Re: For JW Regarding Bone Fractures

March 26, 2005

While I realize this is addressed to JW you posted it to the list so I have a

question.

What's your point? Are you suggesting JW shouldn't carry bags of cement or

whatever

while he can? My understanding is that bone health is more damaged by lack of

stress.

Of course no one advocates stress to the point of fracture.

As I get older my experience is that the less I do, the less I can do. I suspect

bone remodeling

would be similar to muscular remodeling (i.e. you don't stress it, you lose bone

mass).

Please clarify what you find the implications of that report are, other than

eating right and

making sure you accumulate decent bone mass as early as possible. If you're too

old to do anything

early, try not to lose it any faster than you have to.

JR

-----Original Message-----

From: Rodney [mailto:perspect1111@...]

Sent: Saturday, March 26, 2005 2:28 PM

Subject: [ ] For JW Regarding Bone Fractures

Hi JW:

This is from the Surgeon General's Report ( " Bone Health and

Osteoporosis " ) on this issue:

" Falls account for [ONLY] about one-fourth of the spine fractures

that come to clinical attention ( et al. 1992a) [therefore much

less than one-fourth of all spine fractures since the great majority

initially produce no symptoms, see below]; the majority of clinically

diagnosed spine fractures result from excess stresses on the spine

caused by everyday [*****] activities (Myers and 1997). The

incidence of clinically recognized spine fractures increases rapidly

with age [*****] in both sexes (Figure 4-1). "

The stuff in [.....] is added by me.

Eventually, JW, while you may still have the musculature to carry 85

pound weights, you may find your bones are not equally up to the task

(arthritis + fracture). And since the vast majority of symptomatic

fractures are caused by everyday activities, and the risk increases

rapidly with age, eventually you (we all) will enter the danger

zone. Who knows when that will be (was?).

Even more disturbing, perhaps, is the following quote from the same

report which says that only 23% of spine fractures show enough

symptoms to cause the patient to visit the doctor. We all could

already have bone fractures - implying future problems - without

knowing it. (None showed up on my DXA scan). " In a recent study

from Sweden, only 23 percent of vertebral deformities in women were

diagnosed clinically (Kanis et al. 2004). In other words, there are

many " silent " spine fractures that produce no obvious symptoms to the

patient. These silent fractures may involve compression (or

flattening or crushing) of the vertebrae, can result in kyphosis

(curvature of the spine) and chronic back pain, and may be associated

with an increase in morbidity. "

Just trying to be helpful here (!)

Rodney.

March 26, 2005

Hi folks:

Here is the link for the Surgeon General's Report:

http://www.surgeongeneral.gov/library/bonehealth/chapter_4.html#Fractu

resCausedbyBoneDisease

(Sorry snipurl doesn't seem to be working)

Rodney.

--- In , " Rodney " <perspect1111@y...>

wrote:

>

> Hi JW:

>

> This is from the Surgeon General's Report ( " Bone Health and

> Osteoporosis " ) on this issue:

>

> " Falls account for [ONLY] about one-fourth of the spine fractures

> that come to clinical attention ( et al. 1992a) [therefore

much

> less than one-fourth of all spine fractures since the great

majority

> initially produce no symptoms, see below]; the majority of

clinically

> diagnosed spine fractures result from excess stresses on the spine

> caused by everyday [*****] activities (Myers and 1997). The

> incidence of clinically recognized spine fractures increases

rapidly

> with age [*****] in both sexes (Figure 4-1). "

>

> The stuff in [.....] is added by me.

>

> Eventually, JW, while you may still have the musculature to carry

85

> pound weights, you may find your bones are not equally up to the

task

> (arthritis + fracture). And since the vast majority of symptomatic

> fractures are caused by everyday activities, and the risk increases

> rapidly with age, eventually you (we all) will enter the danger

> zone. Who knows when that will be (was?).

>

> Even more disturbing, perhaps, is the following quote from the same

> report which says that only 23% of spine fractures show enough

> symptoms to cause the patient to visit the doctor. We all could

> already have bone fractures - implying future problems - without

> knowing it. (None showed up on my DXA scan). " In a recent study

> from Sweden, only 23 percent of vertebral deformities in women were

> diagnosed clinically (Kanis et al. 2004). In other words, there are

> many " silent " spine fractures that produce no obvious symptoms to

the

> patient. These silent fractures may involve compression (or

> flattening or crushing) of the vertebrae, can result in kyphosis

> (curvature of the spine) and chronic back pain, and may be

associated

> with an increase in morbidity. "

>

> Just trying to be helpful here (!)

>

> Rodney.

March 26, 2005

Hi JR:

Sorry for my lack of clarity. Here is another try:

I am sure that carefully controlled exercise, with or without

weights, without getting one's body into unusual contortions and

without extreme loads will benefit BMD.

However, the amount of load one might consider extreme presumably

declines with age - no one would expect a one hundred year old's

bones to be as strong as those of a thirty year old. For a fit

individual, who has worked up to it at an appropriate rate, lifting

85 pound weights in a controlled environment (say in a gym) is almost

certainly beneficial. But as people get older lifting heavy weights

in far from controlled conditions simply because their muscles are

capable of it does not mean their bones will automatically also be

equal to the task - since bone density declines with age. It also

declines with BMI which may be especially relevant to some of us

here.

The majority of spine fractures, as previously noted, are caused by

simple daily activities. IMO lifting 85 pound bags of cement is one

of the more extreme (both in amount of weight and the contortions

involved) forms of 'normal daily activity' and the risks such an

activity presents must, surely, rise with age? Does JW know at what

age he should reduce the weight of his cement bags to 75 pounds in

order to remain safe? Is it ten years from now? Or tomorrow? Or

ten years ago?

I believe JW's cement bag lifting is greatly increasing his risk of

spine fracture now, and that risk will increase as time passes, and

he gets older. Indeed, since the vast majority of spine fractures

are asymptomatic I wonder, given his penchant for exercise - both

volume and type - if he may already have fractured vertebrae that he

does not know about yet.

Of course you do not have to agree. Nor does JW. But it is a point

of view that seems to me to be relevant to living healthily to a

great age. Which is what this place is about, I think.

Is this explanation any better?

Rodney.

--- In , " " <crjohnr@b...>

wrote:

> While I realize this is addressed to JW you posted it to the list

so I have a question.

> What's your point? Are you suggesting JW shouldn't carry bags of

cement or whatever

> while he can? My understanding is that bone health is more damaged

by lack of stress.

> Of course no one advocates stress to the point of fracture.

>

> As I get older my experience is that the less I do, the less I can

do. I suspect bone remodeling

> would be similar to muscular remodeling (i.e. you don't stress it,

you lose bone mass).

>

> Please clarify what you find the implications of that report are,

other than eating right and

> making sure you accumulate decent bone mass as early as possible.

If you're too old to do anything

> early, try not to lose it any faster than you have to.

>

> JR

>

> -----Original Message-----

> From: Rodney [mailto:perspect1111@y...]

> Sent: Saturday, March 26, 2005 2:28 PM

>

> Subject: [ ] For JW Regarding Bone Fractures