Pump Up Your Bones: Staying Strong to Prevent Osteoporosis
By Lynn Pattimakiel, MD
Those dinosaur skeletons at the museum may have given you the wrong impression. Bones inside your body are more than just scaffolding. They’re not hollow. And they’re certainly not lifeless. Your bones are alive! They are living tissues that are constantly changing. On the outside, they have a “shell” of dense bone. But on the inside, they’re like a sponge. In addition to supporting your body and protecting vital organs, bones store calcium and other minerals. When your body needs calcium, it breaks down and rebuilds bone in a process called “bone remodeling.”
When Bones get Weak
Up until about age 30, you build more bone than you lose. That reverses after age 35, when bone breakdown outpaces bone buildup, resulting in a gradual loss of bone mass. In a person with osteoporosis, the loss is quicker. The bone’s spongy center begins to have more and larger “holes,” making the bone weaker and more likely to break. Up to 50 percent of women and 25 percent of men older than 50 will break a bone due to osteoporosis. You're at higher risk for the disease if you:
- Are petite and thin. Smaller people have less bone to lose than people with more body weight and larger frames.
- Are White or Asian.
- Have entered menopause, are postmenopausal and/or are low in estrogen. Menopause is when estrogen, a bone-protecting hormone, drops dramatically in women..
- Have a family history of osteoporosis. Take notice if your parents or grandparents had signs of the disease. Breaking a bone when falling from a standing height — even when slipping on ice — is a telltale sign.
- Take certain medicines, such as steroids.
- Lead a sedentary lifestyle.
Often, there are no symptoms of osteoporosis. You might not know you have it — until you break a bone, that is. But you can take steps to prevent it, starting with exercise.
Just like other parts of your body, bones get stronger with exercise. The sooner you start bonebuilding exercise, the better. The stronger and healthier your bones are in your younger years, the stronger and healthier they’ll be in your later years. It’s like getting a running start to get ahead of osteoporosis.
The best exercises for bone building? The weight-bearing kind, which provides resistance and stress to bones. A muscle pulling against a bone stimulates cells to build new bone.
Weight-bearing exercises include:
- Strength training with free weights, resistance bands or machines
- Walking, hiking
- Dancing, aerobics (Zumba®, Jazzercise® classes)
- Active sports (tennis, baseball, basketball, soccer)
- Karate, kickboxing
- Tai chi
Swimming and bicycling, while great cardiovascular exercises, don’t force your body to work against gravity as much as the above exercises. Therefore, they aren’t as effective at strengthening bones.
Exercising if you Already Have Osteoporosis
Always check with your doctor before you begin an exercise program — especially if you’ve been diagnosed with osteoporosis. Fear of fracture is no excuse to avoid exercise. In fact, strengthening your muscles is a great way to protect your bones, not to mention improve your coordination and balance so you’re less likely to fall.
Experts usually advise people with weaker bones to protect their spines. To do this:
- Avoid back-bending and trunktwisting movements. Golf and tennis, which use these motions, are off-limits. Perform Yoga and Pilates® with caution, avoiding risky movements and positions.
- Avoid high-impact exercise. Running, jumping and other abrupt movements can spell trouble for weaker bones.
- Low-impact exercises. Gentler movements are gentler on your bones. Brisk walking, light jogging and dancing are good options.
- Strength training. Squats (or gentler chair squats) and other exercises that use your own body weight as resistance are usually safe exercises. Try using small free weights at least twice a week.
- Stretching. Move your joints through their full range of motion to improve fl exibility and promote good posture.
- Balance exercises. Doing tai chi, or even simple challenges like standing on one leg, can build up your stability.
The Backbone of Osteoporosis Prevention
Of course, exercise alone doesn’t prevent weak bones. It plays a supporting role. The backbone of osteoporosis prevention is still a diet rich in calcium and vitamin D. That means getting plenty of dairy products, dark green vegetables like spinach and broccoli, and fish (with bones). Many people require calcium and vitamin D supplements, as well. Check with your doctor.
In addition, avoid smoking and excessive drinking. Both are associated with low bone density. For some, these lifestyle factors may not be enough to ward off osteoporosis, particularly when certain medications or medical conditions are involved. Ask your doctor if you should have a bone mineral density test or if medication might help strengthen your bones. With good lifestyle choices, you and your doctor can help keep your bone health from becoming extinct.
Lynn Pattimakiel, MD, is a physician in Cleveland Clinic’s Center for Specialized Women’s Health. To schedule an appointment with her or another women’s health specialist, call 216.444.4HER or visit clevelandclinic.org/womenshealth.