Get Moving and "Do More, Safely" to Maximize Bone Health
By Rodrigo J. Valderrábano, MD
My name is Rodrigo J. Valderrábano and I am an Endocrinologist and Assistant Professor of Medicine at Brigham and Women’s Hospital, Harvard Medical School. As a skinny teenager growing up in Puerto Rico, I discovered resistance exercise as a way of building up my physical capacity and confidence. Routine exercise became part of my way of life, but it was not until my endocrinology training at Stanford University that I realized how important it could be for healthy aging and prevention of diseases such as osteoporosis. When I discovered that researchers from around the globe study the effects of exercise on osteoporosis and other musculoskeletal diseases I was hooked. In my role as Medical Director for the Research Program in Men’s Health Aging and Metabolism I oversee and conduct research on function promoting therapies including exercise in men and women. As a scholar in the Boston Older Americans Independence Center I am part of interdisciplinary research network of investigators who share the mission of reducing the burden of disabling functional limitations in older adults.
Prevention is the name of the game in osteoporosis. It is always easier to hold on to the bone you have than trying to gain back the density that is lost. All women after menopause and men after a certain age will lose bone over time. Like any connective tissue, bone needs constant stimulation to maintain itself. Bone density loss can be worse in those who are sedentary, following the old adage “if you don’t use it you lose it.” Medications like glucocorticoid steroids and any inflammatory condition can also accelerate bone loss. Osteoporosis awareness and prevention means knowing if you are at risk for bone loss and fractures and doing something about it before your bone gets to a critically low density. Be proactive: get those bone density scans when they are indicated, get your calcium, vitamin D and protein (to maintain muscle mass), take medication into consideration if it is recommended by your clinician… and get moving!
The theme of this May’s Osteoporosis Awareness & Prevention Month is #ExerciseToMaximize Bone Health. I am often asked in the clinic, “What is the best exercise for osteoporosis?” That is a more complicated question than it may seem, and one that I am dedicating my life to answer. However, my guiding principle is “do more, safely.” If you are not acutely ill or have an ongoing disease state your bone will already be adapted to the daily stresses you place on it. Your skeleton will respond to any signals you send it, but it needs to be challenged in order to get the message to grow and become stronger. That means if your main activity is couch surfing get to walking; if you are already walking, get to jogging or jumping rope; if you are jogging, add some weights at the gym (ideally under supervision); if you are already doing weights, add full body movements like squats and deadlifts; if you are an Olympic weightlifter . . . well I guess you are set there, just “do more, safely.” One great resource to get started is “Too Fit to Fracture.”
For my own Osteoporosis Awareness & Prevention Month activities, I am getting out of my comfort zone and doing more safely with a pull-up challenge on Memorial Day on May 30. I am training to beat my previous record of 20 consecutive pull-ups in 2020. I encourage everyone to get informed about osteoporosis, ask your medical professional if you are at risk and get out there for some physical activity in this improving May weather.