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Focus on Bone Health

Today we're going to look at the health of our skeleton and how we can support it supporting us.


We'll look briefly at:

  • how our bodies make bone

  • what happens to it as we age

  • how to keep our bones as healthy as possible

  • factors which affect our bone health

  • exercise recommendations for bone health

  • further learning opportunities


Read on for an overview of your osseous matter.


How is bone made?


There are two main type of bone. We have compact bone tissue along the line of the long bones (think femur) and the outside of the vertebrae and skull, and spongy bone at the end of the long bones and inside of the vertebrae and skull.


The spongy bone cells replace themselves every three months in a constant cycle of renewal. Bone breaking cells use acid to break down old bone and bone building cells appear at the breakdown site. They fill the site with a tissue which finally calcifies and hardens into bone. Calcium is therefore a key component of this cycle.


What happens to our bones as we age?


Our greatest bone growth is in childhood with peak bone mass appearing at around 25-30. This, however, is site specific and although our hips may reach peak density by the age of 16, we're 35 before our lumbar spine is as strong as it can be.


The spongy bone will decline from the age of 30, the compact bone will decline from the age of 50. Normal rate of decline is then around 1% per year.


How to keep our bones as healthy as possible


The majority of work is done in our childhood through active lifestyles. Once we've reached peak bone density and begun the decline our best hope is to prevent bone loss and provide the best circumstances for good quality cell renewal.


Ensuring you have the right amount of calcium and Vitamin D (the bone making vitamin) is vital. When your body needs extra calcium, it sends a signal to your hormones to release it from your bones. When you have an excess of calcium, your body sends a signal to stop breaking down and re-absorbing the bone cells.


Maintaining a mineral balance in your diet and lifestyle is vital in allowing optimal cell renewal because it allows the body to get on with its job without extra mineral demands being prioritised.


Factors which affect our bone health


1. Risk factors we can't change:

  • Our age - bone mass deteriorates as we age

  • Our gender - women experience a greater deterioration of bone mass, especially during and post-menopause

  • Our genetics - some people are pre-disposed to greater bone mass deterioration


2. Factors we may be able to change

  • Drugs - Glucocorticoids which reduce inflammation can also increase the risk of bone mass deterioration

  • Hormonal issues which may or may not be treatable with hormone therapy or lifestyle such as premature menopause, delayed menarche (onset of periods), amenorrhoea (stopping of periods) and early hysterectomy.


3. Factors we can definitely change

  • Physical inactivity - moving increases the blood supply to the bones and creates forces which strengthen the bones.

  • Calcium and/or vitamin D deficiency - regulated through a healthy diet and supplements

  • BMI - having a BMI below 19 can increase the chance of bone mass deterioration. Yes, heavier people have stronger bones

  • Chronic smoking - more than 20 per day

  • Excessive alcohol - more than 21 units per week

  • Time outdoors - Northern European studies have shown that 3+ hours outside per day in winter would be required to maintain adequate vitamin D levels. Quite hard to acheive!

  • GI disorders - can prevent mineral absorption which affects bone health

Exercise recommendations for bone health


The National Osteoporosis Society has advocated a change in exercise prescription for people with osteoporosis. Their recommendations are for a three pillar approach they call Strong, Steady and Straight.

  • Strong exercises include muscle strength and impact, including hopping and jumping

  • Steady exercises include balance, gait and muscle strength

  • Straight exercises include core strengthening, advice on posture, moving and lifting techniques

Pilates plays a large role in both the Steady and Straight components of this exercise prescription framework although many other types of exercise and daily activities assist overall.


What's next?


I'll be delivering a bone loading course in early spring to delve further into programming for Strong, Steady and Straight exercise. Many regular Pilates-goers have already expressed an interest. If you'd like to know more, please click here. No Pilates experience is required.


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