Bad to the Bone…No! Be Good to the Bone

Bad to the Bone…No! Be Good to the Bone

As orthopedic surgeons we deal with the bones, muscles, tendons, and ligaments that collectively make up our musculoskeletal system. These structures work in an amazing, coordinated fashion, allowing our bodies to move. We often encounter these structures when they are injured or diseased. Bones can break. Muscles can be strained. Ligaments and tendons can be sprained. While all these injuries can take time to heal and recover, orthopedic surgeons are often needed when bones break (fracture). As our population continues to age, bone health is very important. We see fractures occur in high energy settings such as a motor vehicle accident or in low energy settings when someone falls at home.

We often get asked by our patients “what can I do to speed up the healing”. The short answer is nothing.

Drinking excess milk with calcium and excess vitamin D does NOT speed up bone healing.

A broken bone heals in a systematic way that requires time. Factors that affect bone healing include age of the patient, nutritional status, smoking or tobacco use, and certain medications to name a few. The type of fracture, its location, orientation, and whether it is lower vs. upper extremity can all impact the time it takes to heal.

How do we measure bone health?

We quantify bone health by measuring its density. A bone density score can be obtained using a DEXA (dual energy X-ray absorption) scan. An X-ray will give some insight to bone density only in the most extreme cases. If we have a low bone density, we can develop osteopenia or osteoporosis. This makes our bones weaker and more susceptible to fracture.

Non-modifiable risk factors

Certain non-modifiable risk factors are associated with poor bone health. These include:

  • advancing age
  • being female (especially Caucasian)
  • family history of osteoporosis

Modifiable risk factors

Other modifiable risk factors for poor bone health include diets that are:

  • low in calcium
  • low in vitamin D

Vitamin D is necessary for building and maintaining healthy bones as it is the key to allow for calcium absorption. Without sufficient vitamin D, bones can become soft. In children this is known as Rickets. In adults, severe deficiency is known as osteomalacia. Vitamin D is obtained typically through foods fortified with vitamin D such as milk, yogurt, and cereal. Multivitamins are also a good source of vitamin D. The recommended daily amount of vitamin D is 400 international units (IU) for children up to age 12 months, 600 IU for ages 1 to 70 years, and 800 IU for people over 70 years. As you can see, vitamin D demands go up with age.

Vitamin D with age
Recommended Vitamin D and Age

As orthopedic surgeons, we see a number of fractures in the elderly that are directly linked to decrease bone health rather than high energy injury mechanisms. Some of this is associated with aging, lifestyle choices, and other factors described earlier.

It is our advice to do what you can to optimize your bone health by having a diet sufficient in vitamin D & calcium.

We recommend resistance type exercises to stress the bones to stimulate bone remodeling.

We also recommend working with your primary care physician and your orthopedic specialist to know what your risk of fracture is by getting a DEXA scan at the appropriate time. We usually get involved after a fracture has occurred but it is our goal to bring awareness so that we can minimize your risk of fracture.

If you would like more information, our experts at Decatur Orthopedic Center will be happy to help.

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