Patients with varying stages of osteoporosis were being referred to David Wilsey, a physical therapist with the Inova Mount Vernon outpatient clinic, and there was nothing he could do for them. So he created a program, BONE (Beating Osteoporosis Now with Exercise).
"The program was designed to be four sessions: evaluation, exercise, posture and nutrition, and fall prevention," Wilsey said. "You can't reverse the process of bone loss, but you can slow it down and replenish the calcium."
As the body gets older it losses calcium, which can weaken the bones, a condition more commonly known as osteoporosis. Weak bones can lead to fractures that can take longer to heal. Osteoporosis can not be cured, but it can be prevented and once diagnosed, it can be managed.
OSTEOPOROSIS is not a women's disease. It is not gender, age or race specific. However, some people are at greater risk, including those with a family history of the condition and certain health-related risk factors. For example, said Dr. Marcia Coe, a rheumatologist with Kaiser Permanente Mid-Atlantic States, some diseases and even some medicines can cause bone loss.
"Men, especially over the age of 70, and women at menopause can get osteoporosis. Close to 10 million Americans have osteoporosis," said Coe. "It's the influence of estrogen. Lower estrogen levels lead to lower bone mass."
From birth, the body is constantly building and breaking down calcium, said Wilsey. Up to around age 25, the body makes more calcium than it breaks down. From age 30 on, the body breaks down the calcium faster than it replenishes it, creating weakened and less-dense bones. Bone-density scans, which are the equivalent of low-energy X-rays, are recommended for men in their 70s, women at menopause or anyone considered at risk for osteoporosis because of family history or certain medical conditions.
"The bone is a very metabolically active place. As we grow, we reach or peak bone mass between 25-35. That's way it's important to make sure we have a diet rich in calcium," Coe said. "Having a diet that contains enough calcium, around 1,000-1,500 milligrams of calcium and 400-500 international units of vitamin D; and avoiding excessive alcohol or smoking are important."
Coe said supplements can be an effective way of ensuring a person gets his or her daily requirement of calcium or vitamin D, but that supplements should always be taken in consultation with a doctor.
BESIDES a calcium-rich diet, weight-bearing exercise is essential in staying off the effects of osteoporosis.
"Weight-bearing does not necessarily mean going to the gym and lifting weights," Wilsey said. "It's putting positive pressure throughout the length of the bone."
Activities such as brisk walking, wall push-ups, dancing and aerobatics can be done by people of all ages. Swimming, said Coe, while a great form of exercise, does not strengthen bones because the water displaces the force of gravity on the body.
Wilsey said that no matter what form of exercise a person chooses, it's important to exercise all the parts of the body. If a person only walks, the bones in the legs get stronger, so the body will take the calcium from the arms. Walking with light weights or even just swinging the arms will provide the full-body resistance needed to help keep bones strong.
Avoiding falls will also help protect the bones. Wilsey said things like making sure rugs are secured, placing handles in the bathroom to assist with getting in and out of the tub or using the commode, having light switches at the top and bottom of stairs, as well as having a phone extension upstairs and downstairs can help prevent falls in the home. In addition, placing reflective tape on the edge of stairs and adding grit sand to porches and steps can prevent slips outside.
"As we get older, if a bone breaks, it takes longer to heal. When we break a bone, we have a greater need to build calcium," Wilsey said. "Hip and wrist breaks are the two most predominant breaks for seniors, mostly due to falls. It's more of a prevention kind of thing, like kid-proofing your house."