to put in place now.
All women over the age of 65 should get a scan, according to the National Osteoporosis Foundation and the U.S. Preventive Services Task Force. Experts differ in their recommendations for bone scans for men. The National Osteoporosis Foundation recommends that all men over the age of 70 should get a bone scan. With certain co-morbidities and family history, scanning is recommended at a younger age.
Consider the importance of fall prevention strategies for those with decreased bone density. Fall prevention is especially critical for those with osteoporosis. People with low bone density are more likely to break a bone compared to people with normal bone density. Remember you can build bones at any age. Take action now to improve your fitness level and safety.
Just like building a bank account
Structured exercises help build stronger bones. Regardless of age, we can always still strengthen our bones and remember, we can always improve our balance too. Think of your bones as a savings account. There is only as much bone density in your account as you deposit. Keep depositing!
Bones builds in relation to impact, speed, direction, and force. Site specific exercise helps: hip, spine, wrist. Beware to avoid spinal flexion, especially loaded flexion. Avoid combining spinal flexion, lateral flexion and rotation all at the same time.
Weight bearing and strength training exercises are ideal to help you build strong bones. A new program called Buff Bones® is one of the few programs safe for those with osteoporosis and can be easily modified for other chronic conditions commonly seen in the adult population.
Buff Bones® is a medically-endorsed, full body workout for bone strengthening and balance. It helps strengthen your muscles too. It integrates Pilates, strength training, functional movement and rehabilitative exercise to improve the health and longevity of your bones and joints.
Only licensed instructors can teach this class. As a licensed instructor I offer this at two locations: Oasis Rochester in Rochester, NY and at the Canandaigua YMCA in Canandaigua, NY. Current classes are sold out but more will be offered soon. I also bring my physical therapy experience with me to focus on proper form and to help to provide education to all.
Each class is one hour long and performed with bare feet for optimal benefit. We use a mat and light hand weights are encouraged if desired. Participants need to be able to get up and down from the floor without assistance. Always consult with your physician before starting any new exercise program.
Each class follows a sequence starting in standing, then we lay on our backs. We then transition to side-lying, hands and knees, and on our stomach before rising back to standing. The class ends with light stretching and “centering.” Class participants describe the class as gentle, yet effective.
In summary, remember that movement and exercise on a regular basis are critical for long term health, fitness and quality of life. We need to keep moving! For those with osteoporosis or osteopenia, seek out safe bone strengthening strategies that integrate alignment and balance techniques. Even if you don’t have osteoporosis or osteopenia, strengthening your bones is important and can and should be done at any age.