5 things you (probably) didn’t know about osteoporosis.

1. Johann Friedrich Georg Christian Martin Lobstein

While you may not recognize the name, you surely know the name this French pathologist gave to bone he found with large, porous holes in it: osteoporosis (osteo=bone, poros=Greek word for passage.)

So the next time you spot the word, make sure you give a shout out to:

Jean-Freed-rik-Gay-org-Martin-Lobs.  That’s my name toooooooo.

LA LA LA LA LA LA LA!!!!!!

Sorry. I couldn’t help myself.

2. You can actually spot-treat osteoporosis.

Osteoporosis is not a systemic or whole-body disease, but an indication of where your bone is not loaded correctly. Osteoporosis doesn’t mean that you have a bad-bone condition — your bone loss is not happening over your entire skeleton but in a few key places. The areas that most people experience bone loss is:

  • Ribs
  • Wrists
  • Vertebrae
  • Head of the femur (top of the thigh bone, commonly mis-referred* to as the hip bone.)

In order to get bone to generate, you have to know your sites. If you are given a diagnosis of osteoporosis or osteopenia (a little bone loss), ask WHERE the density is low.

And, P.S. the only test really valid to give you a diagnosis is a DEXA. In-office bone screenings are not valid enough to give you a diagnosis. The margin of error is too high. They are simply supposed to be a screening technique for referral to the better DEXA.

*P.P.S. There is no “hip bone.” The hip is a joint made from the pelvis and the thigh bone, called, the femur.

3. Exercise trumps nutrition.

Many people think osteoporosis is a result of poor nutrition. However, poor nutrition doesn’t explain the fact that most bone tissue, even in the bones with osteoporosis, is doing just fine. Just here and there is there a problem. The failure for bone to generate at its correct rate is really a mechanical one — which is why I am blogging about it, of course.

While proper nutrition is absolutely a requirement for healthy bone, the signal for bone to grow is mechanical in nature. The “GROW BONE” signal starts with a cell being *squished* within the bone. Without that *squish* of these mechanoreceptors (sensors sensitive to physical deformation) the nutrients that support bone growth can’t do their job . Your body cannot use them without the signal. Taking supplements is 1/2 of the correct prescription for osteogenesis (bone growing). The other 1/2 is exercise, and let’s have some words about exercise and bone development…

4. Weight bearing exercise doesn’t not mean “using weights.”

For optimal bone regeneration, you need as much *squish* in the bone-growth-signaling cells as possible. In order to get the greatest amount of *squish* you need to keep your bones holding the proper amount of weight — not too much and not too little. The research done on bone and exercise shows that moving around while weight bearing gives the greatest response to bone development in the right places.

Why do I say in the right places?

Because, any resistance exercise will help build bone. The act of a muscle working, pulling on the bone, is enough to stimulate bone growth. This is the rationale for doing weights or other types of non-functional resistance exercises in gyms, classes, etc.

So, what’s the problem?

Bone loss at muscle attachment sites is not the problem in osteoporosis. Bone loss in the hips (and the eventual break) is the biggest problem in osteoporosis, with the second largest issue being bone loss (and then fracture) in the spine. “Weights” don’t hit these areas in a way that reduces the risk of breaks or fractures — even though you may be adding bone tissue in other places.

Best bone-building weight bearing exercise = walking. Walking is better than running because bone building favors lower impact loading as opposed to high impact and frequent loading cycles.

Non weight bearing exercise = swimming, cycling, blogging. That’s why I am only doing one more fact — my bones are not impressed with me right now.

5. The “hump” is not caused by osteoporosis. The “hump” is actually a cause of osteoporosis.

It was believed for a long time that the excessive curve in the upper back (called the dowager’s hump*) was the result of weak, porous bones unable to hold up the weight of the spine. This weakness in the bones allowed the spine to collapse forward. It makes sense, in a way. It makes so much sense that no one actually researched it — it’s just a belief that has been perpetuated and is now on the title page of almost every bone website under Bone Facts. Which is a bummer, because the actual research shows that this curve of the spine, called “hyperkyphosis” is a risk factor for osteoporosis and not the other way around. Which makes sense because osteoporosis is caused by a lack of loading. The farther something curves forward, the less weight it places on what sits below it.

Your alignment is actually a huge deal when it comes to bone growth. You can make your daily walk more weight-bearing by stacking your body. See those walkers with their torso out in front of them? Their walk is less weight-bearing than it could be. Have too much curve in your upper spine? Wear your head out in front of the rest of the body?

These are all things that decrease bone regeneration and fixing them is as simple as stretching your muscles to their correct length and using your body as it was designed.

Off to walk…

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28 thoughts on “5 things you (probably) didn’t know about osteoporosis.

  1. You are so amazing Katy! I want to be just like you. Will you be my mentor? Serious…What you know and how to apply it, helping out the community as well as those across the nation/country/world who have become involved in their health….it is remarkable!

  2. I agrree wholeheartedy with Matt. We are very lucky to have Katy here imparting all this valuable healthy information. It has enabled me to move correctly and to understand what is not good movement. Her passion for her work shines through! Cheers, Canadian Sue.

    1. Hi Lori –
      With chemo-induced ostoeporosis it might be a little different — chemotherapy-induced ovarian failure will increase bone loss, although the data is still site-specific. It would be interesting to see if, perhaps, whole-body activity went down after chemo. That all being said, the treatments for osteoporosis is still weight-bearing exercise for stimulating bone growth. Osteoporosis meds won’t stimulate bone grown, only halt bone loss which isn’t really that great.

  3. I love your blog and *try* to apply what I learn as often as I remember… I’m more successful in some areas than others. But what I keep hoping to learn about is scoliosis — Is there any way to turn it around? Will the imbalance cause more problems because the upper half of my body can’t be centered over the lower half? Is there any way to compensate for that? (Sorry if you’ve already answered this somewhere and I just haven’t found it.)

  4. Thanks Katy. I’m eager to see more on what constitutes proper walking, and pictures of what it looks like.

    1. Hi Kerry-
      I know walking seems like the most basic thing, but it’s really the *most complicated* thing that we do as a human being. That we have conscious control over anyway 🙂 Walking in a reflex-based, biologically best way is what we teach in our 7 month course. SEVEN MONTHS just to understand it! Every joint and muscle has a roll. It’s crazy. Right now, if people could just straighten the edges of their feet, stack the main axes of the body, push off instead of fall forward…these are great starting points!

  5. Great article. I’ve been struggling with intermittant bone loss for many years now. I really appreciate the piece about walking and that bone loss is really a mechanical issue.

  6. Thanks Katy! I so appreciate the way you give us such great information in an easy to understand & applicable way. I have to go for a properly aligned walk now!

  7. I liked this article so I forwarded it to my Mom. I’m commenting to see if she is actually reading it. Are you reading, Mom?

  8. Great article. I am involved with whole body vibration machines in our studio and our monthly members are enjoying low impact exercise on their joints on these machines that simulate walking (10 min = 1 hr workout)…. and I am happy to see your article that stresses proper posture and walking! Having gone to chiropractors many times in my earlier career I learned proper posture and how much difference it makes, but did not know the relationship to osteoporosis. Thank you for the info.

  9. Hi Katy,

    LOVED your blog about pelvic floor. Preachin’ to the choir there:>)) I have a question about the osteoporosis however. After 7 years my hip t score has gone from -1 to -3.26. I am 58 yrs old and of course have gone through menopause during that time. My back however is 101% for my age group, vs 69% for my hips. I am VERY active. Long walks with dogs daily, weekend hikes, teach pilates, gyrotonic and see about 10 massage clients a week. WHAT is up with this? I take a good cal/mag/pot supplement with Vit K and all the other “supposed to” stuff. Only thing that came back on my blood test is that I was pounding too much Vit D, so off that now.

    Got any suggestions?

    Keep up the great work!

    1. If you’re getting the movement, then the only variable left is that your not loading your hips while walking. If you’re wearing positive heeled shoes, or have a psoas issue that pulls your trunk anterior to the hips, then all that walking isn’t loading the hips. Read the free chapter at http://www.footpainbook.com to get a better sense of this (and, may I suggest the whole book) as well as evaluate your psoas length (search “psoas” on this blog to get a sense of how to measure, as well as read the latest “neutral pelvis” blog. Also, how did you get a 101%? Sketchy math???

  10. I’m wondering where I can find the studies this information is based on. I’d love to pass this onto my husband who is a physician but he’s going to want to see the studies. Thank you!

    1. Hi Brenda! This is basic bone-science stuff. For the most updated references, you can use Pubmed or Google scholar and do a keyword search. Also, a biomechanics of bone tissue textbook is a good read, although they are written at a graduate level as far as biomechanics goes…

  11. Bone loss is also caused by various diseases that are hard to spot and often missed by general practitioners. Primary hyperparathyroidism is caused by the parathyroids putting out too much hormone that makes the body suck calcium from the bones and therefore weakens them. It’s not the only thing it does. It also causes depression.
    I found the tips here very useful as I’ve just been diagnosed with this horrible condition myself and face bone density scans and surgery.

  12. hello!
    M, from Holland here, sorry for my english
    Unfortunately my bones are very bad (because of my own fault)…I’m gaining weight now, but my back (spine?) is very bad and I’m afraid for a fracture because that can cause invalidity.
    My hips ar also bad.
    I’m doing speciall fitness two times a week and I walk every day, but I must also gain weight.
    Wich exercise is the best for my back?

    By the way: doe you know “the Bellicon” (www.bellicon.nl) they say this is good for your bones

  13. Hi Katy – Great blog post! I wonder if you could point me to the research you mention in #5 about how hyperkyphosis “is a risk factor for osteoporosis and not the other way around.”

    Thanks!

  14. Wow, you were right— I didn’t know any of these things about osteoporosis! The most interesting thing to me is that the bone is only weak in a few key places. Hearing that makes me wonder how well my bones are doing. It has been many years sine I’ve ever seen a doctor for my bone health, so it might be a good idea to get a checkup on that.

  15. What type of shoe do you recommend for walking? I heard a thin sole is best for impact and not walking sneakers. Any suggestions on a style or brand?

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