Bone Health

A natural change with ageing is a loss of bone density. It is important to do what you can to keep your bones as strong as possible to avoid potential fractures, and the possible knock-on effects and recovery from these.

So there is an expected loss of bone density as we age, but a loss of bone density can occur as a result of some illnesses and taking some medications. There is also a sharp change in hormones around the female menopause. This can make ladies more susceptible to a reduced bone density, however reduced bone density is not just a female issue.

The ideal scenario would be to try and counter these changes with more conservative approaches in order to try and prevent further issue later down the line. The best time to do this is in childhood, this is the time you build-up your skeletal mass. Think of it as a “bone bank” that you borrow from for the rest of your life.

So we need to be guiding the young people in our lives regarding diet and exercise (see below) as well as possible to give them the best “bone bank” possible.

Another crucial period of time in a female’s life, is the year running up to her menopause. But how do we know when this will be? We don’t. We may have a rough idea what could be likely if we know what our mother’s age of menopause was. We know the approximate age it’s likely to happen at. But this is an unknown. So it’s important to make taking care of your bones a part of your lifestyle.

 The following factors are important to counter an excessive loss of bone density:

  • Weight-bearing exercise, such as walking, skipping and jogging. Do what feels appropriate for you. Also resistance exercises help. So try a little weight lifting. Just using a little resistance would help e.g. baked bean cans for upper body weights. You don’t have to train to an Olympic standard!
  • Making sure you have the appropriate amounts of calcium, vitamin D and magnesium (see below). This may need to be through a combination of diet and supplementation. Keep a food diary for a couple of typical weeks for you to try and gauge what, if anything is required. These are not the only vitamins and minerals essential to bone health. A consultation with a nutritional therapist might be necessary, since nutrition can affect how healthy it is and how a person feels in energy and focus.
  • If you know you have suffered an illness, possibly an eating disorder or a digestive issue that may effect the uptake of nutrients. Be aware that you could be at slightly more risk and discuss this with your GP.
  • Be mindful that some medications can predispose to a reduction in bone density, especially if they have needed to be taken over a long period. For example steroid treatment, and some epilepsy medications.

These are the current recommendations for supplementation.

  • Calcium – for all adults, aged 19-64 years of age 700mg/day.
  • Magnesium – for men aged 19-64 years of age, 300mg a day. For ladies of the same age range, 270mg a day.
  • Vitamin D (be aware that it can be difficult to get the required amounts of vitamin D from your diet. Vitamin D is largely synthesised in our bodies via a reaction through sunlight on our skin. This is not possible all year around.) 5 years of age to adult = 10mcg a day. This is possibly only necessary over the autumn and winter months.

 The following foods are examples of sources of the above:


Whitebait 100g is 870mg/Ca

Cheddar/Edam cheese 50g is 350mg/Ca

Canned Sardines 70g is 350mg/Ca

Raw spinach 100g is 170mg/Ca

A large orange is 70mg/Ca

20 shelled almonds is 50mg/Ca


Pumpkin seeds 35g is 184mg/Mg

Taco shell 100g is 104mg/Mg

Muesli 95g is 90mg/Mg

Boiled brown rice 100g is 88mg/Mg

30 Peanuts is 70mg/Mg

2 slices brown bread is 40mg/Mg


2 fillets cooked mackerel (about 110g) is 21micrograms/vit D

Tinned salmon 100g is 12.5 micrograms/vit D

Tinned tuna 100g is 5 micrograms/vit D

1 egg (60g) is 1 microgram/vit D

All Bran 45g is 0.8 microgram/vit D

1/2 pint semi-skimmed milk is 0.03 micrograms/vit D


The core muscles, is a collective term for a group of deeper muscles that help provide support to our spine. If strong and activated, they can also aid good posture, and so a better alignment body-wide. When you look at this from an Osteopathic point of view. You are trying to achieve as good as balance as possible in our body structure. If this is good, then the idea is that our body structure and the internal environment of our body will function properly.

How do you activate the core muscles?

I always explain this to people the way it has been explained to me in Pilates classes. I like to think “zip up and hollow”. “Zip up” refers to the pelvic floor. So think about raising this up, as if you were trying to stop yourself having a wee. “Hollow” refers to pulling your navel back towards your spine, so activating the lower abdominal muscles.

When you are performing most core muscle exercises. The idea is to use the contraction of these muscles to maintain your neutral spine. We all have different spinal curves, so our neutral spine position will be different too. In whatever position you are exercising in. It’s the point where your lower back is not too arched, but not too flattened with a level pelvis. So the mid-position between the two.

On a daily basis, its a good idea to try and achieve 25% contraction of these muscles. Once you have played around with this for a while, it will be easy to find where your 25% is. So day to day this is good practice. When you are doing a purposeful core exercise, or perhaps a more strenuous activity. It may be necessary to take this up to 100% contraction to achieve your neutral position whilst exercising. Or in strenuous activity, to help protect and prevent injury to your spine. But the muscles have to be strong to be able to help you in the first place, so practice!

Some exercises to try:

Hip abduction

Lay on your back with your knees bent, feet flat on the floor. Try and make sure your feet are in good alignment. Think about where your neutral spine is and maintain this position.

Whilst maintaining contact with the floor with your foot. Allow one knee to drop out to the side. Only go as far as you can whilst keeping a level pelvis and neutral spine position. Then return to normal. Repeat 5 times on each side.

It may be that you don’t go very far in the first instance. The exercise is about quality, not about how far your knee gets towards the floor. As you get stronger and more flexible, you will more than likely go further.

If this feels too easy, the exercise can be made more difficult by raising your feet off the floor, so the lower leg is parallel with the floor. Then repeat the exercise from this start position.

Kneeling arm/leg raises

From a kneeling position, knees under hips and hands under shoulders, think about your neutral spine. Start by extending one leg out behind you whilst maintaining your spinal curves. Return to the start position and extend the other leg out behind you. Repeat 5 times on each side.

You can challenge yourself more by extending one arm and the opposite leg at the same time. Then repeat with the opposite combination. Try 5 times on each side.

If you want to make it even more challenging. Then try the exercise extending the leg and the arm of the same side at once. Then repeat with the opposite side. Try 5 times to each side.

Leg extensions

Come back to laying on your back with your knees bent, feet flat on the floor. Raise your legs with knees bent, lower legs parallel to the floor (this is your start position for the exercise). Straighten one leg. Return to the start position. Then repeat with the other side. The nearer to the floor your leg is when you straighten it, the more challenging the exercise will be. So feel that you’re working the core muscles, but remember to maintain your spinal position. Try this one 5 to 10 times on each side.

Refer back to august’s post – the Dead Bug and Plank exercise are both useful core muscle activators.

Bits that caught my eye in the news!

Scientists have discovered that Parkinson’s disease may be picked up early by listening to someone’s voice. Further research is trying to identify if this could happen in a phone conversation. A computer programme is able to identify the tremors, breathiness and weakness in the voice that is characteristic of Parkinson’s changes. It may provide an early warning sign, so treatment could be given to slow the progress of the disease.

Back pain has gone technological! GP’s will be advised to recommend mobile phone apps. (which are cheap or free) to their patients to use. The thinking being that this will empower patients and reduce visits to GP surgeries. The charity BackCare has launched an android app. They are recommending this to the PCT’s. The app. provides latest information, videos and exercises.

It has been revealed that more than one million people in Britain may be suffering from constant, crippling headaches because they are taking too many painkillers. The pills people take to relieve headaches and migraines may be making things much worse, according to the National Institute for Health and Clinical Excellence (NICE).
As many as 1 in 50 people suffer continual headaches because of “medication overuse”, NICE reports. The problem begins with taking the odd painkiller for tension headaches or migraines, which usually works. But some people take the pills more and more often, until they are on tablets for more than half the days in a month. NICE says that if this goes on for more than three months the medication ends up causing the problem it is intended to cure.

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