Apr 21 2018
Osteoporosis and low bone density are at epidemic proportions. According to the International Osteoporosis Foundation, this affects 55% of the population over 50 years of age, both women and men. This number is expected to increase to 3 of every 4 people by 2020, that’s 75% of the adult population!
According to the U.S. preventative services task force, the protocol dictates that all women over the age of 65 should have a bone mass density (BMD) test. Wait a minute, doesn't something seem a bit amiss? If 50% of the population over FIFTY years of age is affected, and it affects both men and women, how is starting testing at the age of 65 considered preventative?
The BMD test was invented in the late 1960's at which time statistics generated from this test determined that the age of 65 was appropriate and that this was primarily a women's issue. Unfortunately the medical community has not kept up with the change in our lifestyles, so prevention has now become reaction.
Because of outdated protocols, Osteoporosis has been considered an age-related condition up to now. The misunderstanding has been that if you are of a certain age then low bone density and osteoporosis are inevitable. This does not have to be the case. There are many factors that increase the risk of Osteoporosis. Yes, some are fixed, like gender, ethnicity, and menopause. However, many are modifiable risk factors, which means that they are preventable with lifestyle changes. Here are just a few of those preventable risks:
- Alcohol use
- Low body mass (underweight)
- Vitamin D deficiency
- Insufficient exercise / sedentary lifestyle
- Low calcium intake
Notice that I have highlighted Insufficient exercise / sedentary lifestyle. This single risk factor is one of the biggest contributors to low bone mass and eventual osteoporosis in today’s culture, not just for those over 50 but for the entire population. We have just stopped moving! There are so many conveniences available to us that make life easier but that remove movement from our lives. Some examples include driving versus walking, computer usage, delivery services, and efficient workspaces (including in the kitchen and office). Heaven forbid that we have to bend down to get that toaster out of a cupboard.
These days, everywhere we walk is just to sit somewhere else. You walk out of your house to sit in the car, walk from your car (closest spot possible to the door, of course) to sit at work, walk to a restaurant to sit and eat, on Sunday’s maybe go to church to sit, then back to the car, then walk into the house to sit again. Maybe you don’t even leave your house most days, and your walking is just to sit in one room then another. That’s a lot of sitting happening and not much moving. Sitting depletes bone density and decreases strength, both of which inevitably create more wear and tear on the joints (osteoarthritis) and poor balance.
It’s not all doom and gloom, I have some GREAT NEWS: This risk factor is preventable as I mentioned with just a few adjustments to your daily life. If you already have low bone mass or osteoporosis, it is not too late, it is never too late to start moving again, and it doesn’t have to be difficult either.
According to a systematic research review by J A Todd and R J Robinson published in the Postgraduate Medical Journal (2003), "A number of studies have demonstrated significant gains in BMD in individuals with osteoporosis...Muscle strength improved significantly and bone mineral content also increased significantly as a result of exercise. Significant improvements in bone mass can also occur as a result of low impact exercise at the lumbar spine of women referred with established osteoporosis. Similar benefits have been reported in women with low BMD who have taken part in strength training. Iwamoto et al in a randomised controlled trial also found that high impact exercise increased BMD. However continued exercise was required to maintain any gains."
When we have weakness from immobility, there are many postural changes that occur in our bodies and these eventually change the shape of our joints and bones. Postural alignment of all joints and throughout the spine is an important aspect of optimizing how loads (body weight, external weight like carrying bags, babies, handweights, etc) are absorbed and transferred in the body. Joints that are misaligned create an environment for poor load transfer and as a result the bones are not able to become stronger, and in fact become increasingly weaker over time and contribute to deformation of the bony structures. An example of this is the wedging of spinal vertebrae characteristic of Osteoporosis sufferers, demonstrated as a hunched posture or excessively rounded (kyphotic) thoracic spine. The goal for any movement program intended to increase bone density and increase strength around the joints must start with correcting posture to realign the bones and increase load transfer.
"Wolff's Law states that bone will adapt to regular loads placed upon it, becoming stronger over time." (Lesondak, David, “Fascia: What it is and why it matters”). So what constitutes regular loads? Standing, weight bearing on the feet, knees or hands, squatting, lifting, carrying, jumping, walking, running, and basically any upright movement. When people are told they have osteoporosis it often comes along with a prescription to start lifting weights or to begin a more rigorous exercise program. This can be very intimidating for a person who is not already active, and especially for those who have a fear of falling. The key is that you just have to start to move again, even in small doses.
First, let’s check your posture…
1) Stand with both feet directly under your hips – notice if you naturally want to stand much wider than that. This is a common strategy to feel more balanced but this wide-stance puts excessive load on your knee and hip joints.
2) Put your thumbs on the front of your bottom ribs, and your middle finger on your pointy tips at the front of your hip bones.
3) Notice if your ribs are in front of your hip bones or vice versa. Shift the forward bones back until your ribs are stacked directly over your pelvis. Did your weight shift back over your heels? Great, you are now bearing weight over the strongest bone in your foot.
Have a look at my blog article titled “Stack your boxes: Strategies for standing and walking.” for other ways to check and correct your posture.
When your bones are stacked up, you should feel that you are standing straight and tall. Does anyone remember etiquette class or finishing school? A great way to condition the muscles to help you maintain this upright posture, try placing something on top of your head (nothing heavier than 2 lbs) and walk, stand and practice your single leg balance as you keep your new headpiece in place.
Ready to rebuild some bone? Let’s add some more movement into your life.
Here are some easy ways to increase bone-building loads into your daily routine:
- carrying groceries – carry one bag in each hand, and ensure even weight on both sides or switch the bag from one side to the other in equal increments
- lifting your children or grandchildren (depending on their age and size, of course)
- bending down (squatting) to lift something off the floor (see my blog article “Squat for your life” for effective squatting strategies)
- walking instead of driving OR park further away from your destination and walk from there
- sitting down and standing up – try repeating the sit-to-stand movement 5 times every time you sit down or stand up
- throwing and catching anything
- standing on one leg then the other – try to hold as long as you can before putting a foot down. Hold on to a wall to start, then progress to hands on hips
- fold laundry on a table while standing, or even better, while standing on one leg
- dancing (everyone should add a little dance into their day just for fun)
Start a journal of all the new movements that you are doing so that you can see your progress, but also so that you can see how many non-sitting minutes you are adding into your day. You’ll be surprised by how easy and quickly you begin to add more and more movement into your life with very little effort. Even better, you will notice how much better you feel, and even how much more confident you are as you get stronger.
Happy bone building!
Holly Wallis, Certified Movement & Rehabilitation Specialist, PMA®-CPT
Director of US Operations, Body Harmonics Pilates & Movement Institute
Studio Director, ReActive Movement, 6200 LaSalle Ave, Oakland, CA 94611
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