A Blog on Your Bones and How You Can Improve Bone Health:

During my time working with an orthopaedic surgeon for over five years, one of the most common questions asked was how does one improve the strength and durability of their bones to avoid fractures and bone related diseases. There are currently two common methods used to improve bone health, diet and exercise, and the use of doctor prescribed medications.

The first category of preventative methods concerns more conservative approaches associated with lifestyle and can usually be managed by paying close attention to your daily diet and physical activity. In terms of diet, following the dietary recommended intake values for calcium vary based on age and sex and if you are concerned that you are not getting enough, you may refer to the following table retrieved from National Institute of Health website.

Foods rich in calcium include milk products such as yogurt which contains about 415mg for a serving of 8 ounces or about one cup of yogurt which accounts for nearly 42% of the recommended daily value of calcium based on the average recommended daily intake of 1,000 mg for a health adult. Other foods which are high in calcium include fish such as sardines and salmon, vegetables such as kale and bok choi, and fruits such as oranges and kiwis.

Calcium is one of the primary building blocks of bone but in order to absorb calcium in the gut, another player is needed, that being vitamin D. Vitamin D acts as a key that starts conveyer belt which will bring in the calcium and without it, the conveyer belt doesn’t function. This means that you can consume as much calcium as you want but if you don’t have an adequate amount of vitamin D, the calcium will just stack up and be excreted since you have no way to absorb it into the body. Two ways in obtain vitamin D are through exposure to sunlight which activates cells within the skin to produce vitamin D and by dietary supplements. The Food and Drug Administration recommends 400 IU of vitamin D which correlates to about 120 micrograms or about 1 cup of orange juice with vitamin D.

The second category of preventative methods has to do with physical activity. There are two forms of exercise that have been shown to improve bone structure and strength, impact exercises and weight-bearing exercises. Our bones are a living system composed of cells and minerals such as calcium and they are constantly undergoing an intricate process of break-down and build-up. Why you may ask? The skeleton is a dynamic system, which means that the body is constantly changing the skeletal structure to better match the activities we perform on a daily basis. For example, when you constantly play a guitar or go out and shovel snow over a long winter period, you will begin to develop callouses. Areas of skin that are constantly being rubbed will begin to thicken and this is the body’s way of adapting to your daily activities. In the same way, the skeletal system acts to layer bone in areas that are constantly bearing weight, or receiving impact.

You’ll often hear doctors suggest light weight-bearing exercises for patients who have just recently healed from a broken bone or who are at risk for weakened bones, as in the case of osteoporosis. Picture a track-and-field day, where you have a group of middle-schoolers in a central circle as shown here and a couple of ropes on the outside of the circle with you standing on the outside.

The objective of this tug-of-war game is to not allow any of the ropes to be pulled out of the circle, and so when you run along the outside and pull a rope, more and more middle-schoolers will run to that specific rope and pull against you to prevent the rope from leaving the circle.

Our bodies respond to weight-bearing exercises in the same way, when we apply pressure to a certain area of the body with weights, the body senses that and activates bone rebuilding cells called osteoblasts (“osteo” meaning bone, “blasts” meaning immature cells) in the area to strengthen it. Therefore, through lifting certain amounts of weights, we can greatly strengthen our bones, but it is important to note that lifting too little weight will not make that much of an impact and lifting too much weight could result in breaking bones or tearing muscles so there is always a fine balance.

The last category of physical activity is impact exercises and a perfect example of this is Muay Thai, a martial art that originates from Thailand. Muay Thai fighters train from very young ages and one of their main weapons is the shin. From an early age, fighters will begin by lightly kicking banana trees with their shins and banana trees are tough but also have a lot of water so they can absorb kicks without breaking bones.

Over time, as the fighters train and continually kick these trees, they create little microscopic breaks in shins. You might ask, isn’t that a bad thing having these little fractures in your bone? Normally, yes, however, as these very small breaks form, the body detects them and sends osteoblasts to the area to build more bone.

These osteoblasts will keep adding little cross beams to the bone until you end up with shins that are so hard, they can break a baseball bat!

Impact activities such as running and jump roping can have similar effects on the skeletal system and increase bone density resulting in healthier and stronger bones.

In conclusion, maintaining a proper diet where you are receive adequate amounts of calcium and vitamin D as well as participating in physical activities with weight-bearing or impact exercises can greatly strengthen your bones and help you avoid future bone related injuries.