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  • Sami Cattach

Osteoporosis: Reversible, NOT inevitable

Recently I have been asked by the American Recall Centre (who supplied the infographic above) to write about Osteoporosis, in order to help increase awareness about this all too common condition. While not directly a pelvic health-related topic, it is something I am very passionate about and you can't have health of one without the other!

The current statistics show that 1 in 2 women over the age of 50, and 1 in 4 men will experience a fracture due to osteoporosis, with 25% of hip fractures resulting in death within 6 months. Thats HUGE! And devastatingly unnecessary as there is so much that you can do to prevent, and even REVERSE osteoporotic changes.

What is Osteoporosis?

Bone, despite how most of us imagine it, is not solid, rather it is made up of millions of cells that form a strong matrix able to withstand substantial forces. The words osteo (bone) and porosis (porous) refers to the condition characterised by a decrease in (or loss of) the density of this cellular matrix, and when seen up close looks more like the picture on the right, instead of healthy bone on the left:

(Image from

This means that the bones become more brittle, and are now much more susceptible to breaks (fractures) with small impacts or falls. Bone cells (like every other cell in your body) respond to LOAD, and are constantly regenerating via a process called Osteogenesis, in which involves bone building cells called osteoblasts and bone removing/eating cells called osteoclasts. The greater and more frequent the load, the more dense the bones become.

Adults generally reach their peak bone mineral density (BMD) in their early 20s. This means that whatever your density is at that stage of your life, you can never have more than that, although the total density can decrease if the rate of bone removal is slower than the rate of bone building, leading to Osteoporosis (OP).

*Scary Fact*

Osteoporosis is starting to become prevalent in otherwise healthy adolescents due to the lack of whole-body movement of children during their developing years! These are prime years for bone building and if this window is missed, it can never be made up. Prevention and education has to start with the kids.

The interesting thing is, osteoporosis is not a systemic (whole body) disease - meaning that it can occur in some areas of the body, but not others (even within the same bone!). Therefore, it is not just your diet that affects the density of your bones, but also how (and how much) you use your body that determines how much your bones regenerate. The most common sites affected are:

  • Ribs

  • Wrists

  • Vertebrae

  • Neck of the femur (hip)

The most accurate way of determining your bone mineral density and what sites are affected is via a DEXA scan as ordered by your doctor.

So what can you do about it?

Osteoporosis is not necessarily a condition of ageing, rather a condition of underuse which simply becomes more evident over a longer period of time. The great news is that you can spot-treat osteoporosis. Even if you have some bone loss already, it is possible to regain and maintain your bone mineral density by providing appropriate input and load to the bones (1).

Bone cells grow in response to load (think compression). On planet earth, we are subject to compressive loads 100% of the time thanks to gravity. (This is why when astronauts spend extended periods of time in space without gravity, their bone density decreases dramatically! (2))

Start with checking your Alignment!

Because gravity is VERTICAL, the way that we stand, sit and move has a direct impact on how our bones experience that compressive load.

For example, sitting like this:

Poor sitting posture

Will provide much less compressive load to the vertebrae (spine) in the neck and back, as compared to this:

Improved sitting posture

Where the vertebrae are all stacking on top of each other, the weight of the head and upper vertebrae are now able to provide more compression to the lower vertebrae.

Similarly, your standing alignment will affect the load bearing of your vertebrae and femur (hip joint). Standing like this:

Optimal standing alignment

will provide much more direct vertical compressive load to the vertebrae and femurs than this:

Poor standing alignment

(or this candid shot of my husband)

Don't try this at home folks...

Where the head and pelvis are much further out in front of the heels and the femur is now on a diagonal, no longer vertical to receive the compressive load and maintain the bone density of the hip joint.

Best Exercise for Osteoporosis

Weight bearing exercise is the best for increasing the load to the bones and subsequent bone building. Unfortunately this means that cycling and swimming do not help with reducing or preventing osteoporosis.

The best bone building exercise for your spine and hips is walking! (Read more about how much I love walking here). Even though running involves more impact and G forces, these forces don't directly translate to loading at the hip and vertebrae, as a lot of the shock is absorbed with bent knees, hips and ankles.

Please don't become another osteoporosis statistic. Start by using these two simple tips to optimise your bone mineral density right now! by fixing your alignment and walking - walk to the shops, to the post office, to work if you can, or just for fun!

(1) For more info, please see Katy Bowman's blog post (5 things you (probably) didn't know about Osteoporosis) or her book Move Your DNA - I particularly love her explanation of mechanotransduction on p.38!

(2) Also, feel free to check out this old (2001) but interesting link about weightlessness induced osteoporosis in astronauts - Space Bones.

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