Yard work good for bad bones

It's time to grab those trowels, ladies, and head for the garden.

Recent studies conducted by researchers at the University of Arkansas in Fayetteville indicate that all that active yard work: shoveling, pulling, and digging, does more than leave one with beautiful begonias.

Gardening was singled out as one of the most effective activities for reducing the effects of osteoporosis. Active gardening provides the weight-bearing exercise needed to enhance bone growth, and all that sunshine boosts vitamin D absorption, which facilitates the production of bone mass.

Carson City rheumatologist Dr. Teresa Chavez said strengthening exercises decrease the risk of fracture by increasing coordination, improving balance, and creating the muscle bulk that will protect fragile bones from impact. But the weight-bearing exercises such as low-impact aerobics, walking, or hiking will enhance bone density.

Anyone who does strengthening exercises, should consider weight-bearing exercises too.

"If a patient has been swimming five hours a week for most of her life, I might suggest she add something else," Chavez said. "She could, for instance, swim four hours a week and walk one."

The most common variety of generalized metabolic bone disease, osteoporosis affects half of all white women over the age of 50. Of that group half can expect a resultant bone fracture during their lifetime.

However, osteoporosis is largely preventable for most people.

Studies now indicate that a critical part of that prevention occurs long before menopause.

Before the age of 35, new bone is created faster than it is broken down. Peak bone mass occurs between the ages of 25 and 35, then decreases at a rate of about 0.3 to 0.5 percent per year. That loss accelerates to between 1 and 3 percent after menopause, so the risk of developing the disease is related to the amount of bone mass accrued during those early years.

Onset is insidious, and usually painless until the first fracture, which can be brought on by something as routine as coughing, picking up a vacuum, or a newspaper.

Tiny fractures in the spine, called compression fractures, are the most common to osteoporosis. They can lead to a host of problems such as stooped posture, loss of range of vision, poor diaphragmatic function, and susceptibility to upper respiratory infections.

The second most common fracture, a broken hip, can be crippling. Most patients don't regain full function, or lose the ability to walk indefinitely. Twenty-five percent die within the first year.

"The fear factor is debilitating. People alter their lifestyles because they are afraid to go anywhere, or do anything." Chavez said, noting that most of the elderly have known friends or relatives that have fallen victim to its crippling effects.

To counter these problems, Chavez suggests a support group, occupational therapist, or a personal alarm system: anything that might increase confidence, and peace of mind.

The good news is, it's never too late. There are a number of treatment alternatives that can help slow bone loss and may even increase bone density over time.

"Estrogen therapy can increase bone mass five to seven percent over a five-year period," Chavez said.

Use of Fosamax, a biophosphonate, can reduce the risk of fractures by 50 percent. The hormone calcitonin, naturally produced by the thyroid gland, can reduce bone resorption, and ease pain after a fracture, and the drug Raloxifene mimics the beneficial effects of estrogen on bone without the risks, such as an increased risk of breast and uterine cancer.