I've got a bone to pick with you
Today we’re talking bones and bone health, don’t worry if you feel out of your depth with this topic we’ve got your back ;)
You may or may not know that as we age our muscle mass and bone density can both start to decrease. As a basic timeline through our life, we want to aim to build maximum bone strength in childhood into adolescence then maintain and improve this muscle and bone strength during adulthood and as we age we want to do everything we can to reduce the loss of muscle mass and bone strength.
Bone health is an important part of our general health, however, a lot of people don’t realise they have lost any bone strength or density until they have an injury/fracture from a simple fall.
Bones are flexible but very strong, their main function is movement and protection of vital organs (the rib cage). During childhood bones grow, the rate of growth varying through different stages, which leads to those growth spurts. Once fully grown, our bones are constantly rebuilt during adulthood in a process called remodelling. This doesn’t mean the bone “breaks” and is fixed, it means when we apply stress to a bone through things such as impact and resistance based exercise, it adapts and becomes stronger. Bone is living tissue and this process of remodelling happens due to the effects of cells called osteoclasts (break down bones) and osteoblasts (build new bone), this is why bones can heal after a break.
As we age if we don’t help keep our bones healthy by eating a healthy varied diet and exercising, there is a higher risk of developing osteoporosis. Osteoporosis is when the structure of the bone is compromised and becomes weaker and less dense, if this occurs then there is a higher risk of a bone breaking. In Australia, 1.2million people are estimated to have osteoporosis, with a further 6.3million having low bone density.
Now, osteoporosis generally doesn’t affect the whole entire skeleton, research has shown that the most common sites where broken bones occur are the wrist, hips and spine, however, that doesn’t mean other areas are not at risk in someone with osteoporosis.
What can put you at a higher risk of developing osteoporosis or low bone density???
Both women and men can be affected by osteoporosis, but it is more predominantly seen in women with only around 25% of cases in men. People over 50 are the most high risk age category, however, it can occur in younger people depending on specific risk factors, which we will take a look at below.
Family history:
Poor bone health can be hereditary so it's always good to know your family history and if it is in the family then you can be proactive and have your bone density measured before sustaining any fractures or breaks.
Micronutrient deficiencies:
Firstly what is a micronutrient? Within diet and nutrition we have Macronutrients which are your Proteins, Carbohydrates and Fats, then we have micronutrients which include things like vitamins, minerals, fibre, iron etc. Both Calcium and vitamin D are both crucial in bone health, calcium is stored in the bones and teeth giving them structure and “hardness”. Vitamin D is needed to allow for the absorption of calcium. People with low calcium or vitamin D should be investigated.
Medical history:
There are different medical conditions and medications that can have a negative impact on bone health. If you have any of the following conditions or are taking any similar medications you may be of higher risk of low bone density (if you have any of the following you will have already been informed about the risks, hopefully 🤞🏼)
Low hormone levels: perimenopause or early menopause in women or low testosterone levels in men. Also something to be mindful of if you are a young female who has lost a lot of weight and has lost their menstrual cycle, this would also have a big impact on hormone levels and risk of low bone density.
Diabetes
Certain cancer treatments
Anorexia nervosa (and other disordered eating)
Corticosteroids
Thyroid conditions
Rheumatoid arthritis
Chronic liver or kidney disease
Lifestyle factors:
This is a big one and probably one that you have the most control over. Lifestyle factors that would increase your risk of low bone density or poor bone health would include smoking, excessive alcohol intake, poor or limited/restrictive diet and low levels of physical activity or leading a sedentary lifestyle.
What can I do to help myself?
Leading on from the last bullet point more specifically, what can you do to help improve your bone health? For a bone to adapt and get stronger it needs high loads and high strain rates (something that is going to stress the muscles and the bones enough that they need to change and adapt), short bouts of loading (lower volume but increased weight), variability (doing different exercises to challenge the musculoskeletal system) and an excess of readily available energy (this comes down to good nutrition and eating enough to support your bodies needs, as well as doing exercise that is not going to be too energy intensive).
There are different types of exercise we can do to help build bone strength, resistance training/lifting weights is one of the main ones and probably the best for building bone and muscle strength. Remember, without muscles, the only thing supporting our joints would be the ligaments. Strong muscles add stability, help us carry our shopping bags inside in one trip and ultimately are the main character in being functional.
Resistance training exercise examples:
Weighted lunges
Weighted squats
Shoulder press
Rows
Hip ab/adduction - with resistance band or machine
Weighted calf raises - both standing and seated
Back extensions
Core exercises: Bird dogs, deadbugs, side planks
Other things we can do to help increase bone health is weight bearing impact exercises such as running, jumping (bounds, virtical jumping and multidirectional), multidirectional sport, dancing, impact aerobics, skipping, we could go on forever, but make sure you are doing your resistance training as well and not just weight bearing exercise (body weight). We need to be putting high enough load on our bones to force a change and adaptation.
A recent study has shown that running alone doesn’t build bone, for a few reasons, such as its low load, long duration making it energy intensive and its repetitive, so lacks variability. Resistance training allows us to expose ourselves to higher loads, shorter duration and more variability.
As well as impact and ressitance training, as we age its also important to work on balance. This is going to reduce the risk of falls. I know you'll be sat thinking I'm not old enough to be at risk of a "fall" but before you know it you won't be able to stand on one leg while you brush your teeth, so practice those single leg balance exercises, coordination, walking or balancing on uneven surfaces, walking backwards/sideways, ball throws while standing on one leg.
Enough about exercise, you're probably already tired from reading about running, jumping and lifting weights. Now let's talk about the importance of food and nutrition. We need enough calcium to store in our bones to keep them strong, and we need vitamin D to help us absorb the calcium, so ensure to get out in the sunshine (being sunsafe obviously) or if you are vitamin D difficient, speak to your healthcare provider about supplements. Next, is protein, enusre you are eating a high protein diet as proteins are used for growth and repair. After stressing those bones and muscles in the gym, we need proteins to remodel and repair the micro-damage to build stronger bones and muscles. Lastly, Carbohydrates, do not be scared of carbs, they will not make you gain weight on their own, what they will do is provide your body with easy accessible and a readily availble energy source. Ultimately, a balanced diet and lifestyle is what we are looking for. If you need assistance with your diet or more in depth information, get in touch with a qualified health professional (such as your GP) who can help with refering you to who you need to see.
Runners listen up, you have just read above that running alone is not enough to build bone strength, make sure you are doing your resistance training, this is going to help you train for that marathon with less risk of injury to your muscles and bones. Stress fractures can be a result of low bone density and poor bone health, if you want to know more about stress fractures click the link and it will take you to our blog from a few weeks ago about bone stress injuries.
For you lot out there using the “I'm getting old” phrase, make sure you’re prioritising your resistance training. Take a look at the image below, this shows the difference in muscle mass of a quad (thigh muscle) between a young male, an inactive 66 year old male and an active 66 year old male.
So, after all the exercise you are going to be doing after reading this, make sure you get yourself booked in to Muscle Therapy Australia, so we can help you on your journey to building and maintaining bone and muscle strength. We can help with hands on treatment to keep those muscles finely tuned as well as giving some exercise suggestions and build you an exercise program that suits your needs.
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