[HOW DO WE CARE FOR OUR BONE HEALTH?]
How often do you think about your retirement savings? At what age did you start saving? What if caring for our bone health as early as possible in life was thought of as just as important as financially setting ourselves up for success earlier than later?
A very large portion of my patient population include masters level female and males athletes + athletes recovering from bone stress injuries. With these populations bone health is at top of mind and thankfully science is helping us understand the importance of building bone health at early age, how to re-write our path if we diverge from good bone health in our 20s and 30s, and how to decrease the progression of bone health throughout our 40s and beyond as our hormones are contributing to a downturn in our bone health.
Our bone health is vital for our quality of life. Below are a few interesting facts of about bone health and five ways we can take care of our bone health at any age.
FACTS ABOUT BONE HEALTH:
10% increase in peak bone mass in our teens and early twenties can decrease our risk for an osteoporotic fracture later in life by 50%. Participating in multiple types of sports that require change in direction and hard impacts are vital for bone health development in our teens.
Estrogen is the main hormone ruler of bone health. Testosterone in males is converted to estrogen to promote bone health. Other hormones that are protagonists for bone health: thyroxine, cortisol, parathyroid hormone (controls calcium levels), growth hormone, and vitamin D.
There are two main types of bone: Trabecular and Cortical.
Trabecular bone is “spongy” and highly sensitive to a downturn in hormones. The spine, pelvis, and calcaneous (heel bone) are trabecular bones.
Cortical bone is more compact and has an extra layer of protection. This type of bone is more responsive to changes in training load.
Stress fractures are multifactorial in nature and can be related to any number of causes such as a downturn in estrogen in females and testosterone in males, improper training + life load management, underlying history of poor bone health, and abnormal levels of the above mentioned hormones to name a few.
Fragility Fractures are fractures that occurs from a fall and are most often attributed to poor bone health or osteoporosis.
1/2 females and 1/5 males > 50 years old will experience a fragility fracture and there is a 50% change of never living independently again after experiencing a fragility fracture!
HOW TO TAKE CARE OF OUR BONES:
[1] Novel Stress: bones love a change in type of stress every once in a while. So, if you are a runner, performance of a different type of weight bearing sport: pickleball, dancing, etc would be beneficial in creating a novel stimulus for bone.
[2] Progression: bones love to be progressively challenged. Strength training is a well documented way to build bone strength. The pull of the muscle on the bone creates a stimulus that strengthens the bone. So, in the case of strength training, in order to consistently satisfy growth of the bone, it would be important to follow a plan that gradually increases the loaded lifted over time. Ie, 3 x 10-12 reps at 75% 1 rep max to 4-5 x 5 reps at 85-90% 1 rep max over a period several months.
[3] Recovery: bone becomes deafened to the effects of impact after approximately 100 foot contacts. Meaning, once 100 foot contacts have been achieved, the stimulus is no longer productive for improving bone health. And because of this, it’s important to follow a periodized plan for training such as 2-3 weeks of progressive training followed by one week of a step back in training and possibility 1 full week off every 12 weeks. We know that a 10% reduction of impact loading to a bone increases the sensitivity of bone impact by 100%!
[4] Specificity: two things bone love: high intensity variable impacts and progressive strength. Without these specific movements we are missing two specific tools for improving bone health.
[5] Consistency: this is a VERY important aspect of bone health in regards to rehabbing from a bone stress injury or fracture/compression fracture. A period of required rest will contribute to a decrease in bone strength. So, even though an imaging may show the bone has healed from the initial stress reaction or fracture, that doesn’t mean the bone is strong enough to withstand forces of returning to running right away. We must use the above principles of bone health to gradually increase the strength of the bone before jumping back into running.
The integration of the above principles is an art form (an not a panacea) as every individual’s presentation and need are vastly different and constantly changing! Thank you for reading.
References:
Bjsm. (2022, February 14). How to osteofight bone stress injuries. BJSM blog - social media's leading SEM voice. Retrieved December 5, 2022, from https://blogs.bmj.com/bjsm/2022/02/21/how-to-osteofight-bone-stress-injuries/
Keay, N. (2022). Hormones Health and Human Potential. Sequoia Books.
Tenforde, A. S., & Fredericson, M. (2022). Bone stress injuries: Diagnosis, treatment, and prevention. Springer Publishing Company, LLC.
#bonehealth #stressreactions #stressfractures #runners #triathletes
