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Hi Everyone! Welcome to the first Powers Physio newsletter! I have taken the liberty of subscribing all past and present clients to my first newsletter to introduce my new website- www.powersphysio.co.za. This newsletter will be sent out on a monthly basis and will include interesting information and tips on health and injury related topics. The newsletters will be archived on my website so that information can be searched for at any stage. If you do not wish to receive the newsletter in future, please unsubscribe using the link at the bottom of the page. With Tour de France on the go this month, and news of Luxembourg's Frank Schleck bowing out of the race in the first week due to a broken collarbone, the focus of this month's newsletter is bone health, specifically targeting osteoporosis. And you may be surprised to learn that cyclists' bone health isn't always what it should be... Enjoy, and best wishes until next time! Regards Andrea RESEARCH POINTS TO CYCLISTS' POOR BONE HEALTH Many years of research on bone health has uncovered some surprising information on cyclists’ bone density. Several studies, including one from the University of Missouri-Columbia, found lower bone density in elite level cyclists who train for hours on the bicycle. Although researchers are not entirely sure about the specific cause of the bone loss in cyclists, current theories about the reasons include: * Cycling is a non-weight-bearing activity * Minerals, specifically calcium, are lost at an enormous rate during hours of sweating * An energy imbalance over hours of exercise (more calories are used than consumed) * Low bone density (osteopenia) can lead to osteoporosis and a significant risk of bone injury, such as a fractured clavicle, one of the most common fractures to occur in cyclists. It is therefore advisable for cyclists to participate in some form of regular weight-bearing exercise as well, and consume adequate calories, including calcium, during intense, long-distance training or racing. WHAT IS OSTEOPOROSIS? Osteoporosis is a condition in which a progressive decrease in the density of bones weakens the bones, making them more porous and fragile, thus increasing the chance of breaking with even minor injury. Contrary to popular opinion, osteoporosis does not only affect the elderly. Throughout life bones go through a constant state of loss and regrowth, but once total bone mass has peaked around age 30, the loss starts to outweigh the regrowth and all adults are at risk of developing osteoporosis. Women are more likely to develop osteoporosis than men due to several factors: Women have less bone mass than men, tend to live longer and take in less calcium. In women, the rate of bone loss speeds up after menopause, when oestrogen levels fall. Since the ovaries make oestrogen, faster bone loss may also occur if both ovaries are removed by surgery. SIGNS OF OSTEOPOROSIS You may not know you have osteoporosis until you have serious signs. Signs include frequent broken bones (mainly hips, wrists and spine), back pain, loss of height due to vertebral collapse, a curved spine and a stooped posture. These problems tend to occur after a lot of bone calcium has already been lost, thus it is important to take preventative measures to check the state of your bone density as you age. RISK FACTORS FOR OSTEOPOROSIS * Early menopause (before age 45) * Family history of osteoporosis * Surgery to remove ovaries before menopause * Fair skin (Caucasian or Asian race) * Not getting enough calcium * Sedentary lifestyle (not getting enough exercise) * Smoking or tobacco use * Alcohol abuse * Eating disorders such as anorexia nervosa * Thin body and small bone frame * Hyperthyroidism, either from an overactive thyroid or from taking too much medicine to treat hypothyroidism. * Long-term use of corticosteroids, which are medicines prescribed to treat inflammation, pain and chronic conditions such as asthma and rheumatoid arthritis. DIAGNOSIS AND TREATMENT If osteoporosis is suspected, the most frequent investigation undertaken is a bone scan, a common example of which is a Dual Energy X-ray Absorptiometry (DEXA), a test that measures bone mineral density. Osteoporosis cannot be cured, thus prevention is vital. Treatment focuses on slowing down or stopping bone loss, preventing bone fractures by minimizing the risk of falls, and controlling pain associated with the disease. The aim is to increase bone density by ensuring adequate dietary intake of calcium and vitamin D, and increasing physical activity, especially weight-bearing exercise. If necessary, various medications are available that slow the progress of the disease and help to improve bone density. PREVENTION To maintain good bone health and prevent osteoporosis you should eat a balanced diet that includes adequate calcium and vitamin D, engage in regular physical activity and refrain from smoking and heavy drinking. It is important to consume enough calcium and vitamin D throughout your life, in order to achieve maximal peak bone density in early and middle years and to maintain bone in later years. For most adults, a daily intake of 1200-1500 mg of calcium and 400-800 IU of Vitamin D is recommended. Most people get enough vitamin D from their diet and the sun. Calcium is best obtained through diet, but if your diet is lacking in calcium, using supplements such as calcium carbonate and calcium citrate is recommended, taken in doses of less than 600mg, as the body can only absorb so much at once. Calcium-rich foods include: nonfat and low-fat dairy products, dried beans, pink salmon, spinach and broccoli. About 300 mg of calcium are in each of the following: 1 cup of nonfat or low-fat yogurt, 1 1/2 cups of white beans, 5 ounces of salmon, 1/2 cup of spinach or 2 cups of broccoli. PHYSIOTHERAPY AND OSTEOPOROSIS Physiotherapists can help reduce the risk of developing osteoporosis, as well as help to manage osteoporosis related problems, including fractures and poor balance. Being diagnosed with osteoporosis is not the end of the story: appropriate exercise can help improve bone mass or slow down the rate of loss of bone mass. A well-designed exercise programme will help maintain optimal function and help work towards optimal bone health. Weight-bearing aerobic training, and/or strength training (including pilates) contribute to bone health, as the mechanical stresses put through the bone during exercise can affect bone density and stimulate bone remodeling. Research has shown that exercise can help to maintain optimal function as one ages, and slow down some of the functional losses that are often associated with aging. Examples of how physiotherapy and exercise can help with osteoporosis include: * If you have broken a bone because you have osteoporosis, a physiotherapist can help manage the pain of the fracture, and plan a treatment programme to help you regain strength, mobility and function and get you back to regular daily activities. * If you have poor balance and have fallen or are afraid of falling, a physiotherapist can prescribe a programme that meets your needs. Personally tailored exercise programmes have been shown to be more effective than general programmes at helping people regain strength and good balance. Exercise, however, is only one part of a healthy lifestyle for optimal bone health. Contact your physiotherapist for complete information on the prevention and management of osteoporosis. AN UNBREAKABLE BONE...? The funny bone! You can’t break it because your funny bone isn’t a bone at all! Running down the inside part of your elbow is a nerve called the ulnar nerve. The ulnar nerve supplies sensation to your fourth and fifth fingers, and is also one of the nerves that control some movement of your hand. When you hit your funny bone, the ulnar nerve is bumped against the humerus (the upper arm bone) leading to that funny pain, a numbing, often tingling sensation-not really funny at all but rather unpleasant as nerves are very sensitive!

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