Osteoporosis - "That only happens to old people, doesn't it?"

By Michelle Perkins

Well, it depends what you mean by “old”.  Certainly, if you consider over 50 “old”, then you are right – because more than 4.7 million people over 50 in Australia have poor bone health, and subsequent increased risk of fractures. However, even quite young athletes, such as distance runners, can have very low bone density, and suffer stress fractures.

The main issue is how to prevent bone loss as we age. Our bones are alive and remodeling all the time. We reach peak bone mass at around 18-20 years of age, which then stabilizes until age 30. From here, there is a slow downward trend until menopause, when we lose up to 20% of our bone mass in the first 5-7 years.

After 60, things get really bad, as 1 in 2 women over 60 will suffer an osteoporotic fracture! So no matter what age you are, you need to start looking after your bones – they are your invisible means of support.

Osteoporosis and it’s precursor Osteopenia, are painless, so, unless you have some of the risk factors, or have had a bone density ( DEXA) test, you will not know how good your bones are.  Most people are diagnosed AFTER the fracture has occurred – then not so painless at all.

Risk factors;

• Genetics – does your mum have it? Are you Asian or Caucasian?
• Have you ever broken a bone?
• Were you late starting periods, or early entering menopause?
• Have you been anorexic or have a very low body mass index?
• Have you had prolonged corticosteroid therapy?
• Have you been on hormone treatment post breast cancer?
• Are you older today than you were yesterday ??

If you tick any of these boxes, don’t panic! Speak to your Doctor, then start taking preventative measures. It is never too late to look after your bones.

Of course, the best time to worry about bones is prior to the age of 20!

The more you have in the bone bank, the better. So, if you are a mum, make sure your kids have a diet including calcium-rich foods, e.g. milk, cheese, yoghurt, green leafy vegetables, whole canned fish with soft bones in, nuts, tofu set with calcium.

• Age 5-9: aim for 800-1000 mg per day.
• Age 9- 18: up to 1000-1300 mg per day.

These dietary guidelines continue throughout life:

• Age 20 – Menopause: 1000mg Ca per day
• Post-menopause: 1300 mg per day

As well, the usual rules apply

• Reduce alcohol and caffeine intake
• Stop smoking
• Maintain a healthy weight range
• Include daily sun exposure for vitamin D (6-8 minutes a day in Queensland)

And, here’s the Physio/Pilates connection:

Exercise: what is best?

1. Weight-bearing exercise, such as walking, running, , squats, stair-climbing. Planks can be considered weight-bearing for your wrists (a common site for osteoporotic fractures).
2. Resistance – using weight to pull against bone. Can be free weights, springs (as in Pilates Reformer), or theraband .
3. Impact – running, jumping, hopping, skipping. The moves have to be in different directions to strengthen the bones evenly. Gymnasts have the best bones!

In our studio, we have started a “Better bones, Better balance class” which includes all these elements in a single Pilates class, as we have so many clients in the low bone density zone.

Principal Physiotherapist and Certified Pilates Instructor, Physio Plus Pilates Noosa.