Even at the age of 30, the bone substance can become brittle – there is a risk of osteoporosis. But that can be prevented. So now you strengthen your bones
Osteoporosis? Older people are mainly affected by increased bone fragility! You think so. But it’s wrong. Because already at the age of 30 your bone substance can become ailing. And the total bone mass of a person, especially in the first 30 years of life.
In old age, a broken bone can be threatened by coughing. So that this doesn’t happen to you, you should start now to create a stable bone substance. How to do it, you can read here
How does a bone change in the course of life?
Bones and muscles have one thing in common: like muscle mass. one density is by no means constant throughout life. ut rather it slowly but steadily decreases after growth in childhood and adolescence and a peak around the age of 30. From then on, people lose around 0.5 to 1 percent of their bone mass every year.
One speaks of osteoporosis only when this level is clearly exceeded and there is also a pathological weakening of the bone structure, i.e. bones lose strength due to a changed microarchitecture. The consequence is a higher susceptibility to bone fractures – a typical aging phenomenon. Which in rare cases can also occur at a young age.
What exactly is osteoporosis?
To understand this, first a little bone know-how: Both the build-up and breakdown of bone tissue are brought about by special bone cells. The osteoclasts, and osteoblasts. Osteoblasts are responsible for building bone structures. While osteoclasts break them down. Osteoblasts anchor basic bone substances on the surface of existing bone and then ensure its mineralization.
The osteocytes also arise from the osteoblasts. These are built into the bone matrix, on the one hand, to maintain the bone structure and on the other hand to ensure a healthy calcium content. As part of special processes. Osteoclasts cause enzymes to break down the basic bone substance.
In osteoporosis, the interaction between osteocytes, blasts, and clasts is disrupted. According to current studies, this disorder can set in at around 25 years of age due to a shortened lifespan of the bone cells.
How does osteoporosis arise?
The exact cause has not yet been clearly clarified, especially not in men. With women, the gain in knowledge is a little bigger – at least we now know for sure that the reduced release of estrogen after menopause is related to the development of the disease.
With the permanent absence of menstrual bleeding. The level of estrogen falls, and this leads to increased activity of osteoclasts and osteoblasts. At the same time, the lifespan of the osteoblasts is shortened, while that of the osteoclasts is lengthened.
In addition, the body prefers to break down bone trabeculae that have already become thinner. These structures are thus completely lost since new bone formation is only possible on structures that are already there. After menopause, the body increases the net breakdown of the trabeculae. The first thing to do is to dismantle the bone structures with the least static load. These processes lead to a loss of bone tissue. Especially in the areas of the spine, chest, and pelvis.
Are there different forms of the disease?
Depending on the causes, a distinction is made between primary and secondary forms of osteoporosis. Primary osteoporosis is present when it is the direct result of a (hormonal) disorder in the body. Secondary osteoporosis refers to forms that have been caused as a result of another disease or by certain living conditions.
1. Primary osteoporosis
In Germany, around 9 percent of the total population suffers from primary osteoporosis. This variant is one of the most common skeletal diseases. In many of those affected. It begins with diffuse back pain. Especially in the lumbar spine. In addition to postmenopausal osteoporosis. Primary osteoporosis includes juvenile osteoporosis in children and adolescents as well as old age osteoporosis. Primary osteoporosis is triggered by changes in the activity of messenger substances such as cytokines, hormones, or growth hormones. Cytokines are proteins that influence how quickly and how intensely other cells grow or multiply.
Age-related osteoporosis develops due to an age-related decrease in bone density: osteoblasts lose activity. Coupled with a malfunction of the thyroid gland due to declining kidney function. What is noticeable about old-age osteoporosis is that the decrease in bone mass (visible in the X-ray as a brightening) is distributed over the entire body and is not limited to the spine and extremities. As is the case with postmenopausal osteoporosis.
2. Secondary osteoporosis
Secondary osteoporosis develops with previous illnesses. For example in the case of a thyroid malfunction, as a side effect of certain medications such as glucocorticoids or with heavy alcohol consumption. Inactivity osteoporosis, which results from long-term lack of exercise, is also a secondary form. The cause can also be nutritional disorders such as anorexia or bulimia. Which are associated with a permanent deficiency in minerals and protein.
Inactivity osteoporosis results in atrophy (bone breakdown) due to a lack of exercise and the resulting reduced stress on the bone structures. For example, being bedridden for 4 months would mean the loss of 15 percent of the total bone mass. This happens because the attachment and remodeling of the bones are directly influenced by mechanical stress on the structures. This does not weaken the bones but strengthens them. But more on that later.
How will I know if I have osteoporosis?
Osteoporosis often begins with acute or chronic back pain in the lumbar spine. Which is accompanied by severe muscle tension. Often, lateral movements of the upper body are painful, and if you look closely you can see individual folds on the back that look like a Christmas tree when taken together – the so-called Christmas tree phenomenon.
Many sufferers are only diagnosed with osteoporosis when they are diagnosed with a vertebral body fracture after prolonged back pain that has arisen unnoticed. For example by simply bending over. In the X-ray, you can often see the wedge-shaped vertebrae that are so characteristic of osteoporosis and a strong inclination of the upper body in the thoracic spine.
Also noticeable is a loss of height of up to 10 centimeters without causing pain. The loss of size means that the volume of the rib cage also becomes smaller. This can affect breathing.
How is osteoporosis diagnosed?
Orthopaedists can see the decrease in bone density on x-rays of the thoracic and lumbar spine. A bone density analysis provides additional information. Quantitative computed tomography (QCT) or dual X-ray absorptiometry (DXA) are used for this purpose.
What are the phases of the disease in osteoporosis?
Osteoporosis is divided into 3 stages according to its time course:
- Osteopenia (low bone mass), early stage of osteoporosis
- Fractured Osteoporosis Manifestos
- Osteoporosis with fractures that are not the result of an accident or other injury
Additional blood tests, x-rays, a thorough medical history taking into account old fractures and the general constitution, as well as regular follow-up checks, are essential for an accurate diagnosis.
What are the treatment options for osteoporosis?
Osteoporosis therapy consists of a drug basis, targeted drugs, and appropriate physical activity. In addition, those affected should refrain from nicotine and alcohol. This is how you finally become a non-smoker.
For acute pain, warmth and light massages are helpful. Electrotherapy such as TENS (transcutaneous electrical nerve stimulation) can help relax the muscles. Pain-relieving drugs help in the short term. But should not be taken as long-term medication and always in consultation with the treating doctor.
Exercise therapy is one of the basic tools to prevent osteoporosis from getting worse and to maintain the quality of life for those affected. So you don’t automatically have to do without sport. In the case of more severe forms of osteoporosis or, if you are overweight, the exercise pool is often the most popular training location. Because aqua aerobics allows you to move while reducing your body weight. The training of posture as well as the gait by a physiotherapist serves the individual safety and fall prophylaxis.
Which drugs help with osteoporosis?
The basic drug therapy for osteoporosis consists of vitamin D3 and calcium. Vitamin D3 increases the calcium level and in this way contributes to an increase in bone mass. Bisphosphonates regulate calcium metabolism and inhibit the activity of osteoclasts that break down bone.
They also serve to increase bone mass by preventing increased breakdown. Biologics and fluorides either directly promote bone formation or inhibit osteoclast activity. For postmenopausal osteoporosis, estrogen should be prescribed for at least 10 years.
How can exercise support osteoporosis therapy?
The human bone tissue has high adaptability and is constantly undergoing restructuring. Influenced by the stress and relief of the body in everyday life. To maintain their structures and strength, bones do not have to be relieved, but rather regularly stressed. Sport and training, therefore, play a decisive role in bone strength. It has been proven by numerous studies: active people have both greater bone mass and higher bone stiffness than non-athletes.
If the bone is loaded, this results in mechanical deformation (stretching or compression) of the bone surface. This affects the whole bone. The magnitude of the deformation to which a bone is subjected is more important than the frequency or frequency of remodeling processes. If the bone stimulation remains below a certain limit. Bone tissue is broken down. If the stimulation of the bone is higher than the load to which the individual bone balance is adapted. New formation and strengthening of bone tissue occur.
An example from weight training, the following initial situation: You train squats without dumbbells and weights. your bone structure is designed for 12 squats with only your body weight – then you should use a barbell with a weight of 5 kilos per side. This increases the stimulation of the bones beyond the usual level. And the individual bone balance has to adapt to the increased demands. These are the 12 most important strength training tips.
Your training plan
Which sports are particularly effective against osteoporosis?
High-stress peaks during sport, therefore, lead to greater bone mass and more bone stiffness. Both running and strength exercises performed this way have a greater effect on bone development than high repetitions. You should definitely take this fact into account when designing your training. When running, it means in concrete terms: Instead of tearing down many kilometers, you should rather integrate uphill runs and interval units into your training.
With expert guidance, strength training, gymnastics, and jumping (plyometric) sessions are particularly effective at increasing bone density. For training on your own, Nordic walking, running (at the beginning on level, mostly unpaved surface, only later or for the more experienced in the field) as well as cycling, dancing and swimming are suitable sports. Many clubs now offer special osteoporosis sports groups.
How long and how intensely do you have to train?
The adaptation of the bones to training loads takes place quite slowly. Exercise programs aimed at strengthening the bones should therefore be carried out for at least 6, preferably 12 months, to achieve a reliable result and an improvement in symptoms. And: Always increase the training intensity very carefully!
Also important: The changes in bone mass and bone stiffness are limited to the bones that are specifically loaded and trained during training! For weight training, for example, this means that if you work with squats without weight. You will achieve a training effect for the legs. But not for the bones above the hips.