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Maintaining Healthy Bones Stuart Katzman, PT

This educational presentation by Stuart Katzman, PT, focuses on maintaining healthy bones and understanding osteoporosis. Osteoporosis is characterized by a loss of bone mass leading to an increased risk of fractures. This session covers key risk factors, including age, gender, race, and lifestyle choices, emphasizing the importance of a balanced diet rich in calcium and vitamin D, regular exercise, and monitoring bone density through DXA scans. It also provides guidelines for safe physical activities to strengthen bone health and improve stability.

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Maintaining Healthy Bones Stuart Katzman, PT

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  1. Maintaining Healthy Bones Stuart Katzman, PT • This presentation is intended to be educational in nature and is not intended as a substitute for professional health care.

  2. Osteoporosis Osteoporosis is defined as “a loss of bone mass and micro-architectural deterioration of the skeleton, leading to increased risk of fracture.” New England Journal of Medicine, 1991 Bone loss is painless and often unnoticed until a fracture or height loss occurs.

  3. Are You at Risk? • Race • Medications • Disease • Age • Gender • Menopause • Family history

  4. Risk Factors You Can Change • Eat a balanced diet with plenty of calcium and vitamin D - supplement as needed. • Maintain a healthy body weight. • Maintain a physically active lifestyle. • Do not smoke!

  5. Bone-Density Testing • Bone density is an important predictor of fracture. • DXA is a scan that measures bone density. • A physician can order tests for: • all women 65 years and older. • women under age 65: • with history of fractures. • taking medications like corticosteroids. • with considerable height loss. • men and women under 65 with multiple risk factors.

  6. Bone Health and Osteoporosis, 2004 Report of the Surgeon Generalwww.surgeongeneral.gov/library/bonehealth/

  7. Benefits of Exercise • Maximize • peak bone mass achieved in youth • Maintain • bone mass or reduce age-related bone loss • Preserve • muscle strength and postural stability to reduce future risk of falls and fractures • Beck B and Snow C, 2001

  8. Fight Fractures with Fitness! • Research demonstrates the benefits of exercise: • increases peak bone mass • maintains strong bones for life • reduces risk for falls • decreases stooped posture in women who are flexed

  9. Exercise Builds Bone • High-load, weight-bearing, jumping, and resistance exercise are best for bone. • Resistance exercises are site-specific: bone is strengthened when muscles pull on their attachments. • The stimulus must be dynamic, variable, and unique; not usual or familiar. • Bone-building effects of exercise are most pronounced during youth. “Bone is living tissue that responds to exercise by becoming stronger.” National Osteoporosis Foundation, www.nof.org

  10. Guidelines for Bone-Strengthening Exercise • Children and adolescents: • High-impact, high-intensity exercise. • 10-20 minutes 2 or more times a day. • at least 3 days a week. • Healthy adults: • Moderate- to high-intensity exercise. • weight-bearing activity 3-5 times per week (include jumping). • resistance exercise 2-3 times per week, at least 1 set of 10 repetitions (up to 3 sets). • 30-60 minutes a day of a combination of the above. • American College of Sports Medicine Position Stand: Physical Activity and Bone Health, 2004

  11. Consider Your Age, Fitness Level, and Risk Factors • Young healthy adults • high-impact, weight-bearing exercise • resistance training • “core” stabilization/ postural strengthening

  12. Consider Your Age, Fitness Level, and Risk Factors • Healthy adults over 50 • moderate-intensity exercise • strength training • weight bearing • “core” stabilization/postural strengthening • balance and coordination activities

  13. Consider Your Age, Fitness Level, and Risk Factors • Those with osteoporosis or history of frequent falls: • balance and coordination training • “core” stabilization/postural strengthening • before starting a new exercise program, consult your health care provider and physical therapist for instruction in appropriate and safe exercise

  14. High-Impact, Weight-Bearing jumping step aerobics and stairs dancing soccer racquet sports gymnastics Exercise to Strengthen Bone and Muscle

  15. Exercise to Strengthen Bone and Muscle Resistance and Strength Training • weights • elastic tubing • body weight

  16. Exercise For a Stronger, More Erect Spine • Extension exercises • Core stabilization and strengthening • Postural integration

  17. Balance and coordination Tai Chi unstable, uneven surfaces Exercise to Prevent Falls

  18. What About Walking? • Regular walkers have decreased risk of hip fracture. Best if you are a lifetime walker. (Coupland C, 1999; Krall EA, 1994) If you are sedentary, increased activity is beneficial. Risk of hip fracture doubles when you are on your feet less than 4 hours per day decreases when walking distance increases. (Cummings SR, 1995) Stay on your feet at least 4 hours a day!

  19. Bottom Line: No Flexion! • Safe Body Mechanics • Avoid bending, twisting, or flexing the spine. • “Hinge” at the hip.

  20. Take charge of your health by adding more physical activity into your life!If you have any questions, please call me at Evergreen Physical Therapy: 408-270-2280

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