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fracture

Bad Man Break

Men Need To Be More Aware Of Bone Density

Allen was getting out of his fishing boat when he twisted his left leg and fractured two bones in his ankle.  Six weeks after ankle surgery, he landed in our clinic with considerable pain and a very limited lifestyle.  Allen reported lower back pain that he attributed to his limping and use of the boot on his left leg.  On recommendation from his physical therapist, Allen had further medical assessment of his lower back pain.  An x- ray of his lumbar spine revealed two lumbar vertebrae fractures.

On a recent vacation, Mike went on a horseback ride with his grandchildren.  During the ride, he developed pain in his upper back that “took his breath away”.  A visit to the emergency room with what he thought was a cardiac issue revealed a three-level compression fracture in his thoracic spine.  Further assessment showed significant osteoporosis in his hips, pelvis, and lumbar regions.  Allen started on some bone rebuilding medications and physical therapy.  It took over four months to fully recover from this injury.

Randy was working on his garden and fell onto the lawn.  He had right hip pain and was unable to stand.  His wife called the ambulance and he was diagnosed with a hip fracture.  Four days after the surgery to repair his hip, he suffered an embolism and at the age of seventy-one, he passed away.

All three of these older guys had testing that revealed a significant loss of bone density.  Unfortunately, the tests occurred after and not before injury onset.  We are getting better at keeping men alive longer–less smoking and better medications.  As men get older, the need to monitor bone density becomes a crucial aspect of healthy aging.  Men need fewer commercials for the latest in testosterone replacement and ED medication and more awareness of how brittle their bones can become.

The general public views osteoporosis as a “women’s health issue”, but management of osteoporosis is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled or die from the fracture.  Since 2008, the rate of osteoporosis related hip fracture in the American male population is going up at an alarming rate.

Osteoporosis is a silent disease.  Most people do not realize they have a problem until something breaks and they are in the middle of a medical crisis.  Even after a fracture, many physical therapy patients are reluctant to follow up with a bone density screening.  Being proactive is the only method of managing osteoporosis.

We know that individuals that participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a stimulus through your skeleton.  Bone building exercises are easy to understand, but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness.

Jane Brody of the New York Times wrote a helpful *article on bone density testing. It covers the latest medical guidelines for testing and the when and why of testing for both men and women.

Michael S. O’Hara, P.T., OCS, CSCS

*New York Times, July 16, 2018, Jane Brody, When to Get Your Bone Density (View Article:here)

Fracture Facts For Men

osteoporosisJane Brody of the New York Times wrote a great article on the risks men have for osteoporosis related fractures.  The general public views osteoporosis as a “women’s health issue,” but management of osteoporosis and prevention of falls is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled, or die, from the fracture.

In 2012, an international team of researchers and clinicians launched Too Fit to Fracture, an initiative aimed at developing optimal exercise recommendations for individuals with osteoporosis.  In October of 2014, they released a booklet that is available through osteoporosis.ca on managing osteoporosis through exercise.  Everyone should read this booklet and osteoporosis patients should follow their exercise prescription.  Their work brings clarity to an issue that is currently clouded with poor understanding and a lot of bad fitness advice.

The Too Fit to Fracture researchers recommend that individuals with osteoporosis (with or without vertebral fractures) should engage in a multi-component exercise program that includes resistance training in combination with balance training.  Balance train for ten to twenty minutes every day of the week and strength train for 30 to 45 minutes twice a week.  Make sure your strength training teaches you how to move correctly and improves the endurance in your back muscles.  If you have mild to moderate osteoporosis, balance train and strength train first and foremost, and use any extra time on some low impact cardio training.  If you have been told you are at high risk for fracture, keep your focus exclusively on balance and strength training and keep the cardio activities to a minimum.

We know that individuals who participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a growth promoting stimulus through your skeleton.  Bone building exercises are easy to understand but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness and Fenton Physical Therapy for guidance.

-Michael S. O’Hara, P.T., OCS, CSCS
View the NY Times article here: http://www.nytimes.com/2016/10/04/well/live/men-get-osteoporosis-too.html?_r=0

Whether you are trying to maximize bone density at a young age or simply maintain it at an older age, your choice of exercises will be the key to your success. Select exercises that allow for large amounts of force and power to be displayed. Also, choose exercises that effectively stress multiple muscle groups as muscle preservation is highly associated with bone density.

Try the two exercises listed below and look for more next week.

Push Ups

pushup

 

 

 

Building more bone density is just one more great use for the standard push up. This exercise stresses the bones of the wrists, arms, sternum, and clavicle. This is a safe exercise for almost all populations and can be modified to increase or decrease the level of difficulty.

Squat Jumps

Squatjump

 

 

 

 

This exercise is a great low risk, lower extremity power exercise. It stresses the bones of our feet all the way up to our hips and spine. It can be adapted for a range of purposes and populations. Squat jumps can be done with body weight, or you can incorporate resistance in the form of a sandbag, barbell, or resistance bands.

Click on the link below for step by step instructions and video demonstration on how to perform push ups, squat jumps, and their variations:

 

-Jeff Tirrell, B.S., CSCS, Pn1

osteoporosisWorldwide, 1 in 3 women and 1 in 5 men over age 50 will experience osteoporotic fractures.

A 10% loss of bone in the vertebrae can double the risk of vertebral fractures and similarly a 10% loss of bone in the hip can result in a 2.5 times greater risk of hip fracture.

In the USA, the 52 million people with either osteoporosis or low bone mass represent 55% of the people age 50 and older.

About 25% of hip fractures occur in men.  Twenty percent of the men who suffer a hip fracture die within 12 months.  Men have a much higher mortality rate after a hip fracture than women.

Hip fractures cause the greatest loss of function.  Fully 40% are unable to walk independently and 60% require assistance for activities of daily living a year after the hip fracture.  Because of these functional mobility deficits, 33% are totally dependent or in a nursing home in the year following a hip fracture.

Vertebral fractures can lead to back pain, loss of height, deformity, immobility, and reduced pulmonary function.  Statistically a vertebral fracture is the biggest predictor of another osteoporotic fracture in the next two years.

In the USA, the combined lifetime risk for a forearm, hip, or vertebral fracture is around 40%.  That is equivalent to heart disease.

The adjusted mean, first-year costs of a fracture from a comprehensive study by Jefferson University:  hip $26,545, vertebral $14,977, and non-hip, non-vertebral $9,183.  The statistics start at age fifty.  Predictably costs go higher as the age of the patient gets older.  These numbers are now five years old– nothing medical has become less expensive.

Bone Building Preventative Training

We know that individuals who participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a growth-promoting stimulus through your skeleton.  Bone building exercises are easy to understand, but they do require more effort than swallowing a pill or having an injection.  Carry a kettlebell, push a loaded sled fifty yards, or perform a few sets of box jumps–jump up and step down.  Your bones will stay well mineralized, but you will miss meeting all those nice people in the emergency room.

-Michael O’Hara, P.T., OCS, CSCS

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