Preventing broken bones, or fractures, requires a long-term strategy focused on maintaining the strength and integrity of the skeletal system. Although the risk of fracture increases with age, skeletal health is determined by proactive measures taken throughout a lifetime. Prevention involves strengthening bones from within and modifying the external environment to reduce the chance of injury-causing events like falls.
Building and Maintaining Bone Density
The strength of the internal bone structure relies on consistent nutritional support and mechanical stimulation. Calcium provides the essential mineral base, forming the structure that gives bones their rigidity and hardness. Adults generally need between 1,000 and 1,200 milligrams of calcium daily, sourced from dairy products, leafy green vegetables, and fortified foods.
Vitamin D is important because it acts as the facilitator, allowing the intestines to absorb dietary calcium. Without adequate Vitamin D, the body cannot effectively utilize available calcium, which can lead to the body pulling calcium from the bone structure itself. Sunlight exposure is the most efficient natural source, though supplements and dietary sources like fatty fish and fortified milk are often necessary.
Mechanical stress on the skeleton is necessary to stimulate the cells that build new bone tissue. This process is best achieved through two types of physical activity: weight-bearing and muscle-strengthening exercises. Weight-bearing exercises, such as walking, jogging, dancing, or hiking, involve moving the body against gravity while remaining upright. The impact created by these activities encourages bones to increase their density and become stronger.
Muscle-strengthening exercises, also known as resistance exercises, involve moving the body or an object against resistance, such as lifting weights or using exercise bands. While building muscle, these activities also apply tension to the bones through the tendons, stimulating bone formation. Combining these two types of activity is an effective way to maintain bone mass and reduce the age-related decline in density.
Certain lifestyle habits can undermine efforts to build and maintain skeletal strength. Excessive alcohol consumption, defined as more than two drinks per day, interferes with the body’s ability to absorb calcium and Vitamin D. Chronic heavy drinking also disrupts hormonal balance, leading to increased bone breakdown and a higher risk of falls. Smoking introduces toxic chemicals that directly harm osteoblasts, the cells responsible for forming new bone tissue, accelerating bone loss.
Mitigating Environmental and Activity Risks
Preventing fractures involves minimizing the physical risks posed by the environment and certain activities. Falls are the leading cause of fractures, especially in older adults, making home safety modifications a high-impact intervention. Practical adjustments can reduce tripping hazards and increase stability within the living space.
Simple, effective steps can prevent falls through home modification:
- Removing loose area rugs.
- Securing electrical and phone cords.
- Clearing pathways of clutter.
- Installing grab bars near the toilet and inside the shower or bathtub for support on slippery surfaces.
- Improving lighting throughout the home, especially on staircases and in hallways.
For those engaging in high-impact or high-speed activities, using appropriate protective gear is a direct means of fracture prevention. Helmets, wrist guards, knee pads, and shin guards are designed to absorb and distribute the force of an impact away from vulnerable bones. This protects the skeleton during sports or occupational tasks that carry an inherent risk of trauma.
Reviewing prescription and over-the-counter medications with a healthcare provider is an important step in fall prevention. Certain drugs, such as sedatives, sleeping aids, and some blood pressure medications, can cause dizziness, drowsiness, or a drop in blood pressure upon standing. These side effects compromise balance and coordination, increasing the risk of a fall. Adjusting dosages or finding alternative medications can mitigate this pharmaceutical risk.
Professional Assessment and Treatment Options
For certain individuals, professional screening and medical intervention are a necessary part of a fracture prevention strategy. Screening is recommended for all women aged 65 and older and all men aged 70 and older, as well as for younger adults with a history of fragility fracture or specific medical conditions. Early risk identification allows for preemptive action.
The standard tool for assessing bone mineral density (BMD) is the Dual-energy X-ray Absorptiometry, or DEXA scan. This quick, low-radiation test measures the amount of mineral in the hip and spine to determine skeletal strength. Results are reported as a T-score, which compares the patient’s BMD to that of a healthy young adult at peak bone mass.
A T-score of -1.0 or above is considered normal bone density. A score between -1.0 and -2.5 indicates low bone mass, a condition known as osteopenia. A T-score of -2.5 or lower is the diagnostic threshold for osteoporosis, signifying weakened bones and a high fracture risk.
When lifestyle changes alone are insufficient to correct low bone density, medical treatment may be necessary. Bisphosphonates are a widely used class of prescription medications that specifically slow down the process of bone loss. They function by binding to the bone surface and encouraging osteoclasts, the cells that break down bone, to undergo programmed cell death. This suppression of bone resorption shifts the balance toward bone building, improving bone mineral density and reducing the risk of fractures in the spine and hip.