In childhood, you probably had several friends who had broken bones. Falling from the monkey bars, running at recess or playing sports are all common ways kids break bones.
In adulthood, broken bones typically happen less and you might not think about your bones as they carry you through life. However, aging can take its toll on the body and the bones are no exception.
“Your bones are living tissue that grow and renew constantly,” said Taylor Harris, DO, an orthopedic resident at Good Samaritan Regional Medical Center. “To keep them healthy as you age, your bones may need a little more care and support.”
Dr. Harris reported that bones naturally increase in density until about your 20s. After that your bones maintain their peak density. New bone is constantly formed and reabsorbed in adulthood and you typically maintain a healthy bone mass without having to worry too much about it. However, in your 50s and beyond, you may start to lose some density every year unless you take care of your bones.
Bone Density & Osteoporosis
For women, bone loss can accelerate during menopause when protective levels of estrogen decline. The National Osteoporosis Foundation reports women may lose as much as 20 percent of their bone density during the five to seven years following menopause. Men experience loss of bone density as testosterone levels lower, but that process is typically slower and occurs later.
According to research published in the Journal of Bone and Mineral Research, by age 50, 5 percent people have osteoporosis, a condition where the bone structure has deteriorated and is no longer as dense, and 40 percent have low bone mass, a thinning of the bones that can make them vulnerable to fractures. By age 80, the number of adults with osteoporosis grows to 26 percent and another 53 percent have low bone mass.
“Having osteoporosis or low bone mass is concerning because it becomes more likely you’ll have a fracture,” said Dr. Harris. “Healing can be difficult and you are more likely to have another fracture in the future.”
Fractures & Healing
According to Dr. Harris, lumbar spine compression fractures are the most common osteoporotic fractures but a broken hip is the most serious osteoporotic fracture in older adults. Other bones at risk for fractures in those with osteoporosis are the wrist and shoulder. A fall from a standing position is often the cause of fragility fractures in adults with osteoporosis.
“If you have a low-velocity injury, like falling from ground level, we wouldn’t expect you to have a fracture if your bones are healthy and strong,” said Dr. Harris. “However there really are no other symptoms of osteoporosis, so a broken bone is usually the first sign people have that their bones are thinning unless they have been screened.”
A test that determines your bone mineral density is called dual-energy X-ray absorptiometry, or DEXA scan. A DEXA scan is a painless, non-invasive procedure. It is simply a type of X-ray of your bones. The screening determines your bone density compared to a 30-year-old.
“After the screening we can tell if you have thinning bones and then take steps to help keep your bones safe,” said Dr. Harris.
That may involve lifestyle changes or medications.
Not all fractures in your senior years are due to osteoporosis or low bone mass, but Dr. Harris noted it’s a good idea to have your bones checked if you’ve had a break and you’re 50 or older.
Keep Your Bones Strong
While it is difficult for you to change some of the risk factors for osteoporosis such as your gender, family history or age, there are things you can do to modify your risk of a fragility fracture. Maintaining and building bone mass during adulthood is possible. Dr. Harris noted the things you can do to keep your skeleton strong:
1. Get Calcium From a Healthy Diet
Eat foods rich in calcium like cheese, yogurt, legumes, canned sardines or salmon with bones, and dark leafy greens like kale and broccoli. Adults should get 1,000 mg of calcium a day. Women 65 and older and men 70 and older should get 1,200 mg a day. Because too much calcium can have negative side effects, don’t take a calcium supplement unless it is recommended by your doctor.
2. Add a Vitamin D Supplement
Vitamin D helps your body absorb calcium and supports bone growth. Supplementing can play a important role. Living in the Pacific Northwest means that it’s impossible to get enough vitamin D between October and April, since we’re farther away from the sun. Aim for 800 to 2,000 IU each day. Even in the spring and summer months it can be difficult to get enough D if you’re someone who tends to avoid the sun or wears sunscreen regularly.
3. Start Low-impact, Weight-bearing Exercise
This helps to build bone density and muscle which can protect you in the event of a fall and improves your balance and mobility which can help prevent a fall. Activities to help build strong bones include strength training with resistance bands, riding a bike, aerobic exercise on an elliptical machine and stretching. If you are new to this type of exercise, Dr. Harris recommended starting with yoga or tai chi two or three times a week.
4. Quit Smoking
According to Dr. Harris, smoking has been linked to increased alcohol consumption, poor diet and lower physical activity, which are all risk factors for osteoporosis. Studies have shown that smoking is linked to a higher risk of having a fracture, and that smoking makes it harder for your bones to heal if there is an injury.
5. Get a DEXA Scan
Begin getting a DEXA scan at age 65 for women or 70 for men. You may need to be screened earlier if you have other risk factors. Discuss any concerns with your doctor and ask about their recommendations for helping keep your bones strong.
Get up-to-date on your screenings with a primary care provider.