Bone Health

Bone quality vs. bone density

The DEXA scan, which measure bone mineral density, may indicate the presence of osteopenia or osteoporosis. But while the DEXA scan has been the gold standard for testing bone health for the last several decades, some experts believe that bone quality may be a more important indicator of bone health than bone density. While there aren't any perfect measurements of bone quality at the time this was written (2024), tracking your Trabecular Bone Score (TBS) may provide clues to changes in your bone quality over time. There are also bone turnover markers that indicate bone formation (osteoblastic activity) and bone resorption (osteoclastic activity); these bone turnover markers are tested via blood or urine samples and, if results indicate an issue, they can be tested every 3 - 12 months. 

Factors that contribute to bone health

Many factors contribute to bone health, including:
  • hormones
  • nutrition
  • gut health
  • sleep quality and quantity
  • stress levels
  • postural alignment
  • flexibility and mobility
  • strength ​
  • medications
  • ​some diseases & health conditions
It's also important to note that the largest single risk factor for fractures is not osteoporosis but falling. In fact, over 90% of hip fractures are the result of a fall (1). That's why fall prevention and balance training are important.

​Due to these multiple factors, it's important to incorporate a multi-faceted approach to bone health.

Improving bone health and reducing the risk of injury

As a health coach, I recommend a multi-faceted approach to maximizing your bone health.  In no particlar order, your bone health team might include:
  • general physician
  • integrative/functional practicioners (doctor of osteopathy, naturopath, TCM practitioner, women's health specialist, etc.)
  • hormone specialist (endocrinologist, women's health specialist)
  • sleep specialist
  • functional nutritionist
  • health coach
  • personal trainer or strength coach
  • physical therapist
  • postural alignment specialist
  • massage therapist, structural integration therapist, chiropractor, MAT practitioner, body worker
  • acupuncturist
  • yoga teacher, meditation teacher
  • therapist
  • life coach
While a life coach or health coach can help you identify a plan of action to assemble your dream team, always follow your intuition and find practitioners that resonate with you.

Things you can implement now

If you've received a recent diagnosis of osteopenia or osteporosis, it can feel overwhelming (I know this from personal experience!). As you begin the lengthier process of assembling your team, here are some things that you can implement right away:
  • strength training (make sure your form is perfect and include a recovery day between sessions or body parts)
  • core training (note that some core exercises might put you at an increased fracture risk so work smartly)
  • balance and agility training
  • postural alignment training (find resources online or work with a speciaist)
  • flexibility & mobility training (targeted stretching and yoga are great)
  • good office ergonomics (set up your computer & workspace for optimal alignment and movement mechanics)
  • mindful breathing and meditation (start with 2 minutes of sitting meditation or try a 5 minute walk while breathing only through your nostrils)
Check out the free resources on breathing, fitness, alignment, yoga, nutrition and lifestyle on this website. And remember, stress contributes to bone loss so take a DEEP BREATH and give yourself some love. You've got this!
1. The New England Journal of Medicine, May 9, 1991. Vol. 324, No. 19. https://www.nejm.org/doi/full/10.1056/NEJM199105093241905