Bone Health for the Long Haul
How do we maintain healthy, strong bones as we age?
Recently, Dr. Peter Attia interviewed Dr. Belinda Beck (owner of The Bone Clinic in Syndney, Australia). Their discussion of bone anatomy, adaptation, and healthy aging is worth a watch:
There were several highlights for me, which apply directly to both male and female clients in my practice.
Osteoporosis is a “childhood disease”
Young men and women lay down their maximum amount of bone density before the age of 25 (Dr. Beck’s research has shown this could be even earlier for young women…19-20 years of age). So, by the time I see a client in my clinic, her bone density die has already been cast. My biggest priority is to attenuate the further loss of bone density, and to keep her skeletal system as stable and dense as possible as she ages. If I’m trying to add mineral density to her bones, my chances are slim, and I will never get her bones to be more dense than her teenage years…
Bone adapts to training just like muscle
Dr. Beck leads a discussion of Wolff’s Law, stating that bone responds to mechanical loading by becoming stronger and more dense. In fact, bones adapt best to loading in multiple planes (not just overhead). For example: a runner will have plenty of axial loading, but a soccer/tennis player will achieve higher rates of bone adaptation due to the nature of these multiplanar sports. Now, obviously I face an inherent risk if I have my osteoporotic clients start running around on the soccer field, but I get the point. The more I can vary directional loads on my clients the more effective their bone adaptations will be. I can have my clients lunge or shuffle in multiple directions, have them perform rotational loads (throwing a light medicine ball), controlled lateral hopping, etc.
Bones and Anabolic Resistance
If mechanical loading increases positive bone adaptation, then the inverse is also true. Reduction of loading leads to bone de-mineralization and weakness. We know that the majority of muscular anabolic resistance that we face when aging is the result of “inactivity”, not aging itself. This holds true for bone development as well: bones don’t weaken on their own - they need to be unloaded first. If I can help my clients maintain the proper level of safe loading, then there is no reason for their bones to become more brittle with age.
When in doubt…Exercise!
Dr. Beck started her clinic because of her frustration with the medical community’s poor record in treating bone health. Doctors’ advice (especially to women) has historically been to exercise less intensely if you are at risk of osteoporosis. And once you have an official diagnosis - STOP exercising intensely so that you don’t fall and trigger a fracture. Dr. Beck takes the opposite approach in her clinic. She teaches patients to lift heavy loads properly and encourages them to use this progressive strength training on a regular basis. Her data shows a clear attenuation of mineral loss in most women (even into their 80’s), with some women increasing bone density by 4-6% over 8 months.
My job as coach is to take these techniques and think about how to best apply them to each of my clients. When helping clients develop and maintain bone density, my concerns are much the same as working to increase muscular development and strength. I know loading works, but how much and how often can I load each client’s individual tissue to insure the best results with the lowest injury risk. There is no standard template, and I have to approach each client specifically with regard to gender, age, load tolerance, injury history, coordination, etc. How cool is it, though, to see an expert on the other side of the world helping us develop better programing for our clients. I couldn’t be more grateful to Dr. Attia and Dr. Beck for sharing this insight, and making me a better trainer.
Sam Ditzell